HEENT: disease states Flashcards
MC cause of permanent legal blindness and vision loss in older adults (>75 yo)
macular degeneration
MC cause of new, permanent vision loss in 20-74 yo
DM retinopathy
MC type of orbital floor fracture
Inferior
MC primary intraocular malignancy in childhood
retinoblastoma
Fundoscopic exam with AV nicking
Hypertensive retinopathy
–AV nicking is venous compression at the arterial-venous junction
Fundoscopic exam with Drusen bodies
Macular degeneration (Dry)
–Drusen bodies are small, round, yellow-white spots on the outer retina that represent localized deposits of extracellular debris
Fundoscopic exam with microaneurysms, hard exudates, blot and dot hemorrhages, and flame-shaped hemorrhages
DM retinopathy (Nonproliferative)
progressive unilateral peripheral vision loss: shadow or “curtain coming down” in periphery followed by central vision loss
retinal detachment
MC type of retinal detachment
rhegmatogenous
Neonatal conjunctivitis that occurs 5 days postnatal is likely caused by _________ and treated with __________
chlamydia trachomatis, oral erythromycin
Neonatal conjunctivitis that occurs 2 days postnatal is likely caused by _________ and treated with __________
gonococcal, IM Ceftriaxone
PPX for gonococcal neonatal conjunctivitis
topical erythromycin 0.5%
MC organism in bacterial conjunctivitis
Staph aureus
MC organism in viral conjunctivitis
adenovirus
Tx for allergic conjunctivitis
Topical antihistamines (olopatidine, pheniramine-naphazoline) for sxs
Tx for ocular chemical burn
immediate irrigation with LR or NS until pH 7-7.4 is achieved, followed by topical abx
Referral for strabismus rec’d if condition persists >_______ months of age
4-6 months to reduce incidence of amblyopia
Screening tests for strabismus
hirschberg corneal light reflex testing, cover test, cover-uncover test
Clinical differences between septal and preseptal cellulitis (4)
Septal cellulitis presents with ocular pain with movement, ophthalmoplegia (EOM weakness), proptosis, vision deficits
corneal infection due to reactivation of HSV in the trigeminal ganglion
herpetic keratitis
dendritic (branching) corneal ulceration with fluorescein staining
herpetic keratitis
MC causes of uveitis
systemic inflammatory and autoimmune diseases (spondyloarthropathies, sarcoidosis, IBD)
MC cause of blindness in the world
cataracts
RF for cataracts (4)
1- aging (>60 yo)
2- smoking
3- DM
4- steroid use
Fundoscopy shows absent red reflex, opaque lens
cataracts
optic nerve (disc) swelling due to increased ICP
papilledema
optic nerve (disc) swelling due to increased IOP
glaucoma
acute inflammatory demyelination of the optic nerve
optic neuritis (optic nerve/CN 2 inflammation)
ocular pain worse with movement and Marcus gunn pupil on fundoscopy
optic neuritis
Describe Marcus-Gunn pupil
during swinging flashlight test, from unaffected eye to affected eye the pupil dilates (relative afferent pupillary defect)
Tx for optic neuritis
IV methylprednisolone, followed by PO steroids
MC cause of Marcus-gunn pupil
optic neuritis
MC cause of Argyll-Robertson pupil
neurosyphilis