HEENT: disease states Flashcards

1
Q

MC cause of permanent legal blindness and vision loss in older adults (>75 yo)

A

macular degeneration

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2
Q

MC cause of new, permanent vision loss in 20-74 yo

A

DM retinopathy

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3
Q

MC type of orbital floor fracture

A

Inferior

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4
Q

MC primary intraocular malignancy in childhood

A

retinoblastoma

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5
Q

Fundoscopic exam with AV nicking

A

Hypertensive retinopathy
–AV nicking is venous compression at the arterial-venous junction

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6
Q

Fundoscopic exam with Drusen bodies

A

Macular degeneration (Dry)
–Drusen bodies are small, round, yellow-white spots on the outer retina that represent localized deposits of extracellular debris

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7
Q

Fundoscopic exam with microaneurysms, hard exudates, blot and dot hemorrhages, and flame-shaped hemorrhages

A

DM retinopathy (Nonproliferative)

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8
Q

progressive unilateral peripheral vision loss: shadow or “curtain coming down” in periphery followed by central vision loss

A

retinal detachment

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9
Q

MC type of retinal detachment

A

rhegmatogenous

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9
Q

Neonatal conjunctivitis that occurs 5 days postnatal is likely caused by _________ and treated with __________

A

chlamydia trachomatis, oral erythromycin

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10
Q

Neonatal conjunctivitis that occurs 2 days postnatal is likely caused by _________ and treated with __________

A

gonococcal, IM Ceftriaxone

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11
Q

PPX for gonococcal neonatal conjunctivitis

A

topical erythromycin 0.5%

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12
Q

MC organism in bacterial conjunctivitis

A

Staph aureus

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13
Q

MC organism in viral conjunctivitis

A

adenovirus

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14
Q

Tx for allergic conjunctivitis

A

Topical antihistamines (olopatidine, pheniramine-naphazoline) for sxs

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15
Q

Tx for ocular chemical burn

A

immediate irrigation with LR or NS until pH 7-7.4 is achieved, followed by topical abx

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16
Q

Referral for strabismus rec’d if condition persists >_______ months of age

A

4-6 months to reduce incidence of amblyopia

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17
Q

Screening tests for strabismus

A

hirschberg corneal light reflex testing, cover test, cover-uncover test

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18
Q

Clinical differences between septal and preseptal cellulitis (4)

A

Septal cellulitis presents with ocular pain with movement, ophthalmoplegia (EOM weakness), proptosis, vision deficits

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19
Q

corneal infection due to reactivation of HSV in the trigeminal ganglion

A

herpetic keratitis

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20
Q

dendritic (branching) corneal ulceration with fluorescein staining

A

herpetic keratitis

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21
Q

MC causes of uveitis

A

systemic inflammatory and autoimmune diseases (spondyloarthropathies, sarcoidosis, IBD)

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22
Q

MC cause of blindness in the world

A

cataracts

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23
Q

RF for cataracts (4)

A

1- aging (>60 yo)
2- smoking
3- DM
4- steroid use

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24
Q

Fundoscopy shows absent red reflex, opaque lens

A

cataracts

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25
Q

optic nerve (disc) swelling due to increased ICP

A

papilledema

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26
Q

optic nerve (disc) swelling due to increased IOP

A

glaucoma

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27
Q

acute inflammatory demyelination of the optic nerve

A

optic neuritis (optic nerve/CN 2 inflammation)

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28
Q

ocular pain worse with movement and Marcus gunn pupil on fundoscopy

A

optic neuritis

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29
Q

Describe Marcus-Gunn pupil

A

during swinging flashlight test, from unaffected eye to affected eye the pupil dilates (relative afferent pupillary defect)

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30
Q

Tx for optic neuritis

A

IV methylprednisolone, followed by PO steroids

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31
Q

MC cause of Marcus-gunn pupil

A

optic neuritis

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32
Q

MC cause of Argyll-Robertson pupil

A

neurosyphilis

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33
Q

Describe Argyll-Robertson pupil:

A

pupil constricts on accommodation, but does not react to bright light (near light dissociation)

34
Q

Leading cause of preventable blindness in US

A

glaucoma

35
Q

Dx for acute narrow angle-closure glaucoma

A

tonometry with increased IOP >21 mm
fundoscopy with optic disc blurring or “cupping”

36
Q

First line tx for acute narrow angle-closure glaucoma

A

Combination of topical agents (Timolol, Apraclonidine, Pilocarpine), followed by systemic agent to reduce IOP (PO or IV Acetazolamide)

37
Q

First line tx for chronic (open angle) glaucoma

A

Latanoprost (prostaglandin analog)

38
Q

Definitive tx for acute narrow angle-closure glaucoma

A

Iridotomy

39
Q

transient monocular vision loss (lasting seconds) with full recovery

A

amaurosis fugax

40
Q

MC cause of central retinal artery occlusion

A

emboli from carotid artery atherosclerosis (cardiogenic embolic second MC)

41
Q

Suspect this organism in contact wearers

A

pseudomonas

42
Q

fundoscopy with pale retina and cherry red macula

A

central retinal artery occlusion

43
Q

fundoscopy with extensive retinal hemorrhages “blood and thunder” appearance

A

central retinal vein occlusion

44
Q

MC organism in otitis externa

A

pseudomonas

45
Q

invasive infection of the external auditory canal and skull base

A

malignant (necrotizing) otitis externa

46
Q

Define chronic otitis media

A

persistent middle ear infection in the presence of TM perforation >6 weeks

47
Q

MC organism in AOM

A

S pneumoniae

48
Q

Tx for AOM

A

amoxicillin

49
Q

middle ear fluid with no s/s acute inflammation

A

serous otitis media with effusion

50
Q

MC cause of sensorineural hearing loss

A

presbycusis

51
Q

MC cause of conductive hearing loss

A

cerumen impaction

52
Q

MC cause of cholesteatoma

A

chronic middle ear disease or Eustachian tube dysfunction

53
Q

abnormal keratinized collection of desquamated squamous ET in middle ear that can lead to bony erosion of the mastoid

A

cholesteatoma

54
Q

abnormal bony overgrowth of the footplate of the stapes bone

A

otosclerosis

55
Q

MC cause of peripheral vertigo

A

Benign Paroxysmal Positional Vertigo

56
Q

episodic vertigo without hearing loss

A

BPPV

57
Q

episodic vertigo with hearing loss

A

Ménière’s disease

58
Q

continuous vertigo without hearing loss

A

vestibular neuritis

59
Q

continuous vertigo with hearing loss

A

labyrinthitis

60
Q

Tx for vestibular neuritis

A

glucocorticoids first line

61
Q

unilateral sensorineural hearing loss is concerning for

A

acoustic neuroma

62
Q

MC cause of chronic fungal sinusitis

A

aspergilllus

63
Q

inflammation of the nasal cavity and paranasal sinuses for >12 weeks

A

chronic sinusitis

64
Q

invasive fungal infection that infiltrates the sinuses, lungs, and CNS

A

mucormycosis

65
Q

MC organisms to cause mucormycosis

A

mucor, rhizopus, absidia, cunninghamella

66
Q

Tx for mucormycosis

A

IV amphotericin B first line and surgical debridement

67
Q

MC cause of rhinitis

A

allergic

68
Q

MC cause of nasal polyps

A

allergic rhinitis

69
Q

MC site of bleed for anterior epistaxis

A

Kiesselbach plexus

70
Q

MC site of bleed for posterior epistaxis

A

sphenopalatine artery branches and Woodruff’s plexus

71
Q

MC cause of acute pharyngitis

A

viral

72
Q

MC organism to cause acute bacterial pharyngitis

A

Group A Streptococcus (S. pyogenes)

73
Q

lacy reticular leukoplakia of the oral mucosa

A

Wickham striae

74
Q

Wickham striae MC seen in this disorder

A

Oral Lichen Planus

75
Q

rapidly spreading cellulitis of the floor of the mouth

A

Ludwig’s angina

76
Q

Tx for oral lichen planus and apthous ulcers

A

topical oral glucocorticoids

77
Q

painless white patchy lesions in the oral cavity that cannot be scraped off

A

oral leukoplakia

78
Q

painless erythematous, soft, velvety, patchy lesions in the oral cavity

A

erythroplakia

79
Q

MC location for sialolithiasis

A

Whartons duct, Stenson’s duct

80
Q

MC organism to cause acute bacterial sialadenitis

A

Staph aureus

81
Q

primary manifestation of HSV1 in children

A

Acute Herpetic Gingivostomatitis

82
Q

primary manifestation of HSV1 in adults

A

Acute Herpetic Pharyngotonsillitis

83
Q

mucocutaneous manifestation of Epstein-barr virus

A

oral hairy leukoplakia