HEENT

Question 1

What is normal IOP?

Answer 1

< 20 mmHg

Question 2

Irrigation goal in caustic eye injury

Answer 2

pH 7.0-7.2

Question 3

Tx for AOM v. EOM v. Malignant EOM

Answer 3

AOM - oral antibiotics versus wait and see approach, high dose amoxicillin

EOM - topical antibiotics +/- steroid drops

Malignant EOM - pseudomonal coverage, start with IV cipro –> PO cipro once some improvement

Question 4

What abx should you avoid in EOM if there is tympanic membrane perforation?

Answer 4

NEOMYCIN (use fluoroquinolones instead)

Question 5

Vision loss in macular degeneration v. glaucome

Answer 5

MD - central

Glaucoma - peripheral

Question 6

UV Keratitis (hx, dx, tx)

Answer 6

Causes - welding, skiing

Dx - 6 to 12 hrs after exposure, see punctate uptake of fluorescin

Tx - cycloplegics for symptom relief (atropine, cyclopentolate, homatropine, scopolamine and tropicamide)

Question 7

3 Diff Types Neonatal Conjunctivitis

Answer 7

Based on timing

gonorrhea (IV or IM CTX) –> chlamydia (erythromycin ointment v PO)–> HSV (herpetic lesion with fluorescein)

Question 8

What is the most common cause of tracheitis?

Answer 8

Staph

Question 9

Weber and Rinne Tests

Answer 9

Weber = fork on top of head, if localize to bad ear than conductive loss, if localizes to good ear then sensorineural

Rinne = fork on bone and in air, normally air > bone, if conductive loss then bone > air

Question 10

ANUG (acute necrotizing ulcerative gingivostomatitis)

Answer 10

Periodontal lesions, bacteria invade non-necrotic tissue

Fusobacteria and spirochetes

Symptoms/Signs
Pain
Foul breath
Metallic taste in mouth
Fever
Regional lymphadenopathy
Red swollen gums with overlying “grayish” pseudomembranes

Treatment - Warm saline or chlorhexidine rinses, Antibiotics if systemic symptoms, Dental referral

Question 11

Ramsay Hunt Syndrome

Answer 11

facial paralysis, zoster lesions, tinnitus