EENT

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EENT
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DPAP2012 EENT
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  1. Physical trauma to the auricle which causes shearing of the tissues and a perichondral hematoma. The auricle will be very swollen.
    Auricular Hematoma
  2. Infection or Inflammation of the external auditory canal
    Otitis Externa
  3. Symptoms: Pain (esp. with manipulation of the auricle), Hearing Loss, Otorrhea, Fullness, Itching
    Otitis Externa
  4. conduction of environmental air into and out of the respiratory system.
    Airway
  5. mucus and cilia trap and remove airborne viral, bacterial, and particulate matter.
    Filtration
  6. vascular mucosa overlaying the nasal cartilage and turbinates provides radiant heating of inspired air to 310 to 370 C
    Heating
  7. vascular mucosa increases the relative humidity of inspired air to 95% before reaching the nasopharynx.
    Humidification
  8. olfactory sensation detects irritants, chemicals, and temperature abnormalities of inspired air.
    Chemosensation
  9. nasal sensation may be linked to lower respiratory and vascular reflexes.
    Nasal reflex
  10. Airway; Filtration; Heating; Humidification; Chemosensation; Nasal reflex; Endocrine pheromone detection
    Functions of the Nose
  11. Irritation and Infection of the nasal mucosa
    Nasal Mucositis
  12. Treat with topical antibiotic ointment and/or oral antibiotic; Bactroban, Polysporin Keflex, Clindamycin, Amox
    Nasal Mucositis
  13. Seen with allergic rhinitis
    Nasal Polyposis
  14. Treat allergies; Nasal steroids; Systemic steroids; Surgical if obstructive, freq. infections, bony destruction
    Nasal Polyposis
  15. Aspirin sensitivity; Nasal polyposis; Asthma; Often seen with allergic rhinitis
    Samter’s Triad
  16. enlarged adenoids; the unusual growth ("hypertrophy") of the adenoid tonsil.
    Adenoid Hypertrophy
  17. is due to an enlargement of the turbinates- the small structures within your nose that cleanse and humidify air as it passes through your nostrils into your lungs
    Turbinate Hypertrophy
  18. Kiesselbach’s plexus
    Anterior-Epistaxis
  19. Woodruff’s plexus
    Posterior-Epistaxis
  20. Digital manipulation; Septal deviation; Inflammation (allergies, infection)Cold dry air, Foreign body
    Local risk factors for Epistaxis
  21. Clotting Disorder; Hypertension; Leukemia; Liver disease; Medication (aspirin, Plavix, Coumadin); Thrombocytopenia
    Systemic Causes of Epistaxis
  22. IgE mediated reaction causing mast cells and basophils to release histamine, leukotriene, serotonin, and prostaglandins; This causes inflammation of the nasal mucosa
    Allergic Rhinitis
  23. Nasal congestion; Rhinorrhea; Sneezing; Itching; Watery eyes; Allergic Shiner
    Allergic Rhinitis
  24. Common allergens: Grass/Tree pollen, mold, dust, dander
    Allergic Rhinitis
  25. swollen bluish turbinates; allergic shiner; allergic salute.
