HEENT Flashcards
Fluorescein dye “fern like” CN V. Abrupt onset of pain
Herpes keratitis
Round/Irregular
Corneal Abrasions
Acute/severe halos, cupping optic nerve, cloudy cornea, mid-dilated oval pupil. ER STAT.
Acute Angle-closure glaucoma
CN2 gradual changes in peripheral vision LOST FIRST, then second central vision. Pressure 8 - 21
Primary Open Angle Glaucoma
Elderly- night vision issues, extreme glare. Opaque lens. Absent red reflex.
Most common cause of blindness in developing countries
Tx: cataract surgery with IOL –intraocular lens implantation
Cataracts
Painless loss of “central vision” reports straight lines appear curved. Periphery is preserved. Give asmler grid.
Age-Related Macular Degeneration
Floaters, curtain, flashes of light. Painless. EXAM
Retinal Detachment
cauliflower, foul-smell, hearing loss. If erodes bones in face affects CN VII. ENT - SURGERY
Cholesteatoma
Aphthous stomatitis: painful shallow ulcers heal 7-10 days.
Tx: Magic mouthwash.
Canker sores
Optic disc swollen w/ blurred edges due to increased ICP
Papilledema
- Copper/silver wire arterioles.
- AV nicking (mild retinopathy).
- Retinal Hemorrhages.
Hypertensive Retinopathy
- Cotton wool spots (moderate retinopathy)
- micro-aneurysms.
- RETINAL HEMORRHAGES (CENTER OF EYE APPEAR ORANGE RED)
Diabetic Retinopathy
“clusters sm. Size red papules w/ white centers in the buccal mucosa by lower molars”. Rubeola and Measles. Fever, conjunctivitis, coryza, cough (3c). Morbiliform rash. EXAM
Koplik Spots
Lateralization to good ear. Rinne- AC > BC.
Sensorineural:
Lateralization to bad ear. Rinne- BC > AC.
Conductive:
Tunning fork midline. CN 8 (acoustic). EXAM
Weber:
Painful swollen red warm abscess Tx: hot compress erythromycin, dicloxacillin.
Hordeolum
Middle ear. Usually S. pneumo. (others: h influ, mor catarrhalis). Popping, muffled, afebrile or low-grade, TM can rupture blood and pus on pillow on awakening with relief of ear pain. “erythematous TM” bulging or retracting. Decreased mobility.
Acute Otitis Media
1st line Amoxicillin (first line),
Augmentin,
Omnicef, Ceftin, Levaquin.
Acute Otitis Media - Tx
Ear pressure, popping, muffled hearing, chronic allergic rhinitis, sterile serious fluid is trapped in the middle ear. TM should NOT BED RED. TM may bulge or retract.
Otitis Media with Effusion
Oral decongestants, steroid nasal spray, treat like allergies. Usually Painless.
Otitis Media with Effusion - Tx
Pseudomonas aeruginosa. (other- S. aureus). External ear pain- d/c itching, hearing loss, tragus, green d/c.
Tx: Corticosporin, Cipro drops EXAM
Otitis Externa (swimmers’ ear)
Sensorineural loss without lateralization. Involves the inner ear. Symmetrical progressive. Human speech lost first. AGING ADULT EXAM
Presbycusis
“stringy; increased tearing” PO antihistamines. Type I sensitivity. Typically, bilateral. Rhinitis and allergic shiner
Allergic Conjunctivitis
Animals/hides/hair/wool. Lesions begin as papule that enlarges quick 24-48h develops necrosis and ulceration (sort of like a spider bite recluse)
Tx: Doxy, Cipro, Levaquin.
Anthrax
Painful lump hurts more with eating (by jaw) aka calculi or salvary stones. Usually in sub mandibular gland aka whartons; duct.
Sialolithiaisis
VERTIGO TINNITUS, HEARING LOSS
Meinier’s disease
Tx: Epley’s Maneuver - Nystagmus should be horizontal (if vertical, check EOMs and refer)
BBPV DX: Dix Hallpike
Unilateral facial pain or upper molar pain, *worse with bending over, *purulent nasal discharge, s/s over 10 days
Tx: Augmentin (if already watched/waited 10 days)
Rhinosinusitis
S/S: FFPL (Fever, Fatigue, Pharyngitis, Lymphadenopathy-Posterior Cervical)
Enlarged spleen - hold activity until resolved (US) 4 – 6 wks Dx: Monospot (aka heterophile antibody test) (positive 2-3 weeks in)
US to check for if condition has resolved
MONO
Copper/silver wire arterioles.
AV nicking (mild retinopathy
Retinal Hemorrhages.
