HEENT Flashcards
Herpes keratitis
fluorescein dye “fern like” CN V. Abrupt onset of pain.
Corneal Abrasions
Round/Irregular
Acute Angle-closure glaucoma
acute/severe halos, cupping optic nerve, cloudy cornea, mid-dilated
oval pupil. ER STAT
Primary Open Angle Glaucoma
CN2 gradual changes in peripheral vision LOST FIRST, then
second central vision
Cataracts
in elderly night vision issues. Opaque
Age-Related Macular Degeneration
Painless loss of “central vision” reports straight lines appear
curved. Periphery is preserved. Give amsler grid
Retinal Detachment
Floaters, curtain, flashes of light. Painless
Cholesteatoma:
cauliflower, foul-smell, hearing loss. If erodes bones in face affects CN VII.
SURGERY
Canker sores
Aphthous stomatitis: painful shallow ulcers heal 7-10 days. Magic mouthwash.
Papilledema
optic disc swollen w/ blurred edges due to increased ICP
Hypertensive Retinopathy
Copper/silver wire arterioles. AV nicking(mild retinopathy). Retinal
Hemorrhages
Diabetic Retinopathy
Cotton wool spots (moderate retinopathy), micro-aneurysms. ALSO,
RETINAL HEMORRHAGES ON CENTER OF EYE APPEAR ORANGE RED
Kolpik Spots
“clusters sm. Size red papules w/ white centers in the buccal mucosa by lower molars”.
Rubeola. Fever, conjunctivitis, coryza, cough (3c). Morbilliform rash.
Sensorineural hearing loss
Lateralization to good ear. Rinne- AC > BC.
Conductive hearing loss
Lateralization to bad ear. Rinne- BC > AC.
o Rinne (1st mastoid, 2 front of ear, time each area).
o Weber: Tuning fork midline. CN 8 (acoustic).
Hordeolum (stye)
painful swollen red warm abscess TREAT hot compress erythromycin,
dicloxacillin.
Acute Otitis Media
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. TREATMENT:
Amoxicillin (first line), then Augmentin, Omnicef, Ceftin, Levaquin. Weber- Lateralization to bad
ear. Rinne- BC > AC. If your patient is only PCN allergic do azithromycin or clarithromycin.
Otitis Media with Effusion
Ear pressure, popping, muffled hearing, chronic allergic rhinitis, sterile
serious fluid is trapped in the middle ear. TM should NOT BE RED. TM may bulge or retract.
TREATMENT: Oral decongestants, steroid nasal spray, treat like allergies. Usually Painless. Weber-
Lateralization to affected ear. Rinne: BC > AC. PRECEDES OR USUALLY FOLLOWS AOM.
THIS ONE U CAN DO SUPPORTIVE CARE AND WAIT 3 MOS.
Otitis Externa (swimmers ear)
Pseudomonas aeruginosa. (other- S. aureus). External ear pain- d/c
itching, hearing loss, tragus, green d/c. TREATMENT: Corticosporin, Cipro
Presbycusis
sensorineural loss without lateralization. Involves the inner ear. Symmetrical
progressive. Human speech lost first. AGING ADULT
Allergic Conjunctivitis
“stringy; increased tearing” PO antihistamines. Type I sensitivity. Typically,
bilateral. Rhinitis and allergic shiner.
Anthrax
animals/hides/hair/wool. Lesions begin as papule that enlarges quick 24-48h develops
necrosis and ulceration (sort of like a spider bite recluse)- Treatment: Doxy, Cipro, Levaquin. If you
suspect BIOTERRORISM treat 60 d. Prophylaxis – Cipro, doxy. If BIOTERRORISM 60 d.
Sialolithiasis
painful lump hurts more with eating (by jaw) aka calculi or salivary stones. Usually in
sub mandibular gland aka Wharton’s duct.
Meniere’s disease
VERTIGO TINNITUS, HEARING LOSS
BBPV
DIX HALL-PIKE MANEUVAR
SINUSITIS
TX AMOXICILLIN OR AUGMENTIN
PCN ALLERGY CEFDINIR OR MACROLIDE
MONO
Caused by Epstein Barr virus. Goes with strep. Dx with heterophile antibody test