    Allergic Rhinitis
  26. Similar to allergic rhinitis, but caused by non-allergy mediated inflammation due to irritation of nasal mucosa
    Nonallergic Rhinitis
  27. Temperature; Exercise; Foreign body; Fumes; Food; Medication; smoking
    Nonallergic Rhinitis
  28. Drug induced rhinitis caused by overuse of topical decongestants (phenylephrine, oxymetazoline)
    Rhinitis Medicamentosa
  29. Rebound congestion
    Rhinitis Medicamentosa
  30. Treatment: STOP using the spray; May substitute nasal steroids or antihistamine; Afrin taper
    Rhinitis Medicamentosa
  31. Upper respiratory tract infection caused by adenovirus, parainfluenza, corona virus, rhinovirus (and many more).
    Viral Rhinitis
  32. Symptoms usually last <7 days
    Viral Rhinitis
  33. Sore throat; Nasal congestion; Rhinorrhea (may be yellow/green); Fever; Cough (may be productive); Malaise; Fatigue
    Viral Rhinitis
  34. Treatment: Supportive and Time. OTC antihistamines, decongestants, mucolytics, fluids, ibuprofen/Tylenol, rest.
    Viral Rhinitis
  35. If viral URI does not clear in 7-10 days
    Acute Sinusitis
  36. Double Sickening
    Acute Sinusitis
  37. Localized Facial Pain; Upper Tooth Pain; Purulent nasal discharge; Fever, cough, fatigue may still be present; Facial Pain upon percussion
    Acute Sinusitis: signs and symptoms
  38. Strep. pneumo, H. flu, M. catarrhalis, Staph. aureus
    Acute Sinusitis
  39. Sinusitis for 4-12 weeks
    Subacute Sinusitis
  40. Sinusitis for >12 weeks
    Chronic Sinusitis
  41. Same as acute (S. pneumo, H. flu, M. cat., S. aureus); Klebsiella, Pseudomonas, Proteus, Enterobacter; Consider anaerobic and fungal etiologies. Consider antibiotic resistance as cause; Culture and sensitivity
    Subacute/Chronic Sinusitis
  42. is a bacterial skin infection that occurs on the face. The infection is characterized by swelling, redness, warmth, and pain.
    Facial cellulitis
  43. a bacterial infection of the skin and soft tissue that surrounds the eye
    Peri-orbital cellulitis
  44. redness, swelling, and tenderness of the skin around the eye.
    Peri-orbital cellulitis
  45. A circumscribed collection of pus within the orbit; frequently an extension of purulent infection of the paranasal sinuses, usually the ethmoids.
    Orbital Abscess
  46. Differential Diagnosis: Post-nasal drip; Viral pharyngitis; Group A strep; Tonsillitis; Mononucleosis; Peritonsillar abscess; Rare: gonorrhea, HSV, HIV
    Sore Throat
  47. adenovirus, coronavirus, rhinovirus, influenza, parainfluenza, coxsackievirus
    Viral Pharyngitis
  48. Erythema; Edema; Dysphagia; Pain; Fever; Lymphadenopathy; Upper respiratory illness symptoms; Resolves in 3-7 days
    Viral Pharyngitis
  49. an inflammation of the pharynx caused by infection from Streptococcus. Spread by direct contact from person-to-person
    Strep Pharyngitis
  50. indicated by the presence of a sore and/or red throat, an impaired ability to swallow, sudden onset of fever, and the swelling of the lymph nodes.
    Strep Pharyngitis
  51. Can be viral or bacterial: Common bacteria Group A Strep pyogenes
    Acute Tonsillitis
  52. Sore throat; Dysphagia and Odynophagia; Erythema (w/ or w/o exudate); Airway obstructive symptoms; Tender lymphadenopathy
    Acute Tonsillitis
  53. Treat initially with GP (strep/staph) coverage; PenVK, Bicillin injection, Amox/clauv, EES, SMX/TMP
    Acute Tonsillitis
  54. A collection of mucopurulent material in the peritonsillar space; Often follows tonsillitis
    Peritonsillar Abscess
  55. Severe throat pain and dysphagia; Inability to open jaw; Asymmetric swelling; Copious salivation; “Hot potato” voice
    Peritonsillar Abscess
  56. “Hot potato” voice
    Peritonsillar Abscess
  57. Incision and Drainage; Antibiotics with anaerobic cov.; Augmentin; Clindamycin
    Peritonsillar Abscess tx
  58. EBV- Epstein Barr Virus; CMV- Cytomegalovirus
    Mononucleosis pathogens
  59. Fatigue; Malaise; Sore throat with tonsillar; edema/erythema/exudate; Lymphadenopathy; Hepatosplenomegaly
    Mononucleosis S&S
  60. Monospot (heterophile antibody test); CBC diff may show atypical lymphocytes
    Mononucleosis labs
  61. OTC, pain control, consider steroids, avoid contact sports, seatbelt counseling
    Mononucleosis Treatment
  62. fever, chills, facial pain, neck pain, and pain under the tongue pain and chin
    Ludwig’s Angina S&S
  63. Cellulitis of the submandibular spaces of the mouth, usually spreading to the sublingual and submental spaces.
    Ludwig’s Angina
  64. Airway Management; IV antibiotics; Surgical
    Ludwig’s Angina
  65. Cervical Adenitis; Abscess; Sialodentitis; Cat Scratch
    Infectious/Inflammatory Neck Mass
  66. Thyroglossal Duct Cyst, Branchial Cleft Cyst
    Congenital Neck Mass
  67. Lipoma, Neuroma, Fibroma
    Neoplasm Benign Neck Mass
  68. Lymphoma, Salivary, Thyroid, metastasis
    Neoplasm Malignant Neck Mass
  69. Goiter Thyroid cyst
    Metabolic Neck Mass
  70. a fibrous cyst that forms from a persistent thyroglossal duct
    Thyroglossal Duct Cyst
  71. this is a cavity that is a remnant from embryologic development present at birth in one side of the neck just in front of the large angulated muscle on either side (the sternocleidomastoid muscle).
