Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURP 532 > Week 2 Ophthalmology and ENT > Flashcards

Week 2 Ophthalmology and ENT Flashcards

1
Q

non painful red eye conditions

A

conjunctivitis (allergic, viral, bacterial, chemical)

dry eye syndrome

subconjunctival hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

If acute otitis media is associated with conjunctivitis, that’s commonly due to _____ bacteria. So treat with ____

A

haemophilius influenza

Amoxicillin clavulanate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Viral conjunctivitis key findings

A

Adenovirus

  • redness, itchy, swollen conjunctiva
  • tearing, clear watery discharge
  • fever, headache, anorexia, malaise
  • blepharitis
  • pharyngitis with enlarged preauricular nodes
  • concurrent URI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Adenoviral conjunctivitis management

A
  • Cool compresses
  • Lubricating drops
    • Good handwashing
    • avoid touching the eyes,
    • don’t share any towels
    • wash pillowcases
    • resolves in 1-2 weeks
    • NO prophylaxis antibiotics
  • Antihistamine ophthalmic for sx relief
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If non responsive conjunctivitis in sexually active adults, suspect

A

chlamydial conjunctivitis

  • concurrent genital infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bacteria conjunctivitis key findings

A
  • Yellow - green purulent discharge
  • Encrusted and matted eyelid on awakening
  • injected conjunctiva
  • photophobia
  • petechiae on bulbar conjunctiva
  • normal vision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

bacterial conjunctivitis: what organisms?

A

haemophilus influenzae, strep pneumoniae, and staph aureus.

H flu more common in children (dec-april)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bacterial conjunctivitis: adult management vs children

A

adult: conservatively if not immunocompromised = observe or empiric antibiotic x 1 week
- if Chlam/gon = refer CDC

children: empiric (trimethoprim + polymyxin B sulfate ophthalmic soln, erythromycin 0.5% ointment to cover H influ),

Older children/teens = watch and wait! resolves in 1 week no matter what

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Allergic conjunctivitis results from ____ and is associated with ___

A

igE mediated hypersensitivity

a/s with atopic disorders, asthma, atopic dermatitis, seasonal, perennial plant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

allergic conjunctivitis sx’s and on exam

A
  • bilateral severe eye itching, teary
  • rhinitis
  • clear, white stringy mucoid discharge
  • teary boggy conjunctiva
  • allergic shriners/dark circles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

allergic conjunctivitis management

A

Identify/avoid the allergen
Cold compresses and artificial tears
Oral antihistamines if systemic allergy sx’s

  • NO antibiotics/steroids
  • eye drops:
    • Ketotifen (antihistamine)
    • Patanol or Olopatadine (prescription); Used > 3 yrs old
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does chemical conjunctivitis occur

A

Benign: fumes, smoke, chlorine or toxic

  • if causes severe pain, vision disturbances = refer!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

vernal conjunctivitis

A

type of allergic conjunctivitis
common in childhood and spring
bilateral
more severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

atopic conjunctivitis

A

common in >50 yrs old
bilateral itchy, burning, tearing
tx w mass stabilizer eye drop or refer

refer!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

dry eye syndrome sx’s

A
  • foreign body sensation
  • scratchy gritty feeling stinging, tearing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what test to do for dry eye vs lacrimal problem? Explain.

A

schirmer test

assesses aqueous production. using filter paper and placing it in the inferior culdesac, measure tear production after 5 mins. < 5 mm = tear deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

dry eye management and treatment

A

Avoid causative medications
anticholinergics or diuretics
Avoid air conditioners or fans

1st line: preservative-free lubricants (OTC) if not work refer and cyclosporin rx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Subconjunctival hemorrhage

A
  • benign
  • from increased intrathoracic pressure (coughing sneezing, straining)
  • no pain
  • common in HTN or blood thinner pts
  • resolves in 2 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are ocular adnexal disorders? Name them.

