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Clinical Medicine > Test 4 Reverse > Flashcards

Test 4 Reverse Flashcards

1
Q

Inflammation of the eyelidS. aureus or epidermidisSeborrheicFrom direct bacterial infection & response against bacterial toxins Delayed hypersensitivity rxns to bacterial antigens

A

Anterior blepharitis

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2
Q

Inflammation of eyelidsDysfunction of meibomian glands

A

Posterior blepharitis

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3
Q
  1. Burning2. Itching3. Foreign body senstaion4. Crusting of the eye lashes5. Erythematous lid margins6. Scaling lids
A

S/S blepharitis

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4
Q
  1. Rosacea2. Eczema3. Prior lid injury
A

Risk factors of blepharitis

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5
Q

Usually bilateral may be asymmetric1. Lid erythema2. Lid telangiectasia3. Oily collerettes base of lashes4. Papules5. Pustules w/ rosacea

A

What would you see with slit lamp exam of blepharitis?

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6
Q
  1. Warm compresses 2x/day2. Eyelid scrubs after compresses3. Anterior - Topical abx if infected (erythromicin/bacitracin)Posterior - oral doxycyline
A

Tx blepharitis

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7
Q

Blowout FxOccurs with blunt force trauma to globe or orbital rim

A

What is the most common orbital Fx?

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8
Q

Medial wall & orbital floor-lamina papyracea

A

What is the weakest area for orbital Fx?

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9
Q

Blunt trauma1. Diplopia on upgaze2. Periorbital ecchymosis & edema3. Anesthesia of maxillary teeth & upper lip4. Step off deformity over infraorbital ridge5. Orbital crepitus

A

S/S Blowout Fx

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10
Q
  1. Plain skull XR w/ Waters & Caldwell views2. Teardrop sign CT scan needed to Dx & determine extent of damage (coronal & sagittal views)
A

How to Dx blowout Fx?

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11
Q

Surgery for persistent diplopia & endopthalmitisRefer

A

Tx blowout Fx

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12
Q

Aging1. Trauma2. Metabolic disorders3. Infections (rubella)4. Medications5. Congenital problems

A

MCC of cataracts & other causes ?

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13
Q

cataracts

A

What is the MCC of blindness in the world?

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14
Q

Changes in the lens protein affects how the lens refracts light, reducing clarity & visual acuityMay cause color to turn yellow, green, brown or white

A

What causes cataracts?

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15
Q
  1. Painless blurry vision or vision loss2. Glare3. Myopia4. Monocular diplopia5. Absent red reflex6. Leukoria
A

S/S cataracts

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16
Q
  1. Surgery w/ intraocular lens implantMay just remove it w/o implantRefer
A

How to Tx cataracts?

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17
Q

Idiopathic, sterile chronic granulomatous inflammation of the meibomian gland caused by a foreign body reaction to sebum

A

What is a chalazion?

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18
Q
  1. Chronic process of that results from an inflammatory foreign body reaction to sebum2. Blockage of normal drainage glands, especially at at the eyelid margin3. Blepharitis, acne rosacea or hordeolum may contribute to development
A

What causes chalazion?

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19
Q
  1. Nontender, palpable localized swelling2. Swelling points to the conjunctival surface3. No signs of inflammation
A

Dx chalazion

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20
Q
  1. Warm compresses and lid scrubsIf recurrent - refer for incision & curettage
A

Tx chalazion

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21
Q

Adenovirus1. BacterialStreptococcus pneumoniaeHaemophilus influenzaStaphloccus aureusNeisseria gonorrheaChlamydia trachomatis2. ViralHerpes simplex virus type 1 and 2Picornaviruses3. Allergies4. Chemical5. Irritative

A

What is the MCC of acute conjunctivitis, & others?

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22
Q

KidsAdults usually get viral

A

Who more commonly gets bacterial conjunctivitis?

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23
Q

Bacterial/viral1. Reduced host defenses & external contamination2. Leukocyte or lymphocytic inflammatory cascade leading to an attraction of read and white blood cells to the area. Allergic 1. Type 1 immune response to an allergen2. The allergen binds to a mast cell and crosslinking to IgE occurs3. Mast cell degranulation and initiation of the inflammatory cascade4. Releases histamines from mast cells and other mediators5. Histamine and bradykinin stimulate nociceptors resulting in itching, vasodilation, rednessand conjunctical injection.