    Branchial Cleft Cyst
  72. A highly vascular ovoid body of chemoreceptive tissue lying adjacent to the TYMPANIC CAVITY; site of a rare neoplasm
    Glomus tympanicum
  73. a chemodectoma involving the tympanic body
    Glomus jugulare
  74. Osteoma
    benign Nasal Tumors
  75. Squamous papilloma
    benign Nasal Tumors
  76. Inverted papilloma
    pre-malignant Nasal Tumors
  77. Adolescent males with unilateral epistaxis, nasal tumor
    Juvenile angiofibroma
  78. Squamous Cell Carcinoma
    Nasal Tumors
  79. Adenoid hypertrophy
    Nasopharyngeal Mass
  80. Thornwald Cyst
    Nasopharyngeal Mass
  81. Mucocele
    Nasopharyngeal Mass
  82. Squamous Cell Carcinoma
    Nasopharyngeal Mass
  83. Lymphoma
    Nasopharyngeal Mass
  84. Torus
    Oral Tumors and Lesions
  85. Leukoplakia
    Oral Tumors and Lesions
  86. Erythroplakia
    Oral Tumors and Lesions
  87. Lichen Planus
    Oral Tumors and Lesions
  88. Oral Candida
    Oral Tumors and Lesions
  89. Aphthous Ulcer
    Oral Tumors and Lesions
  90. Squamous Cell Carcinoma
    Oral Tumors and Lesions
  91. adherent white plaques or patches on the mucous membranes of the oral cavity, including the tongue
    Leukoplakia
  92. chronic red oral mucosal patch usually not attributed to traumatic, vascular or inflammatory causes but frequently caused by epithelial dysplasia, ca in situ, or squamous cell carcinoma
    Erythroplakia
  93. chronic mucocutaneous disease that affects the skin and the oral mucosa, and presents itself in the form of papules, lesions or rashes
    Lichen Planus
  94. canker sore, is a type of oral ulcer, which presents as a painful open sore inside the mouth or upper throat (including uvula) caused by a break in the mucous membrane
    Aphthous Ulcer
  95. ear
    Otology
  96. Treat with I&D, then bolster both sides with dental rolls.
    Auricular Hematoma
  97. Failure to treat early can lead to permanent remodeling of the auricle in a Auricular Hematoma
    cauliflower ear.
  98. Remove purulent debris; Suction, If the canal is too narrow, insert a wick; Topical Antibiotic Drops:
    Treatment of Bacterial OE
  99. OE that causes temporal bone destruction; Usually caused by Pseudomonas aeruginosa
    Malignant Otitis Externa
  100. OE Seen in diabetics and immunocompromised patients; Diagnosed by Gallium uptake scan
    Malignant Otitis Externa
  101. usually very itchy; can look like bacterial infections
    Acute Fungal OE
  102. infections if antibiotic drops fail to resolve the problem
    Acute Fungal OE
  103. Remove Debris; Topical: Acetic acid/Hydrocortisone ear drops, Antifungal drops (Clotrimazole), Gentian Violet
    Acute Fungal OE
  104. Scarring of the tympanic membrane, Generally benign, but may cause a conductive hearing loss if severe.
    Myringosclerosis
  105. Causes: Nasal Allergy, URI, Nasopharynx mass, Anatomic
    • Eustachian Tube Dysfunction
    • and tympanic membrane retraction
  106. Symptoms: Ear Pain, Hearing Loss, Ear Fullness
    • Eustachian Tube Dysfunction
    • and tympanic membrane retraction
  107. If acute ETD, counsel patience and time, Nasal steroid spray, If ETD is chronic and hearing loss is present, bilateral myringotomy with tube placement
    ETD treatment
  108. Otitis Media with Effusion
    Serous Otitis Media
  109. Causes: Chronic ETD, Acute OM, Barotrauma
    • Otitis Media with Effusion
    • (aka Serous Otitis Media)
  110. Symptoms: Hearing Loss, Ear Fullness, Tinnitus
    • Otitis Media with Effusion
    • (aka Serous Otitis Media)
