HEENT MDT

Question 1

A pt presents with pain in his left eye, he was welding without eye protection, you examine his tears running down the eye and a reduction in visual acuity and increased sensitive to light. What do you expect it is?

Answer 1

Corneal abrasion

Question 2

Your YN2 comes up to complaining of OD pain you note tearing of his R eye, and a 20/50 in his R eye and 20/20 in his left. Also you seen discomfort in your patient when you shine a light into his R eye. he also wears contacts.

What do you think it is the most likely Dx and the cause?

Answer 2

Corneal Ulcer

Wearing contacts overnight.

Answer 3

Ocular Foreign Body

Answer 4

Hyphema

Question 5

You have a patient that states they when they woke up, they are unable to see with their left eye, patient notes no pain, and you see no redness in their eye. What do you suspect it is?

Answer 5

Retinal Detachment
* MEDEVAC

Answer 6

Orbit laceration

Question 7

When flushing the eye for chemical burns, what do you bring the pH down to?

Answer 7

7.5 to 8 pH

Question 8

What treatment would you render for a pentration wound to the eye?

Answer 8

• Secure item in place
• Patch other eye
• Tetanus and IV Cephalosporin, NPO
  MEDEVAC ASAP!!!

Question 9

Ocular globe rupture

Question 10

What is Seidel Test?

Question 11

Viral Conjunctivitis has what findings assoicated with it?

Answer 11

• Red Conjunctiva
• Copious watery discharge scanty exudate

Question 12

Copious amount of purulent discharge, with no visual blurring, and mild discomfort is associated with the eye is likely to be what?

Answer 12

Bacterial Conjunctivitis

Question 13

Gonococcal Conjunctivitis is usually associated with what findings?

Answer 13

• Purulent discharge
• Recent Sexual hx (comes from genital secretions).

Question 14

Herpetic lesion of the eye

Answer 14

H

Question 15

Orbital Cellulitis

Question 16

Darcryocystitis

Question 17

Answer 17

Blepharitis

Question 18

Pterygium

Question 19

What are te common pathogens found within a corneal ulcer?

Answer 19

• Pseudomonas Aeeruginosa
• Pneumococcus
• Moraxella Species
• Staphylococci

Question 20

What treatment options do you have avabiable for a corneal ulcer?

Answer 20

Give Moxioacin drops
* D/C contacts
* pain control
* Frequent visual exams
MEDEVAC!!!

Question 21

How would a Zygomaticomaxillary Complex (ZMC) fracture would present?

Answer 21

Lower eyelid swelling
* Flatten cheekbone
* Dipoplia ( with upward gaze
* Trismus (difficulty opening jaw)

Question 22

What are the steps for Fluorescein Staining?

Answer 22

Administer a drop of topical anethetic (proparacaine 0.5% or tet racaine 0.5%)
* Grab flourescent stip and moist it with steril saline or a topical anethtic
* Have the patient’s eye turned upwards and touch the inside of the lower eyelid.
* have pt blink a few times to spread the dye.

Question 23

What is GABHS?

Answer 23

Group A B hemolytic Streptococcus pyogenes

Question 24

What is treatment for GABHS?

Question 25

One of your sailors accidentally gets a chemical burn in their eyes, what are you doing for treatment?

Answer 25

• Review the MSDS
• immediately flush the the site with a minimum of 1 to 2 L of saline
• if no corneal epithelial defect, and the anterior segment is normal, administer erythromycin ointment QID
• if there is corneal epithelial defect or clouding, administer erythromycin cyceopegia (cyclocopentolate 1% or scopolamine 0.25%) and optional eye patching.