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PANCE study guide > HEENT > Flashcards

HEENT Flashcards

1
Q

Diagnose

Tx

A

Hordeolum (Stye)

Warm compress mainstay

If no drainage after 48 hours I&D

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2
Q

Dx

Tx

A

Chalazion

Eyelid hygiene, warm compress

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3
Q

Difference between Hordeolum and Chalazion

A

Hordeolum is painful swelling with redness

Chalazion is painless swelling

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4
Q

DX

Tx

A

Dacryocystitis

Systemic abs. Clinda + 3rd gen cephalosporin

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5
Q

clinical description of pt:

Present with Redness to nasal side of lower lid. What is the TX for this?

A

This is Dacrocystitis

Tx with systemic abx - clinda and 3rd gen ceph (omnicef)

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6
Q

MC pathogen of dacrocystitis

A

S. Aureus

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7
Q

What eye condition is assoc. w/ UV exposure in sunny climates as well as sand wind and dust?

A

Pterygium & Pinguecula

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8
Q

Diff between Pterygium and Pinguecula

A

Pterygium grows

Pinguecula: Does not grow

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9
Q

What structures make up the orbital floor?

A

Maxillary,

Zygomatic

Palatine

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10
Q

Pt presents w/ Dec VA, “sunken” eye, Double vision, and anesthesia to anteriomedial cheek

w/u and Tx?

A

Ct scan to assess severity

Nasal decongestants (pain), Avoid nose blowing, Prednisone, Clinda or Unasyn

Ophtho referral

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11
Q

Pt presents w/ misshapen eye w/ prolapse of ocular tissue, VA markedly reduced, enophthalmos, severe conjunctival hemorrhage, obscured red reflex, Teardrop shaped pupil

DX W/u

TX

A

Globe Rupture

Seidel’s test (flourescene dye parting by clear stream of aqueous humor)

Ophtho emergency!!! - Rigid eye sheild

If blood in anterior chamber place pt as 45deg to keep RBC’s from staining cornea.

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12
Q

What is the most common cause of permanent legal blindness and vision loss in the elderly?

A

Macular degeneration

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13
Q

What do presence of Drusen indicate?

A

Small, round, yellow-white spots on outer retina

Dry (atrophic) Macular degeneration

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14
Q

What are drusen?

A

small, round, yellow-white spots on the outer retina d/t an accumulation of waste product from the pretinal pigment epithelium

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15
Q

Pt presents with what manifestations in macular degeneration?

A

Bilateral blurred/loss of central vision

Scotomas (blind spots, shadows)

Metamorphosia (straight lines appear bent)

gradually occuring sx.

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16
Q

What is the most common cause of new, permanent vision loss/blindness in ages 25-74

A

Diabetic retinopaty

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17
Q

describe

What are these assoc. w/

A

Cotton Wool spots

Non-proliferative Diabetic retinopathy

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18
Q

4 grades of HTN retinopathy

A
  1. Arterial narrowing
  2. AV nicking

3 Flame shaped hemorrhage

4 Papilledema

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19
Q

What sg are present on funduscopc exam in HTN retinopathy

A

Copper and silver wiring

AV nicking

Flame shaped hemorrhage, and cotton wool spots

Papilledema

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20
Q

Etiology of Papilledema

A

Optic nerve swelling 2ry to intracranial pressure

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21
Q

w/u for papilledema

A

MRI/CT to r/o mass effect

Lumbar puncture

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22
Q

Tx for papilledema

A

Diretics and acetazolamide

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23
Q

Clinical presentation states pt w/ floaters, flashing lights, shadow “curtain” in peripheral no pain/redness.

DX Tx

A

Retinal detachment

Ophtho emergency. keep patient supine

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24
Q

What test can be used to detect fB?

A

Flourosceine Dye

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25
Q

Organisms in Orbital Cellulitis

A

S. pneumo

GABHS

Hflu

S aureus

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26
Q

Orbital cellulitis presentation

A

Dec vision

Pain w/ movement

Proptosis

eyelid edema

exopthalmos

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27
Q

W/u for orbital cellulitis

A

High res CT scan

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28
Q

Tx for orbital cellulitis

A

IV VAnco, clinda, cefotaxime

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29
Q

halo’s around lights make you think ____

A

Glaucoma

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30
Q

Mid-dilated, nonreactive pupil makes you think ____

A

glaucoma

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31
Q

Steps to manage glaucoma

A
  1. dec iop (acetazolamide IV, manitol)
  2. topical beta blocker (Timolol)
  3. Open the angle (cholinergics pilocarpine)
  4. Periphera iridotomy-definitive tx.
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32
Q

Mc pathogen of viral cojunctivitis

A

Adenovirus (swimming ppool mc source)

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33
Q

Clinical sx. of viral cojunctivitis

A

Preauricular lymphadenopathy w/ URI sx, copious WATERY drainage, scant mucoid d/c, often bilaterally

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34
Q

TX for viral cojunctivitis

A

cool compress, antihistamines

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35
Q

Allergic conjunctivitis differs from viral conjunctivitis in that it _____

A

(similar in that it may have the same URI sx),

Key term is “cobblestone mucosa” in upper eyelid, itching tearing, redness, STRINGY d/c

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36
Q

Bacterial Conjunctivitis is different than viral or allergic conjunctivitis becaues it has ____

A

purulent (instead of mucoid or stringy) d/c,

Lid crusting,

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37
Q

MC pathogen in bact. conjunctivitis

A

Staph/strep. Contact lens wearers-think pseudomonas

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38
Q

TX of bact. conjunctivitis

A

For contact lens wearers consider pseudomonas - tx w/ FQ, or tobrex

Otherwise topical Emycin

39
Q

MC etiology of optic neuritis

A

MS

40
Q

Clinical manifestation of optic neuritis

A
  1. Color vision loss
  2. scotoma (blind spot)
  3. Ocular pain worse w/ eye movement
41
Q

Define Marcus Gunn Pupil

A

When light is shown from unaffected eye to affected eye the pupils appear to dilate rather than constricut (deayed response to affected nerve)

42
Q

“Limbic flush” is related to what dx?