  111. Nasal steroids; Myringotomy with tube placement if not better in 3-4 months.
    • Otitis Media with Effusion
    • (aka Serous Otitis Media)
  112. Symptoms: Ear Pain, Hearing Loss, Tinnitus, Ear Fullness
    Acute Otitis Media (AOM)
  113. Treated with oral antibiotics
    Acute Otitis Media (AOM)
  114. Symptoms: Hearing loss, Tinnitus, Otorrhea, Ear pain if acute
    TM Perforation
  115. Treatment: Watchful waiting, Treat infections with topical drops (quinolones only), Tympanoplasty; Paper patch, Temporal muscle fascia graft
    TM Perforation
  116. Occurs in the presence of a TM perforation or tympanostomy tube
    Chronic Suppurative OM
  117. Middle ear infection with otorrhea through the perforation
    Chronic Suppurative OM
  118. Treat with topical antibiotic drop (quinolone only), May need surgery
    Chronic Suppurative OM
  119. Non-cancerous skin cyst
    Cholesteatoma
  120. Can arise from retraction pocket or after the middle ear is seeded with skin cells following perforation
    Cholesteatoma
  121. Causes a conductive hearing loss, Destroys bone through enzymatic action, Requires surgical excision
    Cholesteatoma
  122. Etiology: Thought to be viral vs. Mycoplasma, S. pneumo, H. flu
    Bullous Myringitis
  123. Symptoms: Severe ear pain, especially when sneezing, coughing, laughing, Yellow, clear otorrhea, Hearing loss
    Bullous Myringitis
  124. Treatment: Watchful waiting, Topical antibiotic drops, Oral antibiotics with atypical coverage (clarithromycin)
    Bullous Myringitis
  125. Ear Pain
    Otalgia
  126. Hypertension, Atherosclerosis, Diabetes Mellitus, Stroke, Sickle Cell
    Vascular (SNHL)
  127. Lyme Disease, Syphilis, HIV, Labyrinthitis (Viral), Bacterial Toxins, HSV, Meningitis
    Infectious (SNHL)
  128. Acoustic Neuroma, Cancer Metastasis to Temporal Bone
    Neoplasm (SNHL)
  129. Ototoxicity, General Anesthesia
    Drugs (SNHL)
  130. Sudden Sensorineural Hearing Loss
    Idiopathic (SNHL)
  131. Absent 8th Cranial Nerve, Intrauterine Infection, Syndromes, Teratogens, Hypoxia, Prematurity, Low Birth Weight, Hyperbilirubinemia
    Congenital (SNHL)
  132. Multiple Sclerosis, Autoimmune Hearing Loss, SLE, Giant Cell Arteritis
    Autoimmune/Allergy (SNHL)
  133. Noise Induced Hearing Loss, Temporal Bone Fracture, Radiation Therapy
    Trauma (SNHL)
  134. Hypothyroidism, Ménière’s, Presbycusis, Cochlear Otosclerosis
    Endocrine/Metabolic/Misc (SNHL)
  135. Any abnormal sound in the ear
    Tinnitus
  136. Only the patient can hear
    Subjective Tinnitus
  137. Examiner may be able to hear
    Objective Tinnitus
  138. pharyngeal muscle spasm
    Objective Tinnitus - Clicking
  139. patulous eustachian tube
    Objective Tinnitus - Breathing
  140. referred vascular sounds vs. tumor
    Objective Tinnitus - Pulsatile
  141. No impression of movement, Imbalance/Disequilibrium, Lightheadedness, Pre-syncope
    Dizziness
  142. False impression of movement; Rotational dizziness, Elevator sensation, Tilting room
    Vertigo
  143. Vertigo which lasts less than a minute, Intermittent
    Benign Paroxysmal Positional Vertigo (BPPV)
  144. Provoked by supine head movements to the right or left
    Benign Paroxysmal Positional Vertigo (BPPV)
  145. Caused by displaced otoliths in the semicircular canals, Positive Dix-Hallpike maneuver
    Benign Paroxysmal Positional Vertigo (BPPV)
