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828 Dosage Forms > PCC - HEENT > Flashcards

PCC - HEENT Flashcards

1
Q

N/V

A

Nausea and vomiting

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2
Q

HA

A

headache

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3
Q

PERRLA

A

pupils equal, round, reactive to light and accomodation

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4
Q

Dx

A

Diagnosis

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5
Q

ou

A

both eyes

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6
Q

os

A

left eye

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7
Q

od

A

right eye

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8
Q

au

A

both ears

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9
Q

as

A

left ear

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10
Q

ad

A

right ear

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11
Q

PCP

A

Primary care physician

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12
Q

APAP

A

acetaminophen

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13
Q

Primary Headaches

A

-No underlying illness
-Examples:
Migraine
Tension
Cluster

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14
Q

Secondary Headaches

A 
-Associated with underlying illness:
Trauma
Stroke
Substance withdrawal
Infections
Hypertensive crisis
Concussion
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15
Q

Cluster Heahaches

A 
Characteristics:
Male >> Female
Onset around 30 years old
Duration of 15 minutes up to 3 months
Causes
Hypoxia
Sudden release of histamine or  serotonin
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16
Q

Cluster Headaches Symptoms

A 
Symptoms:
Constant and severe pain
Usually unilateral; centered around the eye
Episodic or chronic
Tearing of affected eye
Drooping eyelid
Nasal stuffiness
Nausea and vomiting
Photophobia
Phonophobia
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17
Q

Migraine Headaches

A 
Characteristics:
Female >> Male
Causes
Hormonal, vascular changes, or neuronal changes
Change in sleeping patterns
Missing meals
Increased intake of fatty foods
Weather changes
Onset between 15 – 35 years old
Duration per episode: 4 hours – 3 days
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18
Q

Migraine Headaches Symptoms

A

Pulsating or throbbing pain
Usually unilateral near the temples
Nausea/Vomiting
Sensitivity to light, sound, movement

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19
Q

Migraine Headaches Warning Signs may occur hours to days before episode

A

Psychologic, neurologic, or autonomic

Roughly 10% of patients experience an aura

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20
Q

Migraine Headache Aura = neurologic symptoms prior to migraine attack

A 
-Visual symptoms:
Flashes of light or blind spots
-Sensory or motor symptoms:
Tingling/numbness of extremities
Dysphasia/Aphasia
Weakness
Hemiparesis
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21
Q

Tension Headaches

A

-Most common type of headache
-Causes
Stress or anxiety
-Symptoms
Often described as “band-like” pain
Dull, non-pulsating tightness/pressure
Usually bilateral
Episodic or chronic
Sensitivity to light and sound (photophobia and phonophobia)

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22
Q

Self-care

A

-Pharmacologic: OTC products
-Non-pharmacologic
Heat
Cold compress
Massage
Sleep hygiene
Stress management
Relaxation techniques
Avoiding triggers

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23
Q

Primary Headache: When to refer

A

Patient has symptoms suggestive of migraine or cluster headache
Headache associated with significant hypertension
Headache lasting >10 days
>3 headaches per week
Last trimester of pregnancy (preeclampsia)
Stiff neck (possible infection)
Head trauma
Symptoms resistant to self-care

24
Q

Conjunctivitis

A 
-Conjunctiva
Clear membrane lining the inner  surface of the eye and eyelid
-Conjunctivitis (AKA pink eye)
Inflammation of the conjunctiva
-Meds that cause conjunctivitis:
Amiodarone
Isotretinoin
Bisphosphonates
COX-2 inhibitors
25
Q

Viral Conjuntivitis

A 
-Cause
Typically preceded by sore throat or cold (Adenovirus)
-Symptoms
Pink/red eye
Watery discharge
Blurred vision
Low-grade fever
-Duration: 1-3 weeks
-Only symptomatic treatment
Lubricants (e.g. artificial tears)
Ocular decongestants (e.g. Naphazoline - Naphcon-A ® )
26
Q

Bacterial Conjuntivitis

A

-Common bacterial causes: S. aureus, S. epidermidis, S. pneumoniae, H. influenzae
-Symptoms
Pink/red eyes
Purulent discharge (green/yellow)
Eye discomfort/pressure
Crusted eyelids
Eyelid edema
Blurred vision
-Duration: roughly 2 weeks
-Treatment: requires antibiotics

