missed rosh review - EENT

Question 1

what is the most common cause of viral conjunctivitis?

Answer 1

adenovirus

Question 2

clinical characteristics of viral conjunctivitis?

Answer 2

Viral conjunctivitis may occur in isolation or as part of a viral prodrome followed by preauricular lymphadenopathy, fever, pharyngitis, and upper respiratory infection

Question 3

what is the most common cause of orbital cellulitis?

Answer 3

bacterial rhinosinusitis
(S. aureus, Strep anginosus)

Question 4

describe the presentation of orbital cellulitis?

Answer 4

Orbital cellulitis presents with eyelid swelling, eye pain with and without eye movement, and ophthalmoplegia

In some cases, there may also be vision impairment, chemosis, proptosis, and leukocytosis

Question 5

how is the diagnosis of orbital cellulitis confirmed?

Answer 5

CT –> shows inflammmation of extraocular muscles, fat strandings, and likely anterior displacement of eye globe

Question 6

treatment of orbital cellulitis

Answer 6

IV abx- vanco + 3rd gen cephalosporin (ceftriaxone or cefotaxime

Question 7

how can orbital vs periorbital cellulitis be differentiated?

Answer 7

periorbital cellulitis is only an infection of the skin and NOT the fat behind –> no worsening pain with eye movements

Question 8

What are possible complications of orbital cellulitis?

Answer 8

Subperiosteal abscess, orbital abscess, visual loss, and intracranial extension.

Question 9

how is bacterial rhinosinusitis differentiated from viral rhinosinusitis

Answer 9

symptoms for more than 10 days or by the worsening of symptoms within 10 days of initial improvement

Question 10

what is the treatment for sensorineural hearing loss?

Answer 10

surgical –> cochlear implantation

Question 11

what are the tx options for conductive hearing loss?

Answer 11

• abx - if cause is AOM
• fluid removal/myringotomy tube - if chronic serous otitis media is the cause

Question 12

acute management of epiglottitis

Answer 12

EMERGENT INTERVENTION - do not do diagnostics first
* bag valve mask O2 at 100%
* secure airway - intubation
* empiric abx - 3rd gen cephalosporin and antistaph (ex. vanco)

Question 13

What are the indications to refer a patient with strabismus to opthalmology?

Answer 13

constant strabismus at any age, intermittent strabismus after 4 to 6 months of age, cranial light reflex test or cover test demonstrating strabismic deviation, asymmetric pupils, dilation that changes depending upon position of gaze, torticollis not explained by a musculoskeletal etiology, patient reports of double vision or fatigue with near-eye work (e.g., reading), or parental concern about ocular alignment

Question 14

what is the most common complications of strabismus?

Answer 14

amblyopia

Question 15

what is the first-line tx for allergic rhinitis

Answer 15

intranasal corticosteroid –> Fluticasone, mometasone

Question 16

what is the treatment for dacryostenosis

Answer 16

observation and massage

Question 17

what is the treatment for acute mastoiditis

Answer 17

uncomplicated: IV abx (amp-sulbactam if no recent abx use, pip-tazo if recent use) and middly ear drainage

complicated - aggressive surgical managment w a mastoidectomy + IV abx and myringotomy

Question 18

what are complications of acute mastoiditis

Answer 18

• meningitis
• epidural or subdural abscess
• facial nerve palsy
• labrynthitis, hearing loss
• osteomyelitis
• venous sinus thrombosis.