  146. A disorder of increased endolymphatic fluid pressure
    Ménière’s Disease
  147. Classic Triad- Episodic SNHL, Vertigo x hours, and Roaring Tinnitus
    Ménière’s Disease
  148. SNHL is low-frequency, usually unilateral.
    Ménière’s Disease
  149. Treatment: Diuretics, Low sodium diet, Anti-vertigo medication, Surgery (to prevent vertigo)
    Ménière’s Disease
  150. Infection or inflammation of the inner ear.
    Vestibular Neuritis/ Labyrinthitis
  151. affects semicircular canals only
    V. Neuritis
  152. vertigo and hearing loss
    Acute Labyrinthitis
  153. Vertigo is severe, lasts 24-48 hours, is disabling. Vertigo subsides and the patient will have several weeks of imbalance
    Vestibular Neuritis/ Labyrinthitis
  154. Treat with steroids and physical therapy
    Vestibular Neuritis/ Labyrinthitis
  155. Slow growing non-cancerous tumors arising from Schwann cells on 7th/8th Nerve
    Acoustic Neuroma
  156. Causes Asymmetric SNHL (any slope possible)
    Acoustic Neuroma
  157. Early Symptoms: asymmetric hearing loss, tinnitus, imbalance (not vertigo)
    Acoustic Neuroma
  158. Late Symptoms: Due to brainstem compression
    Acoustic Neuroma
  159. Diagnosed with MRI of Internal Auditory Canals with contrast
    Acoustic Neuroma
  160. Treatment includes: observation, stereotactic radiation, and/or surgery.
    Acoustic Neuroma
  161. lasts seconds, head movements, no hearing loss
    BPPV
  162. lasts several hours, associated hearing loss, tinnitus, ear fullness
    Ménière’s
  163. lasts 1-2 days, gradual recovery
    Neuritis/Labyrinthitis
  164. Years, Imbalance, with unilateral hearing loss
    Acoustic Neuroma-
  165. flashes of light
    Photopsias
  166. loss of night vision
    Nyctalopia
  167. double vision
    Diplopia
  168. Light focuses on the retina
    Emmetropia
  169. Focal point falls outside of retinal plane
    Ametropia
  170. Nearsighted
    Myopia
  171. Light focuses in front of the retina
    Myopia
  172. Farsighted
    Hyperopia
  173. Light focuses beyond the retina
    Hyperopia
  174. Light does not focus to a point
    Astigmatism
  175. Decrease in the ability to focus near
    Presbyopia
  176. Over 40 syndrome
    Presbyopia
  177. Corrected with concave lens (diverges light)
    Myopia
  178. Written as a minus prescription: -3.00
    Myopia
  179. Corrected by a convex lens (converges light)
    Hyperopia
  180. Written as a plus prescription: +3.00
    Hyperopia
  181. May “worsen” with age as accommodation lost
    Hyperopia
  182. Treatments: Glasses, Contact lenses, Lens implant, Surgical correction (laser)
    Refractive errors
  183. Comparison between normal and patient
    Snellen Acuity
  184. Trial frames, phoropters and pinholes
    Refraction
  185. Normal range 10-21mmHg
    Intraocular pressure (IOP)
  186. Visual Fields: superior
    50 degrees
  187. Visual Fields: nasal
    60 degrees
  188. Visual Fields: inferiorly
    70 degrees
  189. Visual Fields: temporally
    90 degrees
  190. Hirschberg light reflex
    tropia
  191. Cover-Uncover Test
    tropia
  192. Alternating cover test
    phoria
  193. used to measure deviation
    Prisms
  194. Horizontal misalignment; Visual axes form a divergent angle; eyes diverge- as one eye fixates, the other eye is turned outward
    Strabismus - Exotropia
  195. Refractive error, Cataracts, Diabetic retinopathy, Macular Degeneration, Glaucoma, CVA
    Persistent loss of vision
  196. Migraine, Transient ischemic attack, Dry eyes
    Transient loss of vision
  197. TIA, CVA, Tumor, Glaucoma, Retinitis Pigmentosa, Optic Neuritis, Optic Neuropathy
    Loss of Visual Field
  198. Physiological, Hemorrhage, Retinal detachment, Vitreous detachment, Uveitis
    Floaters
  199. Vitreous traction, Migraine, Occipital Ischemia, Detached retina
    Photopsias (flashes of light)
  200. Refractive error, Aging, Cataracts, Retinitis Pigmentosa, Vitamin A deficiency
    Nyctalopia (loss of night vision)
  201. Strabismus, Cranial nerve palsies, Restrictive/ Mechanical
    Diplopia
  202. Conjunctivitis, Iritis, Foreign body, Corneal abrasion, Corneal ulcer, Dry eyes, Herpetic keratitis
    Itching, redness, discharge, irritation
  203. Horizontal misalignment; Visual axes form a convergent angle; The eyes are crossed- as one eye fixates, the other eye is turned inward
    Strabismus - Esotropia
  204. Decreased vision in one or both eyes
    Amblyopia
  205. Also called “lazy eye”
    Amblyopia
  206. decrease in vision for which no explanation can be found on physical examination; Can be binocular but usually is monocular