A

Pathophysiology of Conjunctivitis

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24
Q
  1. Foreign body sensation2. Burning3. Itching4. Photophobia5. URI6. Family member with same symptoms7. Tearing8. H/o cold sores9. Crusting10. Lids stuck shut in the morning11. Hyperemia12. Pseudoptosis13. Preauricular LAD
A

S/S Conjuncitivits

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25
Q
  1. Rapid adenovirus immunoassay kit2. Bacterial or viral culture
A

Dx conjuncitivitis

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26
Q

Self limiting 10-14 daysIf Tx - 1-3 daysBroad specturm topical abx

A

Tx of bacterial conjuncitivits

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27
Q

Oral tetracylcine, doxycylcine, erythromicin or azithromycin Topical ointments of drops used

A

Tx of chlamydial conjuncitivitis

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28
Q
  1. Artificial tears2. Cool compressesAcyclovir if herpes
A

Tx of viral conjuncivitis

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29
Q
  1. Topical antihistamines2. Short course of topical steroids
A

Tx of allergic conjunctivitis

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30
Q

Lid stuck shut in morningLess itching

A

Good sign for bacterial conjunctivitis

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31
Q
  1. Preauricular LAD 2. Subconjunctival hemorrhage 3. Punctate keratopathy4. Photophobia
A

Good signs for viral conjuncitivitis

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32
Q
  1. Intense itching2. Chemosis3. Thick stringy mucus4. Conjunctival papilla
A

Good signs for allergic conjuncitivitis

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33
Q
  1. Sudden onset 2. Foreign body sensation3. Photophobia4. Excessive tearing5. Blepharospasm6. Blurry vision7. Pain worse with eye movement
A

S/S corneal abrasion

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34
Q
  1. Remove foreign body2. Anesthetic eye drop3. Topical abx (Tobramycin)4. NSAIDNo patching, no contacts
A

Tx corneal abrasion

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35
Q

P. aeruginosa

A

What ulcers can contacts cause?

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36
Q
  1. Contact lenses2. HIV3. Trauma4. Ocular surface disease5. Ocular surgery6. Age7. Gender 8. Smoking9. Low socioeconomic class, poor hygiene
A

Risk factors for corneal ulcers

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37
Q
  1. Staphylococcus sp, Pseudomonas2. Fungi - Fusarium3. Amoeba - Acanthamoeba4. Herpes simplex, Varicella-Zoster5. Idiopathic6. Neurotrophic keratitis7. Exposure keratitis8. Severe dry eyes9. Severe allergic disease
A

Common causes of corneal ulcers

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38
Q
  1. Pain2. Photophobia3. Tearing4. Decreased/blurred vision5. Erythema of eyelid and conjunctiva6. Circum-corneal injection7. Purulent or watery discharge8. Foreign body sensation
A

S/S corneal ulcer

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39
Q
  1. Broad spectrum abx - usually ciproIf contact lens wearer - fluoroquinolone 2. Cycloplegic eye dropsRefer
A

Tx of corneal ulcer

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40
Q

Inflammation of lacrimal glandMay be primary inflammatory condition of secondary1. Mumps2. Measles3. Influenza

A

Dacryoadenitis & when is it commonly seen in kids?

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41
Q
  1. Autoimmune diseases - Sjorgen syndrome, Sarcoidosis, Tumor2. Rare caused by staphyloccus, aures, Nesseria gonorrhea or streptococci3. Mumps, mononucleosis, influenza and herpes zoster
A

Causes of dacryoadenitis

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42
Q
  1. Unilateral eye pain2. Redness3. Swelling over lateral 1/3 upper eyelid4. Tearing or discharge
A

S/S dacryoadenitis

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43
Q
  1. Inflammatory - Refer to ophthalmologist for treatment pseudo tumor cerebri2. Viral - Cool compresses to swelling, NSAIDs PRN3. Bacterial or infectiousmild to moderate amoxicillin/clavulanate or cephalexinModerate to severeHospitalize treat according to causative organism
A

Tx of dacryoadenitis

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44
Q

Eversion of lower eyelid Relaxation of the orbicularis oculi muscle or degeneration of the lid fascia

A

What is ectropion caused by?

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45
Q
  1. Previous surgery, trauma, chemical burn or seventh nerve palsy2. Excessive tearing3. Corneal abrasion from eyelashes4. Foreign body sensation
A

S/S ectropion

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46
Q
  1. Artificial tears & lubricant2. Bacitracin/erythromycin3. Warm compress4. Tape lid into placeRefer for surgery
A

Tx of ectropion

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47
Q

Onward turning of the lower eyelid 1. Due to age related laxity of the lower eyelid muscles and degeneration of the lid fascia2. Can also be caused by birth defect (Down’s Syndrome), facial palsy & scar tissue of conjunctiva and tarsus

A

What is entropion caused by?