A

disorders of structures that surround the eye

Blepharitis
Hordeolum (stye)
Chalazion
Nasolacrimal duct obstruction
Preseptal and orbital cellulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

flakey, yellow scaly debris over eyelid margins on awakening

inflammation of eyelid or follicles

A

Blepharitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

blepharitis management (3)

A
  1. 1st line: warm compresses x 10 mins several times a day
  2. dilute baby shampoo with warm water and just cleanse the eyelid every day
  3. Topical antibiotic is only needed if due to a staph infection.
    usu resolves with conservative treatment.
    If it’s persistent or severe, doxycycline often not needed.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define hordeolum (stye) and symptoms

A

Acute infection and inflammation of eyelid gland d/t to a blocked meibomian gland

Staph aureus

  • contact lens use
  • painful furuncle/nodules
  • NO injection, NO discharge, NO redness
  • foreign body sensation

resolves 1-2 weeks (ruptures from compresses or I&D)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define chalazion and management

A

Chronic, inflammation of eyelid from lipogranuloma of meibomian

non-painful, non-infectious nodule; results from hordeolum

Warm compresses, gentle massage, weeks to resolve, I&D if persistent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hordeolum vs Chalazion

A

chalazion results from a hordeolum

Chalazion: located AWAY from the eyelid margin, more firm, and it’s non-tender, deeper in eyelid

Hordeolum: closer to the eyelid margin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Nasolacrimal duct obstruction (dacryostenosis) symptoms and management

A
  • tearing, mucoid discharge
  • blepharitis
  • painful, tenderness/swelling over duct
  • elevated WBC from exudate

manage:

  • Daily massage of the lacrimal duct. If it doesn’t resolve by 12 months = refer for probing procedure.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Complications from dacryostenosis (2)

A

Dacryocystitis (inflammation of duct = infection)

I&D or systemic antibiotics

Peri/orbital cellulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

preseptal cellulitis aka periorbital cellulitis sx’s and treatment

A
  • NOREFER!
  • staph aureus
  • superficial infection
  • NO painful eye movement, eye is spared, no fever
  • infection that’s ANTERIOR to orbital septum
  • tx < 1 yrs: hospitalization, IV antibiotics
  • >2 yrs: mild (no vision changes, eye moves, no ptosis):
    • oral amoxicillin, cefdinir, cefpodoxime 1-2 weeks
      • warm soaks 2-4 hrs x 15 mins
      • f/u 24 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is orbital cellulitis and how does it affect the eye?

A
  • IMMEDIATE CT SCAN! Can go blind
  • severe infxn of soft tissue POSTERIOR to orbital septum
  • affects eye: PAIN with eye movement or restricted eye movement, chemosis, ptosis (late), dec visual acuity
29
Q

Painful red eye conditions

A
  • URGENT REFERRAL!
  • Severe eye pain
  • Loss of visual acuity
  • Loss pupillary reactivity
  • Hypopyon
    • Neutrophils and fibrin in anterior chamber
  • Hyphema
    • Blood in aqueous anterior chamber
30
Q

pain, photophobia, conjunctiva hyperemia, hypopyon, cloudy appearance, pupil constriction, blurred vision, epiphora

ciliary flush, pupil constriction

A

uveitis

inflammation of middle layer (choroid, ciliary body, iris)

30
Q

inflammation of cornea affecting visual acuity

  • can progress to corneal ulceration and blindness
  • Severe pain, foreign body
  • Photophobia
  • Erythema
  • Spasms of eyelid
A

keratitis

31
Q

keratitis major risk factor and diagnostic

A

trauma: contact lens

seen using a slit lamp, stained green with a fluorescent strip

32
Q

Herpes zoster ophthalmicus’s classic symptom is called ___

A

hutchinson sign

lesion at tip/right side of nose (but absent does not r/o it)

vesicular eruption along trigeminal nerve causing conjunctivitis

33
Q

severe eye pain, tenderness, blurred vision, tearing, photophobia

pain radiates into the brow bone or jaw

occurs in autoimmune disorder disorders (uveitis, IBD, lupus)

