HEENT (Eyes, Ears, Throat) Flashcards
Headache
Most important attributes of a headache is (1) its severity, and (2) chronologic pattern
Severe and of sudden onset
Consider subarachnoid hemorrhage or meningitis
Tension headaches
Often arise in temporal areas
Cluster headaches
May be retro-orbital
Valsalva Maneuvers
May increase pain from acute sinusitis or from mass lesion due to changing ICP
Genetics
Genetic inheritance appears to be present in 30 - 50% of patients with migraine
*Remember
WHO advises against using estrogen-progestin contraceptives in women with migraines over 35 (with aura)
Farsightedness
Hyperopia
Aging vision
Prebyopia
Nearsightedness
Myopia
Sudden, unilateral loss that is painless
PainLESS. Consider vitreous hemorrhage from diabetes or trauma, macular degeneration, retinal detachment, retinal vein occlusion, or central retinal artery occlusion
Sudden, unilateral loss with pain
WITH pain. Causes are usually in the cornea and interior chamber as in corneal ulcer, uveitis, traumatic hyphema, and acute glaucoma. Optic neuritis from multiple sclerosis may also be painful.
Vision changes that are bilateral and painless
Medications that change refraction such as cholinergics, anticholinergics, and steroids may contribute.
Vision changes that are bilateral and painful
Consider chemical or radiation exposures
If onset of bilateral vision loss is gradual…
Usually arises from cataracts or macular degeneration