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48
Q
  1. Eye irritation2. Foreign body sensation3. Tearing redness4. Conjunctival injection5. Blepharospasm
A

S/S entropion

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49
Q
  1. Artificial tears & lubricants2. Surgical repair
A

Tx of entropion

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50
Q
  1. Pain, worse with eye movement (significant relief with topical anesthetic)2. Foreign body sensation (relieved by topical anesthetic)3. Photophobia4. Tearing5. Redness
A

S/S corneal foreign body

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51
Q
  1. Topical anesthetic2. Remove FB3. If rust ring is present must completely removed4. Tx w/ abxPts w/ intraocular foreign body need immediate referral
A

Tx corneal foreign body

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52
Q

Glaucoma

A

What is the 2nd leading cause of blindness?

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53
Q

Inc. intraocular pressure causing optic nerve damageOpen- angle: Neurodegenerative condition from dysfunction of aqueous humor Angle closure: restricted flow of aqueous humor

A

Cause of glaucoma

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54
Q
  1. Usually asymptomatic early2. FH diabetes or glaucoma3. Halos around lights
A

S/S open angle glaucoma

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55
Q
  1. Halos around lights2. Aching eye/brow pain3. HA4. N&V5. Dec. vision 6. Eye redness7. Use of sulfa based drugs
A

S/S closed angle glaucoma

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56
Q
  1. IOP >212. Loss of rim tissue on optic disc3. Enlarged cup to disc ratio or asymmetric cup to disc
A

Dx open angle glaucoma

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57
Q
  1. Reduced visual acuity2. Hyperemia3. Elevated IOP4. Corneal edema5. Dilated fixed pupil6. Shallow anterior chamber
A

Dx closed angle glaucoma

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58
Q
  1. Reduction of aqueous production beta-adrenergic drops timolol or levobunolol contraindicated in asthma and cardiac conduction defects.Alpha-adrenergic agonists apraclonidine and brimonidine.2. Laser trabeculectomy
A

Tx of open angle glaucoma

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59
Q

Medical Emergency!!!1. Reduce IOP and break the angle closureBeta-adrenergic dropsTopical Streoids drops Prednisilone acetate 1% Alpha-adrenergic agonistsCarbonic anhydrase inhibitor acetazolamide 500 mg2. Hyperosmotic agents when pressures are very high3. Laser peripheral iridotomy used to relieve pressure in iris

A

Tx closed angle glaucoma

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60
Q

Angle closure 1. Cycloplegia (atropine 1% BID to TID2. IV hyperosmotic agents3. IV steroids (methylprednisione250 mg QID) Refer - emergency

A

Tx glaucoma caused by Topiramate or sulfonamide

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61
Q

S. aureusMeibomian glandTx w/ warm compress

A

What bacteria causes Hordeolum & what is infected?

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62
Q

Adults1. Diabetes2. Blepharitis 3. Seborrhea4. High serum lipids

A

Who is at inc. risk of Hordeolum?

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63
Q
  1. Acute pain or tenderness eyelid2. Erythematous eyelid3. Pustule on eyelid4. Hyperemia5. Eyelid bump6. Eyelid swelling7. Previous eye surgery or eyelid surgery8. Rosacea or blepharitis
A

S/S hordeolum

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64
Q
  1. Palpate lid for eyelid nodule2. Visual examination for blocked meibomian gland3. Eyelid swelling4. Localized eyelid tenderness
A

Dx hordeolum

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65
Q

preseptal cellulitisTx w/ cephalexin & refer

A

What should you consider if there is periorbital erythema & warm edema?

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66
Q
  1. Warm compresses 10 minutes QID with lid massage over nodule2. Eyelid scrubs3. Abx maybeIf no improvement after 3-4 weeks refer to an ophthalmologist curettage and drainage
A

Tx hordeolum

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67
Q

Post injury accumulation of blood in the aqueous humor of the anterior chamber Inc. intraocular pressures REFER - Medical Emergency

A

Hyphema

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68
Q

anterior aspect of ciliary body

A

What is the most common site of bleeding w/ hyphema?

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69
Q
  1. Blunt or penetrating trauma, intraocular surgery2. Vision loss3. Eye pain4. N&V5. Blurry vision6. Vision loss (is it changing over time?)7. Medications w/ anticoagulation properties
A

S/S hyphema

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70
Q
  1. Blood/clot in anterior chamber2. R/O ruptured globe3. Measure IOPScreen black & mediterranean Pts for sickle cell
A

Dx hyphema

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71
Q
  1. Avoid ASA & NSAIDS2. Bedrest or limited activity3. Elevate head of head to allow blood to settle4. Eye shield either metal or plastic (do not patch)5. Atropine 1% BID to TID6. Acetaminophen only
A

Tx of hyphema

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72
Q

Macular Degeneration

A

What is the leading cause of blindness in industrialized nations?

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73
Q
  1. Age2. FH3. Smoking4. Previous cataract surgery5. ARMS2/HTRA1
A

Risk Factors of Macular Degeneration

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74
Q
  1. Gradual loss of central vision2. Drusen’s3. Macular retinal pigment epithelial changes4. Variable vision loss 5. Amsler Grid changes
A

S/S non-exudative macular degeneration

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75
Q
  1. Severe vision loss2. Choroidal neovascularization noted on fundus examination3. Drusen and subretinal fluid or retinal pigment epithelium detachment4. Disciform scar
A

S/S exudative macular degeneration

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76
Q
  1. AREDS formula vitamins 2. Monitor with Amsler Grid3. Smoking cessation
A

Tx non-exudativee macular degeneration

77
Q
  1. Laser photocoagulation2. Intraocular injections of anti-vegf drug
A

Tx exudative macular degeneration

78
Q

Fast uncontrollable mvmts of the eyeCan be in one or both eyesAcquired/CongenitalUsually asymptomatic unless developed after 8y/o

79
Q
  1. Idiopathic2. Albinoism3. Aniridia4. Leber congenital amaurosis
A

Causes of congenital nystagmus

80
Q
  1. Vision loss2. Toxic or metabolic causes3. CNS disorders4. Non-physiologic5. Trauma 6. Labyrinth’s/Meniere’s disease7. Thiamine/Vit B12 deficiency8. Drugs/alcohol9. Vertigo10. MS
A

Causes of acquired nystagmus

81
Q
  1. Maximize vision by refraction2. Treat amblyopia3. Prism glasses maybe4. Muscle surgery maybe
A

Tx congenital nystagmus

82
Q
  1. Treat underlying etiology2. Periodic alternating nystagmus treat baclofen (not for use in children)
A

Tx acquired nystagmus

83
Q

Inflammation of the optic nerve 1. Epstein-barr VirusOther viruses - demyelinating disease2. AutoimmuneSLE, Sarcoidosis, Sjogren, Behcet & MS

A

Optic neuritis & Causes

84
Q
  1. Monocular periorbital pain/retro-ocular pain2. Eye pain worse w/ eye mvmt3. Loss of visual acuity w/ scotoma4. Color desaturation/loss of color vision5. Relative afferent papillary defect6. Uhthoff phenomenon7. Pulfrich phenomenon8. Phosphenes (see light with sight being present)
A

S/S Optic Neuritis

85
Q

Worsening of symtoms w/ inc. in body tempsSeen w/ Optic neuritis

A

What is Uhthoff phenomenon?

86
Q

Altered depth perception of moving objects Seen w/ optic neuritis

A

What is Pulfrich phenomenon?

87
Q
  1. Visual acuity2. Optic disc swelling3. Color perception4. Contrast sensitivity5. Visual field - APD (90% pts)6. Optic disc pallor (optic atrophy from previous ON)7. MRI brain/orbits8. Labs -CBC, RPR, FTA-ABS, ESR & CRP
A

Dx optic neuritis

88
Q
  1. MRI w/ 1 demyelinating lesion - steoids for 14 days2. Antiulcer meds - ranitidine 150 mg BID3. MRI w/ >3 demyelinating lesions - steroids then refer for interferon Tx
A

Tx optic neuritis

89
Q

Could be underlying bacterial sinusitis

A

Why is periorbital cellulitis concerning in kids?

90
Q

Infective process occurring in the eyelid tissues superficial to the orbital septumAffects muscles & fat w/in orbit but not the globeCommonly spread & causes other infections

A

Orbital cellulitis

91
Q
  1. Superficial inoculation - insect bite, chalazion, epidermal inclusion cyst, folliculitis2. Local spread from respiratory tract 3. Orbital injury, Tx, dacryocystitis, endophthalmitis, dental infections
A

Causes of orbital cellulitis

92
Q
  1. S. aureus2. S. epidermidis3. Strep & anaerobes4. Fingal seen in immunosuppressed/diabetics…very aggressive
A

What organisms commonly cause cellulitis?

93
Q
  1. Ocular pain2. Proptosis3. Ophthaloplegia (paralysis of extraocular muscles)4. Eyelid edema5. Vision loss6. Chemosis7. Eyelid erythema8. Elevated intraocular pressure9. HA10. Decreased eye motility11. N&V
A

S/S orbital cellulitis

94
Q
  1. Complete dilated eye examination with visual acuity2. Head and neck examination3. Oral examination (tissue necrosis and black eschar) 4. Check for +APD5. CT scan
A

Dx orbital cellulitis

95
Q
  1. Empiric oral or IV antibiotics2. Incision and drainage of abscess3. Culture for causative organism4. Antifungal therapy with amphoteracin-B (for immunosuppressed or ketoacidosis pts)
A

Tx orbital cellulitis

96
Q

Optic disc swelling that is secondary to elevated intracranial pressureNo dec. vision***Usually bilatCaused by infection, infiltration or inflammation

A

Papilledema

97
Q
  1. Primary and metastatic intracranial tumors2. Hydrocephalus3. Pseudotumor cerebri4. Subdural and epidural hematomas5. Subarchnoid hemorrhage6. Arteriovenous malformation7. Brain abscess8. Meningitis9. Encephalitis10. Cerebral venous sinus thrombosis
A

Causes of papilledema

98
Q
  1. HA (worse on awakening, exacerbated by coughing or other types of Valsalva maneuver)2. N&V3. LOC, pupillary dilation and death4. Pulsatile tinnitus5. Blurry vision, constriction visual field & decreased color vision6. Diplopia (6th nerve palsy)No visual disturbances
A

S/S papilledema

99
Q
  1. Full dilated eye examination2. Automated visual field test (detect blind spot or constriction of field)3. Color vision testing4. Optic disc photos5. BP6. MRI head with gadolinium and MRV head7. Lumbar puncture with CSF analysis and opening pressure msmt
A

Dx papilledema

100
Q

Fix cause1. Diuretics-carbonic anhydrase inhibitors (idiopathic intracranial hypertension)2. Weight reduction (idiopathic intracranial hypertension)3.Corticosteroids (inflammatory disorders)

A

Tx papilledema

101
Q

Fleshy, fibrovascular overgrowth from the conjunctiva onto the corneal surface1. UV 2. Irritation from wind 3. Genetics

A

Pterygium & Risk factors

102
Q
  1. Ocular irritation and burning2. Redness3. Tearing4. Blurred vision5. Diplopia6. Altered ocular cosmesis
A

S/S Pterygium

103
Q
  1. Wing shaped, vascular, conjunctival overgrowth2. Increased tear lakes
A

Dx Pterygium

104
Q
  1. Protect eyes from direct sun and wind2. Topical steroid drop to reduce irritation3. Refer to ophthalmologist for surgical excision if overgrowth encroaches into the pupillary area
A

Tx Pterygium

105
Q

Acute or progressive condition where the neuroretina separates from the retinal pigment epithelium with accumulation of subretinal fluid and loss of visual function

A

Retinal Detachment

106
Q
  1. Flashes of light2. Floaters3. A curtain or shadow moving over the field of vision4. Peripheral or central vision loss
A

S/S Retinal Detachment

107
Q

Traction1. Diabetes2. Trauma 3. Previous surgery

A

Causes of Retinal Detachment

108
Q
  1. Full dilated eye examination2. Confrontational fields3. Indirect ophthalmoscopy with scleral depression4. B-scan (ultrasound) is used if media problem
A

Dx retinal detachment

109
Q
  1. Pneumatic retinopexy2. Surgical-vitrectomy and/or scleral buckle
A

Tx Retinal Detachment

110
Q

Embolus1. Cholesterol - Hollenhorst plaque from carotid artery bifurcation 2. Calcium - from heart valves3. Fibrin - from atheromas in carotids4. Thrombosis5. Giant cell arteritis6. Collagen-vascular disease7. Hypercoag. disorders

A

Causes of Retinal Artery Occlusion

111
Q
  1. Acute persistent vision loss2. Visual acuity finger count to light perception3. H/O HA, weight loss, jaw claudication, scalp tenderness, fever, proximal joint pain4. H/O atrial fibrillation, endocarditis, coagulopathies, atherosclerotic disease5. Direct pressure to the globe or drug induced stupor
A

S/S Retinal Artery Occlusion

112
Q
  1. Whitening of the retina on the posterior pole2. Cherry red spot macula3. + APD4. Narrowed retinal arterioles5. Boxcaring or segmentation of the blood columns in the arterioles
A

Dx Retinal Artery Occlusion

113
Q

Tx underlying medical problems

A

Tx Retinal Artery Occlusion

114
Q

Non-ischemic - milder Ischemic

A

Retinal Vein Occlusion

115
Q
  1. Atherosclerosis of the adjacent central retinal artery causing thrombosis2. HTN3. Optic disc edema4. Glaucoma 5. Optic disc drusen6. Hypercoagulable states7. Vasculitis8. Drugs
A

Causes of retinal vein occlusion

116
Q
  1. Unilateral painless vision loss
A

S/S Retinal Vein Occlusion

117
Q
  1. Diffuse retinal hemorrhages, dilated, tortuous retinal veins2. Cotton-wool patches, disc edema, retinal hemorrhages, retinal edema, optociliary shunt vessels on the disc, neovascularization of the optic disc, retina and/or angle3. Intravenous fluorescein angiography4. Labs-FBS, HgbA1c, CBC with diff, platelets, PT/PTT, ESR, lipid profile, homocystine, ANA, FTA-ABS5. Medical eval CV disease and hypercoagulability
A

Dx Retinal Vein Occlusion

118
Q
  1. Chronic macular edema-focal laser or anti-VEGF intraocular injections2. Retinal neovascularization-panretinalphotocoagulation laser
A

Tx Central Retinal Vein Occlusion

119
Q

Non-proliferative1. Venous dilation2. Microaneurysms3. Retinal hemorrhages4. Edema5. Hard exudates6. Cotton-wool patchesProliferative7. Neovascularization8. Hemorrhage in the vitreous body9. May lead to retinal detachment10. Fibrosis

A

S/S Diabetic Retinopathy

120
Q
  1. Based on history and funduscopic examination2. Optical coherence tomography scanning of the macula3. Fluorescein angiography
A

Dx Diabetic Retinopathy

121
Q
  1. Management of blood glucose, BP & lipids2. Yearly dilated eye examination3. Neovascularization of the retina and disc is treated with panphotocoagulation laser4. Neovascularization of the angle is treated with PRP laser, cryotherapy and/or topical glaucoma medications5. Macular edema use intraocular injectable
A

Tx Diabetic Retinopathy

122
Q

Deviation from perfect ocular alignment Congenital or defective nerves

A

Strabismus

123
Q
  1. Diplopia2. Scotoma3. Amblyopia4. Abnormal eye movements5. Visual confusion6. Asthenopia (weakness or fatigue of the eyes with headache)7. Intermittent closure of the eye8. Cranial nerve palsy
A

S/S Strabismus

124
Q
  1. Full dilated eye examination with cycloplegics2. Cover test3. Forced duction testing4. MRI of bra if needed to r/o mass lesion5. CT chest if needed to r/o possible thyoma6. CT or MRI orbit if needed to orbital fracture, entrapment of extraocular muscle or tissue or Graves disease
A

Dx Strabismus

125
Q

Primary and secondary strabismus1. Correct refraction2. Treat amblyopia or diplopia3. Extraocular muscle surgery4. Chemodenerviation5. Over-minus prescription or occlusionParalytic and restrictive strabismus1.Botulinum toxin injections

A

Tx Strabismus

126
Q

Acute Closure

A

What type of glaucoma is a medical emergency?

127
Q

Retinal Artery Occlusion

A

When is a cherry red spot macula seen?

128
Q

aka swimmer’s ear1. Pseudomonas Sp.2. Enterobacteriaceae3. Proteus Sp4. Fungi sometimesor contact dermatitis

A

Common organisms w/ otitis externa & sinusitis

129
Q
  1. Pain in ear2. Tenderness w/ palpation of tragus/auricle 3. Grayish discharge in canal
A

S/S otitis externa

130
Q

Fungal infection due to excessive use of abxgreenish drainage

A

What is otomycosis?

131
Q
  1. Abx drops - Quinolone2. Keep canal clean & dry Maybe steroid & acetic acid
A

Tx otitis externa

132
Q
  1. Poor drainage from eustachian tubes 2. Inflammation & edema3. Congenital deformity (Down’s)Most common in 4-24 months
A

Cause of otitis media

133
Q
  1. S pneumoniae2. H. influenzae3. Moraxella catarrhais4. Strep pyogenes5. S. aureus
A

Organisms w/ otitis media

134
Q
  1. Fever (rare)2. Pressure3. Pain4. Hearing loss 5. Immobile, erythematous, bulging TM
A

S/S otitis media

135
Q
  1. TM rupture - otorrhea & dec. pain2. Mastoiditis - spiking fevers, postauricular pain, erythema
A

Complications w/ otitis media

136
Q

> 2 y/o or 6mo-2y/o w/o middle ear effusion - watch & wait for 48-72 hrsIf effusion/more severe Sx - AmoxicillinIf fever + otalgia - Amoxicillin + Clavulanate

A

Tx otitis media

137
Q

Destruction & expanding growth of keratinizing squamous epithelium in the middle ear &/or mastoid process Sx - discharge & hearing lossTx - Surgery

A

Choleseatoma Sx & Tx

138
Q

inability to equalize barometric stress on the middle ear causing pain Caused by auditory tube dysfunction from congenital narrowing or acquired mucosal edema TM may rupture if not equalized

A

What is barotrauma & cause?