A

scleritis

inflammation of sclera

34
Q
A

episcleritis

superficial inflammation

not painful, resolves w/o tx

35
Q

severe pain, photophobia, decreased vision, disrupted tear film over corneal epithelium

uses fluorescein stain (woods lamp)

from trauma to eye like fingers, lens, airbags, job

A

corneal abrasion

36
Q

corneal abrasion management

A
  • topical antibiotic ointment.
  • ibuprofen
  • Eye patch does NOT improve healing but if must wear, max 24-48 hrs
  • Educate it’ll heal within 1-3 days. If not improving after 3 days, refer
  • if have these, refer:
    • purulent discharge, worsening eye pain, photophobia = refer !
37
Q

Severe pain; nausea, vomiting; halos around lights; photophobia; conjunctival hyperemia; pupil mid-dilated and
fixed; firm globe; shallow anterior chamber

A

acute angle closure glaucoma

abrupt increase in intraocular pressure

REFER!!!!

38
Q

sudden onset of visual field defects, floaters, photopsia/flashing lights

A

retinal detachment

refer! need surgery and NPO

39
Q

1 eye, dyschromatopsia (abnormal color vision), pain with eye movement, vision loss worse with exercise and heat, central scotoma (blind spot in center)

preceding viral infection

objects appear curved

A

optic neuritis

40
Q

optic neuritis management

A

REFER!

IV then oral steriods

brain MRI (demyelinating lesions for MS)

41
Q

transient monocular loss of vision

grey curtain peripheral vision

30 seconds

A

amaurosis fugax

form plaque buildup in carotid artery

refer! get cardio workup, assess carotid

42
Q

otitis media risk factors

A
  • allergies
  • upper respiratory infection
  • cleft palate
  • adenoid hypertrophy
  • tobacco exposure.
43
Q

otitis media sx’s

A
  • ear pain
  • pulling at ear
  • fever (otitis externa has NO fever)
  • TM erythema and pain
  • worse when child lying down
  • otorrhea
44
Q

mild vs severe otitis media

A

mild: < 102.2F, sx’s < 48 hrs
severe: >102.fF, sx’s > 48 hrs

45
Q

otitis media management

A

Pain control (Tylenol)

Only treat amoxicillin(-clavulanate) or cephalosporin if healthy children (no Down S, cleft palate, tubes):

  • severe sx’s > 6 months, then f/u 48-72 hrs of onset of sx’s
  • no severe sx’s, < 24 months, bilateral
  • if sx’s persist after 48-72 hrs of sx onset

DON’T treat if:

  • < 24 months, no severe sx’s, unilateral
  • > 24 months, not severe sx’s
46
Q

Complications of otitis media

A
  • mastoiditis (fever, pain behind ear, swelling posterior ear over mastoid process)
  • perforation of TM
  • otorrhea
  • effusion (fluid; hearing test if > 3 months; refer if > 6 months or hearing lost but watch and wait 48 hrs if mild)
  • cholesteatoma (cyst in ear; pearly white lesion = refer!)
47
Q

acute otitis externa risk factors and sx’s

A

inflammation of external canal aka swimmers ears

  • foreign bodies (q tips, ear buds)
  • sx’s (pain when palpate tragus/auricle, otorrhea, fullness/clogged, hearing loss, intense itching)
  • TM normal
  • infection with edema, discharge, erythema
  • furuncles or small abscesses at hair follicles
  • infection of epidermis
48
Q

otitis external differentials and treatment

A
  • acute otitis media
  • TMJ because sometimes the pain can refer into the jaw.
  • fungal infection (uncommon)
  • tx (topical antibiotic drops)
49
Q

Otitis externa education

A
  • educate cerumen = protective mechanism
  • NO Q-tips
  • Keep their ears dry.
  • NO swimming or submerging their head until the infection has cleared.
  • Use hair dryer when they come out of the pool or shower = ears dry
  • If 1st episode, use earplug or cap when swimming
  • improve in 5 to 7 days.
    • come back if they’re not improving or if their symptoms are worse
50
Q

