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NP > Peds - Eyes and Ears > Flashcards

Peds - Eyes and Ears Flashcards

1
Q

A common staphlococcal abcess on upper or lower eyelid with ABRUPT onset; PAINFUL

A

Hordeolum / Stye

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2
Q

When to refer hordeolum?

A

If no resolution within 48 hours

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3
Q

Management of hordeolum

2

A

Warm compresses

Consider bacitracin on erythromycin ophthalmic ointment

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4
Q

A non-tender beady nodule (granuloma) on the eyelid; c/b infection or retention cyst of the meibomian gland

A

Chalazion

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5
Q

Management of chalazion

A

Warm compresses

Refer for surgical removal

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6
Q

Chalazion - signs and symtoms

7

A

PAINLESS and may have:

Light sensitivity
Visual distortion if pressing on lens

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7
Q

Conjunctivitis with purulent discharge is associated with:

A

bacterial cause

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8
Q

Conjunctivitis with COPIOUS purulent discharge is associated with:

A

Gonococcal cause

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9
Q

Conjunctivitis with stringy discharge is associated with:

A

allergic cause

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10
Q

Conjunctivitis with watery discharge is associated with:

A

viral cause

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11
Q

Conjunctivitis which is bright red and irritated is associated with:

A

herpes

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12
Q

Treatment of CHEMICAL conjunctivitis

2

A

self-limiting

flush with water

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13
Q

Treatment of BACTERIAL conjunctivitis

3

A

o erythromycin ophthalmic
o tetracycline
o polymyxin B ophthalmic

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14
Q

Treatment of GONOCOCCAL conjunctivitis (2)

A

Penicillin G - IV

Ceftriaxone - IM

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15
Q 
Treatment of CHLAMYDIAL conjunctivitis
(2 with examples of second - class and drugs)
A 
o  erythromycin ophthalmic OINTMENT
o ORAL therapy - tetracyclines or macrolides
     tetracycline
     doxycycline
     erythromycin
     clarithromycin
     azithromycin
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16
Q

Treatment of ALLERGIC conjunctivitis

A

o oral antihistamines

o refer to allergy and ophthamology

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17
Q

Why are ophthalmic steroids not used in primary care for conjuncitivitis?

A

risk of:
increased intraocular pressure
activation of herpes simplex virus

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18
Q

When should conjunctivitis be cultured?

A

baby under 30 days old

suspect gonorrheal cause in any age

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19
Q

Treatment of VIRAL conjunctivitis
mild
mod
severe

A

mild –> refrigerated NSS gtts

mod –> decongestants, antihistamines, mast cell stabilizers, NSAIDS

severe –> sulfacetamide for bacterial prophylaxis

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20
Q

Treatment for HERPETIC conjunctivitis

A

Refer to ophthamlogist

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21
Q

An abnormal, uniform, progressive opacity of the eye often seen with co-morbid conditions.

A

Cataract

22
Q

What co-morbid conditions are associated with CATARACTS?

4

A

o Down’s syndrome
o DM
o Marfan
o Atopic dermatitis

23
Q

Possible causes of cataracts

5

A 
o  congenital
o  prolonged steroid use
o  infection
o  injury
o  radiation
24
Q

NP management of cataracts

A

Refer for surgery

25
Q

Ocular misalignment as a result of uncoordinated ocular muscles

A

Strabismus / lazy eye

26
Q

When is strabismus a concern?

A

o prior to 6 months, considered WNL

o if acquired after 6 months, usually due to underlying problem

27
Q

What finding in strabismus is associated with a brain tumor?

A

hypertropia - eyes deviate upward
hypotropia - eyes deviate downward

immediate referral

28
Q

A rapidly developing cancer that develops from the immature cells of a retina; the most common malignant tumor of the eye in children.

A

Retinoblastoma

Recognize and Refer

29
Q

Inflammation of the external auditory meatus

A

Otitis externa / Swimmer’s ear

30
Q

Possible causes of otitis externa

A

Bacterial (gram-negative)
Fungal
Viral

31
Q

Otitis externa - signs and symptoms

A

o purulent drainage
o otalgia
o pruritis

32
Q

Management of otitis externa (2)

A

bacterial –> acetic acid + hydrocortisone
cortisporin (neomycin, polymyxin)

fungal –> clotrimazole solution

33
Q

Microbes commonly implicated in acute otitis media

A

S. pneumoniae - 30%

H. influenza - 20%

34
Q

Pain management for otitis media

A

o acetominophen

o benzocaine otic gtts

35
Q

When is “watchful waiting” appropriate for acute otitis media?
(4)

A

o child over 4
o unilateral
o mild
o parent educated about red flags

36
Q

Red flags during watchful waiting in AOM?

4

A

o change in appetite
o fever
o vomiting
o irritability

37
Q

Treatment for acute otitis media (1)

A

Amoxicillin

38
Q

Prevention of acute otitis media

4

A

o Hib
o PCV13
o influenza vaccine
o avoid second hand smoke

39
Q

When to refer to ENT for possible tubes in acute otitis media?

A

3x / year

2x / 6 mo

40
Q

The presence of fluid in the middle ears without the signs or symptoms of AOM.

A

Serous otitis media / Otitis media with effusion

41
Q

Weber / Rinne results indicate which type of hearing loss in Otitis media with effusion?

A

Conductive hearing loss

42
Q

Management of Otitis media with effusion?

A

Re-evaluate in 3-6 months

ABT and decongestants – not effective

43
Q

Any degree of impairment in the ability to apprehend sound.

A

Hearing loss

44
Q

Types of hearing loss

A

conductive

sensorineural

45
Q

Causes of conductive hearing loss (4)

A

Cerumen/foreign body
Hematoma
Otitis media
Perforated TM

46
Q

Causes of sensorineural hearing loss (4)

A

CNS disease
Syphilis
Med toxicity - vanco, gent
Acoustic neuroma

47
Q

Which is greater AIR conduction or BONE conduction

by how much?

A

AIR conduction > BONE conduction

air conduction should be TWICE as long as bone

48
Q

What test compares air and bone conduction?

A

Rinne

49
Q

Normal findings in Rinne test?

A

AC > BC

50
Q

Normal findings in Weber test?

A

sound equal in both ears

51
Q

Conductive hearing loss -
Weber
Rinne

A

Weber - sound is louder in AFFECTED ear

Rinne - abnormal (BC > AC)

52
Q

Sensorineural hearing loss -
Weber
Rinne

A

Weber - sound is louder in the UNAFFECTED ear

Rinne - normal (AC > BC) tho both suppressed

NP (76 decks)

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