139
Q
  1. Cerumen impaction2. Acute otitis externa3. Otosclerosis 4. Otitis media
A

Causes of conductive hearing loss

140
Q

Presbycusis High frequency hearing loss May be assoc. w/ tinnitus Tx - hearing aids

A

What is the MCC of sensorineural hearing loss?

141
Q
  1. Labyrinthitis2. Meniere’s disease3. Vestibular neuritis4. Obstructing anatomic abnormalities 5. Brain stem vascular disease6. Arteriovenous malformations7. Tumors of the brain stem or cerebellum8. MS9. Vertebrobasilar migraine syndrome
A

Causes of vertigo

142
Q

Predicted type of vertigo in certain positionsDx - Dix-Halpike maneuverTx - Epley maneuver

A

Benign Paroxysmal Position Vertigo Dx & Tx

143
Q

Viral/post-viral affecting the vestibular portion of the 8th nerveNeed thorough neuro examWorse w/ rolling over in bed & quick head turning 1. Severe persistent vertigo2. N&V3. Gait instability Dx - Hallpike maneuverTx - Meclizine

A

Vestibular Neuritis Labyrinthitis Cause S/S & Tx

144
Q

Cerebellar/posterior stroke

A

What should you consider in an old person w/ labryinthitis?

145
Q

elderly/immunocompromised Get CT to rule out osteomyelitis

A

Who gets malignant otitis externa & what do you need to get?

146
Q

aka Ramsay Hunt SyndromeCN VII 1. Acute vertigo & hearing loss2. Facial paralysis3. Ear pain4. Vesicules in the auditory canal

A

Herpes Zoster Oticus S/S

147
Q
  1. Chronic hearing loss2. Tinnitus3. Dizziness/vertigoIf yes to all 3 = Meniere’s
A

If a Pt has vertigo, what must you document?

148
Q

Excess endolymphatic fluid pressure 1. Hearing loss2. Tinnitus3. Vertigo4. N&V Tx - diuretics & salt restriction

A

Meniere’s disease S/S & Tx

149
Q

aka vestibular shwannoma More common in females1. Unilateral hearing loss 2. Tinnitus3. Vertigo4. Ataxia5. Brain stem dysfunctionDx - CT/MRI TX- Surgery

A

Acoustic neuroma & Dx

150
Q

Traumatic or w/ OM Small ones heal in 4-6 wks Large may need surgery

A

TM Perforation

151
Q

Rare but seriousTender in mastoid areaFEVER

A

Mastoiditis

152
Q

AnteriorFrom Keisselbach’s plexusCauses:1. Trauma2. Irritation3. Low moisture4. Infection, allergy5. Foreign body

A

What it the most common nosebleed?

153
Q

From Woodruff’s plexus1. Packing2. Surgery3. Embolization

A

Tx of posterior epistaxis

154
Q

Pale stringy mucus1. Antihistamine (Beclomethasone-spray, or benadryl)2. Steroid3. Avoid exposure4. Allergy testing

A

Tx of allergic rhinitis

155
Q

Usually follows a URI - usually viral1. Rhinovirus2. Parainfluenza virus3. Influenza

A

Viruses assoc. w/ sinusitis

156
Q
  1. Nasal drainage & congestion2. Facial pain or pressure worse w/ bending over3. HA4. Thick, purulent or discolored nasal discharge5. Cough6. Sneezing7. FeverTooth pain & halitosis may be bacterial
A

S/S acute sinusitis

157
Q

persistent, recurrent, or chronic sinusitis

A

When do you get a CT scan w/ sinusitis?

158
Q

If 10 days, facial pain or fever = amoxicillin Symptom Tx

A

Tx of acute sinusitis

159
Q
  1. Fungal in immunocompromised2 . Osteomyelitis3. Cavernous sinus thrombosis4. Orbital cellulitis
A

Complications of sinusitis

160
Q

For Dx acute pharyngitis1. Fever2. Tonsillar exudates3. NO cough4. Tender anterior cervcal chain LAN 0-1 = low possibility of strep - no abx2 or + = RST but only Tx positive Pts 4 = Tx

A

Centor Criteria

161
Q

Viral more common - supportive Tx 1. Rhinovirus2. Coronavirus3. Influenza4. Parainfluenza5. Adenovirus 6. Herpes, Coxsackie, CMV, EBV7. S. pyogenes8. Group A Strep

A

Organisms of pharyngitis

162
Q
  1. Sore throat2. Difficulty swallowing3. Fever4. Erthema of tonsils & posterior pharynx5. LAD6. Rhinitis7. Cough
A

S/S pharyngitis

163
Q

Penicillin/erythromicin

164
Q

Nov-DecApril-MayIncubation 2-5 days Once on abx for 24 hours, risk of transmission greatly dec.