Persistent AOM vs Recurrent AOM

A

Persistent AOM: does not resolve when finished antibiotic therapy or recurs within days of treatment

Recurrent AOM: 3 separates bouts of AOM w/in 6 month period or 4 within 12 month period

  • often positive hx of otitis media and other ENT dz
51
Q

AOM with perforation treatment

A

if mild, wait and watch. Tylenol/motrin, hydration

if no improvements within 48 hours, amoxicillin

52
Q

Peripheral vertigo conditions

A
  • benign paroxysmal vertical
  • vestibular neuritis
  • bacterial labryinthinis
  • viral
  • meniere’s disease
  • neuroma
53
Q

central vertigo conditions

A
  • Brain stem PIA
  • Infarcts
  • Neurological tumors
  • Multiple Scerlosis
  • Basilar migraines or vestibular migraines
  • Cardiac - bradycardia, tachy, anemia, medications, toxins, hypotension
54
Q

episodic dizziness/vertigo, triggered, nausea, nystagmus

confirm with what test and what treatment

A

dix hall pike to confirm benign paroxysmal positional vertigo and treat with epley maneuver, meclizine, antiemetic

refer to vestibular rehab if epley doesn’t work

55
Q

vestibular neuritis

A

viral or post inflammatory disorder affecting vestibular portion of 8th CN or from otitis media

56
Q

persistent continuous vertigo/dizziness, occurs spontaneously, horizontal nystagmus, nausea/vomiting, instability gait, tinnitus

what is it? & treatment?

A

vestibular neuritis

1st line: anticholinergics and antihistamines(Meclizine), antiemetics, vestibular rehab

57
Q

episodic, spontaneous vertigo, unilateral hearing loss, unilateral tinnitus, ear fullness, nausea, vomiting

A

meniere’s disease

58
Q

meniere’s disease management

A

excessive fluid putting pressure and swelling distorts sound and balance

  • referral to ENT
  • limit sodium, alcohol, caffeine
  • H1 receptor agonist (beta histamine, diuretics)
59
Q

herpes zoster oticus (Ramsay Hunt) symptoms

A

herpes zoster activation affecting geniculate ganglion

severe ear pain and vertigo, ipsilateral facial paralysis

vesicles in auditory canal and auricle

60
Q

Bell’s palsy vs Ramsay hunt

A

both have ipsilateral facial paralysis and vessel in auditory canal/aurical as typical features

BUT Ramsay hunt has severe ear pain and vertigo

61
Q

labyrinthe concussion

A

from traumatic peripheral vestibular injury after concussion

vertigo, n/v, imbalance, hearing loss/issues

62
Q

vestibular neuritis vs labyrinthine concussion

A

labyrinthine has hearing loss

vestibular neuritis has tinnitus but hearing intact

62
Q

vestibular neuritis vs labyrinthine concussion

A

labyrinthine has hearing loss

63
Q

vertigo, migraine, h/a, photophobia, nausea photophobia

A

vestibular migraine

64
Q

What does the HINTS exam do?

A

diagnose vestibular neuritis vs stroke in pt with hrs/days of ongoing vertigo and nystagmus

  1. nystagmus
  2. vertigo skew test
  3. head impulse (want rapid movement in both eyes = vestibular neuritis)
65
Q

yellow raised growth on conjunctiva
-usu on side near nose; deposit of fat, protein, calcium

A

pinguecula

from UV (sun), wind, dust
wear sunglasses, glasses/goggles

66
Q

growth of fleshy tissue (blood vessels) that may start as pinguecula

A

pterygium

from UV (sun), wind, dust
wear sunglasses, glasses/goggles

67
Q

corneal arcus

A

blue or gray crescent shape (arc) made of lipid (fatty) deposits that curves around the outer edges of the cornea of the eye.

from high blood pressure, high cholesterol, and atherosclerosis

NURP 532 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions