Walden Flashcards
Use macrolides, fluoroquinolones
Allergies to PCN
Inflammation of eyelids TX baby shampoo, warm compresses
Blepharitis
Stones within the salivary glands or the salivary gland ducts. Painful
lump on jaw that comes and goes, Sialolithiasis typically presents with pain and swelling in the involved gland; these symptoms are usually aggravated by eating or by anticipation of eating.
Sialolithiasis
- Inflammation of middle ear/inner, erythema, decreased tympanic membrane mobility, distorted landmarks, displaced light reflex, moderate to severe bulging, mastoid pain,
- Dx pneumatic otoscopy
- TX analgesics acetaminophen, ibuprofen, narcotic with codeine, amoxicillin, Augmentin, omnicef, ceftin, otic drops ciprofloxacin with dexamethasone
Otitis media
swimmers ear, P. aeruginosa, external canal producing inflammation, itching, pain, tragal/pinna pain, otorrhea, Dx culture, TX fluoroquinolone and polymyxin B cortisporin drops!
Otitis externa
Weber test(top of head)no laterization, normal finding, does not lateralize to either ear, bilateral hearing loss, if hear better in left ear, right sensorineural loss
Sensorineural loss
Rinne test (behind pinna)–normal finding if AC last longer than bone conduction, good ear= air conduction> bone conduction, bad ear BC>AC
Conductive loss
decrease function of lacrimal and salivary glands
Sjogren’s syndrome
Purulent (pus) exudate, initially unilateral, then often bilateral, self-limiting 5-7 days, delay treatment till 3rd day, TX eye drops or ointment polytrim, trimethoprim, polymyxin, macrolide
Bacterial conjunctivitis
Profuse tearing, mucus discharge, burning, concurrent URI, enlarged preauricular node
- TX antihistamine, decongestant drops, Trifluridine in herpes conjunctivitis
Viral conjunctivitis
Eye makes repetitive uncontrolled movements, decrease vision, depth perception, balance
Nystagmus
Check for corneal abrasions, keratitis
Fluorescein strips
Normal for eye to return to midline
Horizontal nystagmus
Cover/uncover test
Strabismus
screening test for strabismus, compare corneal light reflex
Hirschberg test
Visual field by confrontation test
Test peripheral vision
color vision test
Ishihara
Responsible for sharpest vision
Fovea of macula
Responsible for color vision
Cones
Responsible for night vision
Rods
Normally lymphocytosis, maculopapular rash, fever, fatigue, pharyngitis, cervical lymphadenopathy, limit sports/activity, monitor for splenomegaly hepatomegaly,
- Dx monospot screen for heterophil antibodies,
- TX ibuprofen/Tylenol, no virus infection, no Abx treatment, rehydrate, if with strep add Ceftin for 5 days
Mononucleosis
Epstein Barr virus
Caused by Epstein Barr virus Pathognomonic for HIV infection.
Hairy leukoplakia
- Strep pyongenes, cause of scarlet fever affects heart valves and
kidneys, Criteria for strep tonsillar exudates, anterior cervical adenopathy, fever, sore throat, fatigue, NO cough - TX PCN, amoxicillin, macrolide cephalosporin,
- Dx rapid strep test, CNC, monspot if mono suspected, increases mortality in community acquired pneumonia
Strep pharyngitis
Clear discharge, blue tinged or pale and swollen (boggy) turbinate’s, sneezing itching nasal stuffiness
- TX single most effective treatment intranasal glucocorticosteroids, antihistamines, decongestants (raises BP)
Allergic rhinitis
Inflammation of paranasal sinuses due to bacteria, viral fungal or allergic infection, Goal to promote drainage,
- Sx facial pain, tooth pain, purulent discharge, nasal congestion,
- TX wait 10 days then amoxicillin or Augmentin, if allergy, fluoroquinolones/ tetracyclines
Acute rhinosinusitis
Epistaxis commonly occurs anterior, posterior nasal bleeds may hemorrhage, refer to ER
Kiesselbachs plexus
Eye pain, photophobia, blurred vision in affected eye
- DX fluorescein stain, , may result in blindness, refer to ED, ophthalmology stat
Herpes keratitis
Surfers eye, yellow triangular thickening of conjunctiva, web in eye, avoid light, glasses
Pterygium
Opacity in lens, difficulty with glare, halos around light, blurred vision, gradual onset of decreased night vision, red reflex disappears (Red reflex is now opaque gray instead of orange red glow)
Cataracts
Loss of center vision, loss of visual acuity, contrast sensitivity but still have peripheral vision, may find Drusen bodies,
- Dx Amsler grid to evaluate central vision changes
Macular degeneration
Sudden onset of shower floaters with looking thru curtain with sudden flashes of light, refer to ED
Retinal detachment
life threatening infection of epiglottis and surrounding tissue, cellulitis of the epiglottis, drooling, stridor, hoarseness, head is leaned back, can’t swallow because it hurts, big eyes scared, thumbs sign enlarged epiglottis protruding from anterior wall
Epiglottis
Affected ear hearing loss, cauliflower like mass inside middle ear, can erode bones in face, damage facial nerve CN 7
Cholesteatoma
white reflection in child’s pupil
Retinoblastoma
Spinning or rotating common characteristic
- TX antivert
Vertigo