A

When is strep most common?

165
Q
  1. HIV-related lymphomas2. Nasopharyngeal carcinoma3. Burkitt lymphoma4. Oral hairy leukoplakia5. Posttransplant lymphoproliferative disorder
A

Secondary disorders from EBV

166
Q
  1. Fever, sore throat2. Malaise, anorexia, myalgia 3. LAD4. Transient bilateral upper-lid edema (Hoagland sign)5. Splenomegaly 6. Maculopapular rash uncommon (15%), except in patients receiving ampicillin (90%)7. Exudative pharyngitis, uvular edema, tonsillitis, or gingivitis may occur and soft palatal petechiae may be noted
167
Q

Age 10-35

A

Who commonly gets mono?

168
Q
  1. Nasal polyps2. Asthma3. ASA sensitivity
A

What is the common triad w/ nasal polyps?

169
Q
  1. Group A strep2. Pneumococci3. Staph4. H. influenza
A

Organisms of epiglottitis

170
Q

Abrupt onset1. High fever2. Difficulty swallowing3. Sore throat4. Drooling5. Sitting in tripod/sniffing position in kids 6. Stridor7. Hoarseness8. Neck tenderness

A

S/S epiglottitis

171
Q

Thumb sign X-ray, intubationNO tongue depressor IV fluids & abx, steroids Prophylactic rifampin

A

Dx & Tx epiglottitis

172
Q

These areRED FLAGS for no sore throat1. Fever >39.42. Severe unilateral pain3. Trismus4. Drooling5. Muffled “hot potato” voiceTx - surgical drainage

A

Peritonsillar abscess S/S & Tx

173
Q

Usually viral - sometimes bacterialChronic1. GERD2. Chronic sinusitis vocal strain3. EtOH4. Smoking

A

Laryngitis causes

174
Q

Hoarseness, cough maybeVoice rest & Tx underlying cause

A

Laryngitis S/S & Tx

175
Q

Inflammation of salivary glands Causes - Dehydration, poor oral hygiene S - Painful welling redness, fever, purulent exudateTx - hydration, analgesics, abx

A

Sialadenitis Causes, S/S & Tx

176
Q

Calculi in salivary gland ductsMore common in Wharton duct Must clamp duct so it doesn’t go back into glandShock wave therapy

A

Sialolithiasis

177
Q
  1. Mumps2. EBV3. CMV4. Influenza5. S. aureus6. Mixed oral flora Bilateral firm, erythematous swellingElevated amylase but not lipaseSymptomatic Tx
A

Parotitis Causes

178
Q

May be caused by HHV6Topical steroids provide Sx relief

A

Aphthous ulcers

179
Q
  1. Spirochetes 2. Fusiform bacilli1. Acute gingival inflammation & necrosis2. Bleeding3. Halitosis4. Fever5. Cervical LADwarm peroxide rinses & penicillin
A

Necrotizing gingivitis causes S/S & Tx

180
Q

A white lesion that cannot be removed by rubbing the mucosal surface

A

Leukoplakia

181
Q

Similar to leukoplakia except that it has a definite erythematous component

A

Erythroplakia

182
Q

Most commonly presents as lacy leukoplakia but may be erosive; definitive diagnosis requires biopsy

A

Oral Lichen Planus

183
Q

occurs on the lateral border of the tongue and is a common early finding in HIV infection

A

Hairy leukoplakia

184
Q

SCCEarly lesions appear as leukoplakia or erythroplakia; more advanced lesions will be larger, with invasion into tongue such that a mass lesion is palpable. Ulceration may be present.

A

Oral Cancer

185
Q

Hand, foot & mouth disease

A

What is a DDx of oral herpes simplex?

186
Q

aka thrushUsually painful and looks like creamy-white curd-like patches overlying erythematous mucosaCan be scraped off 1. Dentures2. Debilitated & have poor oral hygiene3. Diabetics4. Anemics5. Pts doing chemo or radiation6. corticosteroids or broad-spectrum abxTx = fluconazole

A

Oral candidiasis Risk Factors & Tx

187
Q

Form of candidiasis seen w/ nutritional deficiencies

A

What is angular cheilitis & when is it seen?

188
Q
  1. New & persistent hoarseness in a smoker2. Persistent throat or ear pain, especially with swallowing3. Neck mass4. Hemoptysis5. Stridor or other symptoms of a compromised airway
A

S/S laryngeal CA

Clinical Medicine (11 decks)

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