HEENT Flashcards
red eye red flags (7)
decreased visual acuity
ciliary flush
severe FB sensatio
corneal opacity
fixed pupil
severe HA w/ nausea
photophobia
chemosis is associated w/
allergic conjunctivitis
acute/ subacute painless vision loss, progressive scotoma
retinal detachment
tension HA frequency
intermittent/ chronic (waxes and wanes)
EBV dx
monospot
CBC w/ diff (increased atypical lymphocytes)
also cx for strep
EBV tx
supportive
activity restriction (to avoid splenic rupture)
maintain hydration
maybe steroids if severe
abortive tension HA tx
NSAIDS
what medications can cause rhinitis
topical decongestants
anti-hypertensives (alpha/ beta blockers)
oral contraceptives
burning, red eyes with mucopurulent discharge
bacterial conjunctivitis
conjunctivitis + adherent lids
bacterial conjunctivitis
allergic rhinitis refractory tx
immunotherapy w/ an allergist
matting means what
sticking together (like adherent lids) seen in conjunctivitis
double worsening/
double sickening
bacterial sinusitis
no current infection but recent AOM/ SAR/ eustachian tube dysfunction
otitis media with effusion
malaise
sore throat
fever
enlarged, tender cervical LAD
red throat/ tonsils and exudates
abdominal pain
EBV
epiglottitis tx
admit
intubate
abx
blood and thunder retinal appearance
central retinal vein occlusion
when do you avoid giving ampicillin and amoxicillin in a pt w/ strep
when they also have EBV
retinal hemorrhages and dilated retinal veins
blood and thunder seen in central retinal vein occlusion
w/ otitis externa, what do you ALWAYS document
the appearance of the TM
OE with TM perforation management
ofloxacin otic solution (floxin otic)
abortive cluster HA tx
O2
what tx is not helpful with nonallergic (vasomotor) rhinitis
immunotherapy
oral antihistamines
pale boggy nasal mucosa
allergic rhinitis
bluish purple rings around both eyes
allergic shiners seen with allergic rhinitis
malignant OE tx
admit
IV cipro
ENT referral
Group A Strep pharyngitis tx:
first line:
PCN allergy:
PLUS:
first line: PCN (Pen VK, amoxicillin) or ceph (cephalexin)
PCN allergy: azithromycin/ clindamycin
PLUS
supportive tx: lozenges, NSAIDS, acetaminophen
what triggers nonallergic (vasomotor) rhinitis
perfumes
cigarette smoke
weather conditions
hot/ spicy foods
ETOH, cleaning products
AOM 1st line abx tx
HD amoxicillin 90 mg/kg/day divided Q12
associated sxs w/ tension HA
NO associated sxs (n/v, phonophobia or photophobia)
retinal detachment tx
REFER immediately
acute eye pain
FB sensation
lacrimation
photophobia
corneal abrasian
pharyngitis with cough and rhinorrhea is probably of what etiology
viral
migraine frequency
chronic
clear rhinorrhea
sneezing
itchy eyes/ nose
nasal congestion
post nasal drip
cough
conjunctival injection
allergic rhinitis
edema of the conjunctiva
chemosis
epiglottitis etiology
H flu
Type B HiB
thumb sign on lateral neck xray
epiglottitis
OE with fluffy, white, black discharge
fungal
what do you not do with a pt with epiglottitis
stick something in their throat
conjunctivitis + chemosis,
matting,
hx of atopy
allergic conjunctivitis
OE with NO TM perforation management
cortisporin otic suspension (polymyxin, neomycin, and hydrocortisone)
corneal abrasion tx
topical abx (erythromycin ointment/ trimethoprim-polymyxin drops)
+ contact wearers get pseudo coverage (fluoroquinolone)
+ oral pain meds
associated sxs w/ migraine
photophobia
phonophobia
n/v
+/- aura
acute, total, painless vision loss
+ whitening of retina
+ afferent pupillary defect
central retinal artery occlusion
drooling
tripod position
sniffing position
anorexic
epiglottitis
what do you NOT do to tx corneal abrasion
do NOT give topical steroids or anesthetic drops,
do NOT patch
malignant otitis externa is most common in
immunocompromised pts (elderly, DM, HIV)
best initial test for malignant OE
CT
what is rhinitis medicamentosa
rebound congestion (rhinitis) that is induced by overuse of topical decongestants