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Mind and Movement > Opthalmology & ENT > Flashcards

Opthalmology & ENT Flashcards

1
Q

Management of epistaxis

A
  • Resus if needed
  • Apply pressure and tilt head forwards for 15 mins
  • Find bleeding point and use silver nitrate cautery
  • if not bleeding point refer to ENT
  • If bleeding continues, use anterior nasal pack fro 24 hours
  • If still bleeding use posterior nasal pack
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2
Q

Symptoms and Management of acute angle closure glaucoma

A

Symptoms: Nausea, vomiting, red eye, pain, headache, mid-dilated pupil, haloes around bright lights, blurred vision- unilateral symptoms

Management: Beta blockers - Timolol, Miotics - pilocarpine, carbonic anhydrase inhibitors

Admit to monitor IOP

Peripheral iridectomy once IOP is controlled

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3
Q

Neck lump red flags

A
  • Weight loss
  • Night sweats
  • Fever
  • Dysphagia
  • Hoarseness
  • Dysphonia
  • Sore throat
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4
Q

Differentials for gradual loss of vision

A
  • Cataract
  • Macular degeneration
  • Glaucoma
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5
Q

Differentials for ear discharge

A
  • Otitis externa
  • Chronic suppurative otitis media
  • Cholesteatoma
  • CSF otorrhoea
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6
Q

Ototoxic drugs

A
  • Gentamicin
  • Streptomycin
  • Vancomycin
  • Quinines
  • Chemotherapy
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7
Q

Differentials for nasal blockage

A
  • Septal deviation
  • Chronic rhinosinusitis
  • Allergic rhinosinusitis
  • Chronic rhinosinusitis with nasal polyps
  • Viral URTI
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8
Q

Investigations after loss of vision history

A
  • Eye examination (including visual fields, acuity, reflexes, eye movements)
  • Fundoscopy
  • ESR and temporal artery biopsy
  • Tonometry
  • MRI is MS suspected
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9
Q

Investigations after hearing loss history

A
  • Neurological and Ear exmination (Rinne’s and Weber’s)
  • Otoscopy
  • Pure tone audiometry
  • Medication review
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10
Q

Differentials for a red eye

A
  • Conjunctivitis
  • Subconjunctivial hemorrhage
  • Infectious keratitis
  • Anterior uveitis
  • Episcleritis
  • Scleritis
  • Acute glaucoma
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11
Q

Sore throat history

A
  • History of sore throat (duration, onset, progression, relieving and aggravating factors)
  • ENT symptoms (coryzal symptoms, dysphagia, hoarseness, cough, neck lumps, ear pain)
  • Systemic symptoms (fatigues, weight loss, loss of appetite, rash, abdo pain, headache, shortness of breath)
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12
Q

Most common type of cataract

A

Nuclear

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13
Q

Differentials for diplopia

A
  • Myasthenia gravis
  • 3rd, 4th, and 6th nerve palsies
  • Any cause of raised ICP
  • Alcohol intoxication
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14
Q

Differentials for hearing loss

A

Conductive: Ear wax, otosclerosis, cholesteatoma, tumour, glue ear

Sensorineual: Meniere’s, presbycusis, noise induced, acoustic neuroma, medications, post- infectious

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15
Q

Causes of Congenital cataracts

A
  • Genetic mutation (autosomal dominant)
  • Chromosomal abnormalities (Down syndrome, Edward syndrome)
  • Metabolic disorders
  • Intrauterine infections (Rubella, CMV, Varicella)
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16
Q

Red flags in red eye history

A
  • Visual loss
  • History of trauma
  • Haloes around bright lights
  • Discharge or itchiness
  • Recent urinary symptoms (burning or discharge)
  • Joint pain or rashes
17
Q

Nasal blockage history

A 
Duration
Onset\Timeline
Variation throughout the year
Unilateral or bilateral
History of trauma
Nasal symptoms: discharge, post nasal drip, sneezing, facial pain, epistaxis, sense of smell
Previous nasal surgery
Allergies
18
Q

DVLA rules regarding visual acuity

A

Must be better than 6/12 corrected with both eyes

19
Q

Risk factors for retinal detachment

A
  • Trauma

- Myopia

20
Q

Complications of untreated retinopathy of prematurity

A
  • Retinal detachment

- Vitreous hemorrhage

21
Q

Investigations after a red eye history

A
  • Eye examination (including visual fields, acuity, reflexes, eye movements)
  • Fundoscopy
  • Tonometry
  • Swabs for culture/PCR
  • Gonioscopy
    CXR, syphilis serology, HLA- B27 for complex uveitis
22
Q

DVLA rules regarding first seizure/epilepsy diagnosis

A

First seizure: Stop driving until seizure free for 6 months

Epilepsy diagnosed: Stop driving until seizure free for 1 year

23
Q

Differentials for acute loss of vision

A
  • Retinal detachment
  • Retinal artery occlusion
  • Retinal vein occlusion
  • Temporal arteritis
  • Optic neuritis
  • CVA
24
Q

Symptoms and management of anterior uveitis

A

Symptoms: Pain, blurred vision, red eye, photophobia, increased lacrimation, features of systemic disease

Management: urgent referral; prednisolone drops, cyclopentolate to dilate pupil and prevent adhesions

25
Q

Sore throat differentials

A
  • Acute pharyngitis (common cold)
  • Tonsilitis (viral or bacterial)
  • Peritonsilar abscess (quinsy)
  • Glandular fever
26
Q

DVLA rules after TIA/Stroke

A

Stop driving for 1 month

27
Q

Red flags in loss of vision history

A
  • Sudden loss of vision
  • Red eye
  • Headache
  • Flashes or floaters
  • Weakness
28
Q

Neck lump history differentials

A
  • Malignancy (SCC, salivary gland tumour, lymphoma)
  • Infection (EBV, CMV, TB
  • Thyroid (nodule, goitre)
  • Inflammatory (sarcoidosis)
  • Vascular (carotid aneurysm)
29
Q

Differentials for dizziness/vertigo

A
  • Acute labrynthitis
  • Acoustic neuroma
  • BPPV
  • Meniere’s disease
  • Ototoxicity
  • Ramsay Hunt Syndrome
30
Q

Features of orbital cellulitis

A
  • Lid swelling
  • Fever
  • Diplopia (limited upgaze)
  • Painful eye movements
  • Proptosis
31
Q

Features of retinoblastoma

A
  • White pupil (leucocoria)
  • ## Absent red reflex
32
Q

DVLA guidelines for glaucoma

A

Advised to inform DVLA who will then arrange their own specific tests

33
Q

Driving rules with diplopia

A

Must advise the DVLA and stop driving

  • Group 2 drivers cannot drive
34
Q

Management of diplopia

A

Refer to orthoptist

  • Patch
  • Temporary prism
  • Permanent prism

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