A

Uveitis (iritis)

43
Q

Pale retina w/ “chery red-macula” (red spot)

A

Central Retinal artery occlusion

44
Q

“Blood and thunder appearance”

A

Central retinal vein occlusio

45
Q

“Box car appearance”

A

Central retinal artery occlusion

46
Q

Absent red reflex w/ lens opacification

A

Cataract

47
Q

White pupil w/ absent red reflex

A

Retinoblastoma

48
Q

Which artery is commonly involved in amaurosis fugax

A

External Carotid artery

49
Q

What is a normal cup to disk ratio?

A

1:2

The disk should be 2x as large as the cup

50
Q

MC pathogen of OE

A

Pseudomonas

51
Q

Tx of OE

A

Cipro/dexamethasone

52
Q

MC organisms of AOM

A

S pneumo (MC)

H flu

Moraxella catarrhalis

S pyogenes

53
Q

Tx for AOM

A
  1. Amoxicillin 10-14d (cefixime in children, Augmenting 2ndline)
  2. If pcn allergic - emycin
  3. myringotomy
  4. tympanostomy
54
Q

Deep ear pain, mastoid tenderness concerning for?

A

mastoiditis

55
Q

TX for mastoiditis

A

AV ABX w/ myringotomy (ampicillin, cefuroxime)

56
Q

Weber

A

fork on center of head to see if sound lateralizes

Lateralizes –> Bad ear with CHL

Lateralizes –> Better ear with SNHL

57
Q

Rinne

A

Put fork on mastoid and then up to the ear (should continue to hear)

CHL if Bone>air

SNHL if Air>Bone

58
Q

Eustachian tube dysfunction tx

A
  1. Decongestants (pseudoephedrine, phenylephrine, oxymetazoline nasal spray).
  2. Auto insufflation (yawn, swallow)
  3. Nasal steroids
59
Q

Accoustic neuroma- Define

A

Cranial nerve 8 schwannoma-benign tumor of schwann cells

60
Q

Unilateral hearing loss is _____ until proven otherwise

A

acoustic neuroma

61
Q

Sx of BPPV

A

Episodic vertigo,

No hearing loss

62
Q

Sx. of menieres

A

Episodic vertigo

Hearing loss

63
Q

Sx of Vest neuritis

A

continuous vertigo

no hearling loss

64
Q

Sx. of Labrythitis

A

Cont vertigo

hearing loss

65
Q

Which vertiginous d/o is caused by displaced otoliths?

A

BPPV

66
Q

Which vertiginous d/o is caused by distention of endolymphatic compartment of inner ear by excess fluid?

A

menieres dz

67
Q

diagnostic test of choice for acute sinusitis

A

CT scan

68
Q

Pathogens of acute sinusitis

A

Same as AOM - Strep pneumo, GABHS, H flu, M catarrhalis

69
Q

DOC for acute sinusitis

A

Amoxicillin

70
Q

Chronic sinusitis is defined as?

A

sinusitis >8wks

71
Q

MC pathogen of chronic sinusitis

A

staph aureus

72
Q

MC type of rhinitis

A

allergic

73
Q

Clear rhinorrhea, w/ nasal poyps worse in AM

A

Allergic rhinitis

74
Q

Wharton’s duct is located where?

A

Submandibular

75
Q

Stensos dunct is located where?

A

parotid glands

76
Q

White patchy lesions that can’t be rubbed off in a smoker

A

Leukoplakia

77
Q

Oral hairy leukoplakia is caused by?

A

EBV

78
Q

If you see oral hairy leukoplakia what should you be concerned for?

A

HIV

79
Q

white curd like plaquest that may or may not leave behind erythema/bleeding if scraped?

A

Oral candidiasis

80
Q

Dx of oral candidiasis

A

KOH smear - budding yeast/hypae

81
Q

Management of oral candidiasis

A

Nystatin tx. of choice, fluconazole po

82
Q

Small round oval or painful ulcers w/ erythematous halos

A

Aphthous ulcers

83
Q

for aphthous ulcers

A

topical analgesics (triamcinolone or orabase) Cemetidine if recurrent

84
Q

dysphagia, “hot potato” voice, difficult oral secretion, tismus, uvula deviation.

W/u and TX

A

Peritonsillar abscess

CT scan

Drainage and abx - unasyn or clinda

85
Q

pathogen of peritonsilalr abscess

A

strep pyogenes

86
Q

Pathogen of epiglottitis

A

H flu B (MC cause)

S pneumo becoming more common now though d/t vaccine

87
Q

Primary manifestation of HSV1 in children

A

Acute herpetic geinivostomatitis

88
Q

Gingivitis (gum swelling w/ friable/bleeding gums)

A

Acute herpetic gingivostomatitis

89
Q

Think begnign if ___

A

it hurts

if its acute

Or if it rubs off

90
Q

Think cancer (in the mouth if)

A

It’s painless/lesion ulcer

If chronic

No matter how small in innocent appearing

91
Q

Tx odontogenic pathology with what?

A

Pen VK or clinda

92
Q

What is the most common eitology of laringitis

A

viral

93
Q
A

PANCE study guide (14 decks)

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