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ipap > Ophtho/ENT/GU/MSK > Flashcards

Ophtho/ENT/GU/MSK Flashcards

1
Q

Define Hordeolum

How are these Tx

Systemic ABX such as ? are used if ? Dx is present

A

Painful, hot stye d/t infected eye lid gland

Warm compress
Topical ABX

Cellulitis;
Doxy, Erythromycin

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2
Q

Define Chalazion

Where are these MC found

How are these Tx

A

Painless lesions d/t noninfected obstruction of meibomian gland

Upper eyelid

Warm compress
Incision/curettage
CCX

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3
Q

Defie Blepharitis

What two Dx are commonly assoicated w/ blepharitis’

What do Pts present complaining of

A

Inflammation of eyelids d/t dysfunctional meibomian gland or Staph infection

Seborrhea
Rosacea

Crusty eyelids in AM

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4
Q

How is Blepharitis Dx

How are these Tx

? is the MC Ophtho c/c in ER

A

Slit lamp exam

Warm compress
Eyelid hygiene
Topical ABX

Corneal abrasion

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5
Q

How are corneal abrasions Dx

How are these Tx

What are the 3 MCC of hearing loss

A

Fluorescein staining

Topical ABX:
Cipro
Ofloxacin
Polymyxin
Gentamicin
Erythromycin
Tobramycin

Presbycusis
Impaction
Eustacian dysfunction

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6
Q

Define Conductive Hearing Loss

Define Sensorineural HL

Neural hearing loss is MC d/t ?

A

Lesions in EAC/TM/Mid ear preventing sound conduction

Lesion in inner eary/CN8

Cerebellopontine angle tumor

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7
Q

Weber Test results

Rinne test results

All children under 7y/o have some form of ? ear issue

A

Lateralizes to affected ear w/ CHL;
Lateralizes to unaffected ear w/ SHL

CHL= bone > air
SNHL= air > bone

ET dysfunction

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8
Q

How does Eustachian Tube Dysfunction present

This is a primary cause of ? two issues

How is this Dx

A

Ear fullness/popping w/ intermittent pain/tinnitus

AOM, OME

Tympanogram

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9
Q

How is Eustachian Tube Dysfunction Tx

3 MC microbes causing AOM

Time frames for acute, chronic and recurrent

A

Pseudophedrine
Ibuprofen
Nasal steroids
Surgery- medical failure

Strep pneumo
H influenza
Moraxella catarrhalis

Acute: <3wks
Chronic: >3mon
Recurrent: 3 episodes in 6mon; 4 episodes in 12mon

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10
Q

Time frame for COM

What will be seen in PE

What is a key finding for Dx

A

> 3mon

Clear serous fluid in middle ear w/out S/Sxs of infection

Limited mobility of TM w/ pneumotoscopy

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11
Q

How is AOM Tx

What is used for 2nd line Tx

What is used for Pts w/ PCN allergy

A

Amox
Cefixime for PEds

Augmentin

Bactrim Azith Erythromycin

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12
Q

How is COM Tx

How does Otitis Externa present on PE

What would tuning fork results look like

A

Myringotomy

Itching, Pain w/ manipulation

Weber lateralizes to blocked canal

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13
Q

3 MC microbes causing Otitis Externa

? variant will DMs have

Fungal OM is caused by ?

A

Pseudomonas
Staph A
Proteus

Malignant OE

Aspergillus

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14
Q

How is bacterial OE Tx if there’s a chance of perf

How is Fungal OE Tx

? is the MCC of CHL

A

Cipro and Dexameth
Ofloxacin

2% acetic acid
Clotrimazole
PO Itraconazole

Cerumen impaction

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15
Q

What will Weber/Rinne look like during impaction

How can this be softened for removal

How long are Sxs needed for sinusitis Dx

A

W to affected side
R: A > B conduction

Carbamide peroxide
Trithanolamine

Worsen over 5-7d,
Fail to improve >10d

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16
Q

How are adults w/ sinusitis Tx

How is this Tx in Pts w/ PCN allergy

What is done for second line therapy in Pts that fail to improve in 7d

A

Amoxicillin
Augmentin

Doxycycline
Cephalosporin w/ Clinda

Augmentin
Levo/Moxi-flox

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17
Q

How is Chronic Sinusitis Tx

MC site for anterior nose bleeds to come from

Where do posterior bleeds come from

A

Augmentin
PCN-all: Clinda

Kiesselbachs/Little’s area

Woodruffs plexus: Shenopalatine artery

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18
Q

How are nose bleeds Tx

What types of bleeds are admitted

Define Leukoplakia

A

Pressure x 15min leaning fwd
Afrin x 2
Anterior packing w/ cephalosporin

Posterior w/ balloon packing

White patches on buccal surfaces that can’t be wiped off

19
Q

Leukoplakia itself is benign but can lead to ?

? type of leukoplakia has a higher risk for dysplasia and Ca

? form of leukoplakia is not premalignant

A

SCC

Erythroplakis

Hairy leukoplakia from EBV in HIV Pts

20
Q

How is Leukoplakia Dx

How is it Tx

How is PO Hairy Leukoplakis Tx

A

Biopsy

Excision
Cryosurgery

Zidovudine
Ganciclovir
Topical podophyllin or Isotretinoin

21
Q

Difference between Leukoplakia and Hairy Leukoplakia

When do aphthous ulcers need to be considered for biopsy

What topical anesthetics can be used

A

Hairy won’t progress into SCC

Lasting >3wks

Mg hydroxide
Dphenhydramine hydrochloride

22
Q

Bacterial pharyngitis is MCC by ?

What criteria is used for Dx//ABX

Gold standard for Dx

A

GAStrep

Centor:
Fever >100.4
Anterior adenopathy
Cough, no
Exudate
3 of 4= rapid

Rapid then Culture

23
Q

Why are ABX used in the Tx of bacterial pharyngitis

MCC of viral pharyngitis

How is this form Dx

A

PCN, Macrolide

Adenovirus

Atypical lymphocytes; monospot test

24
Q

How is fungal pharngitis Tx

How is this Dx Tx in Pts w/ HIV

How long after sickness can Pts w/ Mono return to sports

A

Clotrimazole troches
Miconazole
Nystatin

Fluconazole

3wks from Sx onset

25
Q

How is ghonorrhea pharyngitis Tx

What two PE findings are highly suggestive of tonsilar abscesses

These are AKA ? abscess

A

Ceftriaxone

Deviated palate
Asymmetric uvula rise

Quincy’s

26
Q

? are the MC aerobic and anaerobic microbes causing tonsilar abscesses

How are these Tx non-surgically

Infections of upper airway/epiglottitis is MC from ?

A

Staph, Strep
Bacteroides

Augmentin, Clindamycin

H Influenza b

27
Q

What will be seen on PE of epiglottitis

What position do Pts adopt

How is it Dx

A

Drooling Dysphagia Distress

Sniffing dog- neck hyperextended, chin protrusion

Xray- thumbprint sign

28
Q

What ABX are used for epiglottitis after admission

When is throat Ca a DDx from pharyngitis

If PO/IM steroids are going to be used for Tx, what must be done first

A

IV Ceftriax and Clinda

Hoarse >2wks w/ Hx of ETOh/Tobacco

Vocal cord eval prior to start

29
Q

Renal artery stenosis is MCC by ?

What presentation signals this Dx

What imaging is used for Dx

How is this Tx

A

Atherosclerosis,
Fibromuscluar dyplasia

Pt Tx w/ ACEI and develops kidney failure

First: US
GS: renal ateriography

Percutaneous transluminal angiography

30
Q

What causes Syphilis

After 3wk incubation, what are the three phases

What is seen if acquired congenitally

A

Treponema pellidum (spirochette)

Primary: painless chancre
Secondary: erythematous rash, condyloma lata
Tertiary: latent; systemic, mucosal growth- gummas

Hutchinson teeth
Saddle nose deformity
ToRCH syndrome

31
Q

How is syphilis Dx

How isneurosyphilis Dx

? conditions can cause a false pos result

A

Monospot w/ reactive treponemal test

Lumbar puncture

Lyme Malaria Pregnancy TB

32
Q

How is syphilis Tx

What is usd for PTs w/ allergy to mainstay Tx

What is the hallmark PE finding for trichomonas vaginitis

A

PCN G:
Primary/Secondary: IM
Congenital/late: IV

Doxy or Tetracycline

Strawberry cervix
Mobile, pear shaped protozoa w/ flagella on wet mount

33
Q

How is Trichomonas Vaginitis Tx

What causes condyloma acuminate

How are these prevented

How are they Tx

A

Metronidazole

HPV 6, 11

Gardasil- protects from 6, 11 and two most Ca types: 16, 18

Podofilox, Cryo

34
Q

How does HSV present on PE

Where do these reside in for life

What are HHV 3-8 names

A

Grouped vesicles on erythematous base, all in same stages of development

Trigeminal, Sacral ganglia

3: Varicella Zoster
4: EBV
5: CMV
6: Roseolovirus, 6th dz
7: similar to 6
8: rhadinovirus called Kaposi sarcoma associated HSV

35
Q

? is the MC virus passed from mother to unborn baby

How are HSV cases Dx

How are they Tx

A

CMV

Tzanck prep- multinucleated gian cells

FAV-cyclovir

36
Q

What kind/shape is N gonorrhoeae

? biliary-hepatic dz can gonorrhea mimic

How is it Dx

A

Gram neg diplococci

Fitz-Hugh-Curtis syndrome

NAAT:
women: vaginal swab
men: first catch UA
Persistent after ABX= culture

37
Q

How is gonorrhea Tx

What is used for PTs allergic to mainstay Tx

? is the MC STI

A

Ceftriaxone, + doxy for chlamydia

Gentamicin + Azith

Chlamydia

38
Q

Gold standard to Dx chlamydia

How is chlamydia Tx

How is gonorrhea Tx

How is chlamydia Tx during pregnancy

A

NAAT

Azithromycin,
Doxy

Ceftriaxone

Azith, Amox

39
Q

Define Chancroid

What microbe causes this

How is it Dx

How is it Tx

A

STD w/ painful ulcers and inguinal adenpoathy/bulbo

Haemophilus ducreyi: gram neg rod

Serologic testing
Gram stain, culture

Ceftriax or Axithromycin

40
Q

AIDS is defined as a ? three criteria?

How is this Dx made

What is used to monitor infectivity and Tx effectiveness

A

CD4 <200
Opportunistic infections
Malignancies

Immunoassay
ELISA (screen) and Western Blot (confirm)

HIV RNA viral load

41
Q

When is HAART therapy initiated for HIV

What are the HAART regiments for naive Pts

A

CD4 <350 or
Viral load >55K

NNRTI + 2 NRTIs or
PI + 2 NRTI or
INSTI+2 NRTI

42
Q

Opportunistic infections at CD4 count of <250

Opportunistic infections at CD4 count of <200

Opportunistic infections at CD4 count of <150

Opportunistic infections at CD4 count of <100

Opportunistic infections at CD4 count of <50

A

Coccidiomycosis

Pneumocystis

Histoplasmosis

Toxoplasmosis/Crypto

Mycobacterium avium complex

43
Q

Post-HIV exposure prophylaxis needs to be started w/in ?hrs of exposure

How can this infection be passed to infants

A

<72hrs

Breast milk

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