27
Q

Allergic Conjuntivitis

A

-Cause: exposure to allergens

-Signs/symptoms
Pink/red eyes
Clear watery discharge
May be stringy and white
Burning or itching
Eye discomfort
Eyelid edema
Usually affects BOTH eyes
-Treatment:
Topical antihistamine:
Pheniramine eyedrops - Naphcon-A
Mast cell stabilizers:
Cromolyn eyedrops
Anti-inflammatory agents:
Naphazoline eyedrops - Naphcon-A
28
Q

Other Types of Conjunctivitis

A

-Dry Eye
Caused by inadequate lubrication of eye from tears
Symptoms include redness, burning, stinging, and blurry vision
Treatment:
May treat with ocular lubricants (e.g. artificial tears)
Avoid prolonged viewing of electronic screens
Humidifiers

-Irritant
Caused by objects
Do no rub
Treat by removing any contacts & flushing the eye

29
Q

Glaucoma

A

-Group of eye disorders involving optic neuropathy
Changes in optic disc
Loss of visual sensitivity & field
-Caused by:
Reduced blood flow, retinal ischemia, increased intraocular pressure
Primary (hereditary) vs. Secondary (disease, trauma, or drugs)
-Symptoms
Occurs after significant damage

30
Q

Open Angle Glaucoma

A

Most Common
Causes: steroid, anticholinergic
Symptoms: rarely occur unless there is severe damage

31
Q

Closed Angle Glaucoma

A

Emergency!
o Rapid increased intraocular pressure can lead to vision loss within 1 day
Causes: antihistamines, CNS stimulants, SSRI
Symptoms: blurred vision, halos with light, ocular pain, HA, N/V

32
Q

Open Angle Glaucoma Treatment

A 
Treatment:
Nonselective beta  blockers
Prostaglandin analogues
Alpha 2 agonists  (brimonidine)
Carbonic anhydrase  inhibitors
33
Q

Closed Angle Glaucoma Treatment

A

Pilocarpine
Hyperosmotic agents
Secretory inhibitor

34
Q

Blepharitis

A

-Infection of eyelid which may lead to sty formation
-Caused by bacteria
Hands
Cosmetics
Contact Lenses
-Symptoms
Lump on or near edge of eyelid
Painful
Swollen
Pus-filled
-Treatment
Warm compress
Lubricants (e.g. artificial tears)

35
Q

Eye Condition: Refer if…

A 
Symptoms of infection
Conditions resistant to self-care (72 hours)
Exposure to chemicals
Trauma to eye
Glaucoma
Signs/symptoms of vision loss
36
Q

Otitis Media

A 
-Inflammation of middle ear
Common in children <3  years of age
-Causes
Bacterial
Viral
Allergies
Irritants ( e.g. cigarette  smoke)
37
Q

Acute Otitis Media

A
  • Most common
  • Rapid onset symptoms: pain, fever, discharge, redness, pulling at ears, irritable, crying
  • Treatment: antibiotics, analgesics, antipyretics, local heat
38
Q

Otitis media + effusion

A

Not associated with symptoms of infection

Symptoms: rhinitis, cough, diarrhea

Treatment of symptoms: analgesics, antipyretics, local heat

39
Q

Otitis Externa

A

-Inflammation of skin lining the outer ear canal
-Causes
Prolonged exposure to moisture or injury to ear
Bacterial or fungal growth
-Risk factors:
Disrupting the externa with cotton swabs or hairpins
-Symptoms
Pain, ear discharge, hearing loss, itching, swelling or redness, burning, stinging,
fever
-Treatment
Antibiotics, glucocorticoids, acidifying solutions such as aluminum acetate
Warm water or saline

40
Q

Cerumen Impaction

A

-Buildup of cerumen (ear wax) leading to blockage of ear canal
-Ear wax protects the ear
Traps dust and prevents bacteria and small objects from entering ear
Too much wax can block the ear canal
-Symptoms
Earache, fullness in ear, tinnitus, partial hearing loss, itching
-Treatment
Carbamide peroxide (Debrox®)
Baby oil
Glycerin (Neotic ®)
Ear candling (not recommended)

41
Q

Water Clogged Ears

A 
-Causes
Swimming
Bathing
Scuba diving
Being in a humid climate
-Symptoms
Ear fullness
Gradual hearing loss
Itching
Ear drying agent
Isopropyl alcohol (Swim-EAR)
-Ear plugs (prevention)
Low heat
42
Q

Ototoxicity

A

-Damage to the hearing or balance functions of the ear
Reversible vs. Irreversible
-Causes
Chemicals
Infections
-Symptoms
Tinnitus, hearing loss, dizziness, loss of balance

43
Q

Medications Causing Ototoxicity

A
  • Quinine
  • Salicylates (aspirin)
  • Aminoglycosides
  • Platinum antineoplastic agents
  • loop diuretics
44
Q

Ears: Refer when…

A 
Hearing loss, ear pain, drainage, tinnitus
Symptoms of infection
Symptoms of otitis media and externa
Perforated eardrum
Foreign objects in ear
45
Q

Sinusitis (Head Cold)

A

-Inflammation and swelling of sinuses
Interferes with drainage & causes mucus buildup
-Viral sinusitis
Symptoms last up to 10 days
Symptoms: HA, congestion, low fever, nasal discharge , and halitosis
-Bacterial sinusitis
Symptoms increase in severity after 7-10 days
Symptoms: worsening congestion, facial pain, thick yellow-green nasal discharge, toothache, fever, halitosis
-Treat symptoms with oral or topical decongestants
(e.g. Pseudoephedrine – Sudafed ® or oxymetazoline – Afrin ® )
AVOID antihistamines

46
Q

Allergic Rhinitis

A

-Inflammation of nasal mucous membrane
-Cause
Exposure to allergen
-Types:
Seasonal
Persistent (perennial)
-Treatment:
Oral or topical antihistamines
(Oral: Cetirizine - Zyrtec ®; Topical: Azelastine –Astelin ®)
Oral or topical decongestants
(Oral: Pseudoephedrine – Sudafed ®; Topical: Oxymetazoline – Afrin ® )
Intranasal corticosteroids (e.g. Fluticasone – Flonase ®)
-Symptoms
Clear rhinorrhea
Sneezing
Congestion
Post-nasal drip
Itching eyes, ears, nose, throat
Watery eyes
Periorbital swelling

47
Q

Nose: Refer when…

A 
Severe HA not relieved by OTC products
Symptoms of systemic infection
Symptoms lasting >10 days
Cold that worsens after 7 days
Changes in vision
Symptoms resistant to self-care
48
Q

Cold Sores

A

-Blisters located on lips, chin, cheeks, or in nostrils
-Common cause: Herpes simplex virus 1 (HSV-1)
Recurrences likely due to stress or weakened immune system
-Symptoms
Red, painful blisters, oozing/yellow crusting of blister, tingling & itching
-Treatment (self limiting)
Topical antivirals - docosanol (Abreva®)

49
Q

Canker Sores

A 
-Small, round sores inside of mouth
Cheek, under tongue, gums, or in back of throat
-Causes
Stress
Food allergies
Hormonal changes
Malnutrition
B-12, folate, zinc, iron
-Symptoms
Sore usually has red edge with white center
Painful
-Treatment (self-limiting)
Local anesthetics (benzocaine)
50
Q

Gingivitis

A

-Inflammation of the gums
-Causes
Bacteria leading to accumulated plaque
Poor hygiene
-Symptoms
Red/tender gums
Swollen gums
Gums that bleed easily
Receding gums
Bad breath

51
Q

Oral Candidiasis (Thrush)

A

-Fungal infection of the mouth
-Cause
Candida albicans
-Risk Factors
Weak immune system
Dentures
Infants
Steroid medications
Smoking
Dry mouth
-Symptoms
Creamy white lesion
Cottage cheese appearance
Slight bleeding if lesions are scraped
‘Cotton mouth’ sensation
Loss of taste

52
Q

Mouth: Refer when…

A 
Lesions associated with significant pain/large area
Gingivitis
Oral candidiasis
Symptoms lasting >14 days
Immunocompromised patients
Frequent recurrence of cold sores
Symptoms resistant to self-care
53
Q

Pharyngitis

A

-Inflammation of the throat
-Non-infectious
Allergies
Sinusitis
Post-nasal drip
Malignancies
-Viral
Cough
Scratchy throat
Fever
-Bacterial (strep throat)
Pain (worse when swallowing or talking)
Scratchy throat
Dry throat
Swollen or red glands/tonsils
White patches on tonsils
Fever

54
Q

Throat: Refer if…

A

Symptoms of infection (strep throat)
Difficulty breathing
Difficulty swallowing
Symptoms >7 days

55
Q

Rapid Diagnostic Tests (RDTs)

A 
-Community pharmacy based point of care testing
Influenza A &amp; B
Group A Streptococcus (strep throat)
HIV
HCV
H. Pylori
-Collaborative Practice Agreements

828 Dosage Forms (8 decks)

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