    Amblyopia
  207. Etiology: the result of disuse from reduced or inadequate foveal or peripheral retinal stimulation.
    Amblyopia
  208. Main Causes: Anisometropia, strabismus, media opacities
    Amblyopia
  209. Innervates levator palpebral muscle
    ptosis
  210. Pupillary constrictor muscle
    mydriasis
  211. passes under tentorial ridge in brain and susceptible to uncal herniation (look for elevated ICP)
    CNIII
  212. Ptosis; Eye down and out; Unable to elevate, depress, adduct (turn inward); Look for pupil involvement (dilated)
    Cranial Nerve III Palsy
  213. Innervates levator palpebral muscle (ptosis)Inferior oblique: medial, inferior, and superior recti (eye turns down and out; Pupillary constrictor muscle (mydriasis)
    Third cranial nerve palsy
  214. Superior oblique palsy; Cannot look down and in; Will cause torsional diplopia; Hypertropia; Compensatory head tilt(contralateral to site of palsy); May be bilateral or congenital
    Fourth cranial nerve palsy
  215. Vertical deviation; Patient with oblique diplopia; Hypertropia (elevated) eye worse in ipsilateral head tilt and opposite gaze (adduction); Usually from ischemia; also minor head trauma, tumor
    Cranial nerve IV palsy
  216. Lateral rectus muscle palsy; Cannot adduct eyes; May be congenital; May mimic strabismus
    Sixth cranial nerve palsy
  217. Unable to abduct (turn out) eye; Usually ischemic; Can also be from moderate head trauma, elevated ICP, tumor, aneurysm, MS
    Cranial nerve VI palsy
  218. Thyroid Eye Disease; Retraction of eyelids; Prominent globes; Diplopia; Corneal exposure; Possible optic neuropathy
    Grave’s Disease
  219. Superior oblique palsy
    Fourth cranial nerve palsy
  220. Hypertropia (elevated) eye worse in ipsilateral head tilt and opposite gaze (adduction)
    Cranial nerve IV palsy
  221. Lateral rectus muscle palsy
    Sixth cranial nerve palsy
  222. Cannot adduct eyes
    Sixth cranial nerve palsy
  223. Cannot look down and in
    Fourth cranial nerve palsy
  224. Unable to abduct (turn out) eye
    Cranial nerve VI palsy
  225. Drooping of one or both eyelids; Usually age-related, involutional
    Ptosis
  226. If sudden ptosis, consider 3rd nerve palsy
    Horner’s syndrome
  227. If new and variable ptosis
    myasthenia gravis
  228. sebaceous glands located in the tarsal plates along the eyelid margins
    Meibomian
  229. sebaceous glands located on the margin of the eyelid.
    Zeis
  230. Chronic inflammation of the eyelid
    Blepharitis
  231. Burning, watering, foreign body sensation, crusting & matting of the lashes and medial canthus, red lids, red eyes, photophobia, pain, decreased vision
    Blepharitis
  232. Posterior Blepharitis: Involves the meibomian gland orifices
    Meibomian Gland Disease
  233. Involves the eyelashes & follicles; can be Staphylococcal or Seborrheic
    Anterior Blepharitis:
  234. Pathophysiology: Direct microbial invasion of the lid tissue; Damage caused by bacterial toxins; waist products & enzymes, Immune system-mediated damage
    Blepharitis
  235. Three steps: Warm soaks, Lid scrubs, Baby shampoo and/or warm water, Antibiotic ointment (anti-staphylococcal)
    Blepharitis: treatment
  236. Refractory cases: Low dose oral antibiotics (long term)Topical antibiotics (short term)Topical corticosteroids (short term)
    Blepharitis: treatment
  237. Focal, chronic, lipogranulomatous inflammation of the Zeis or meibomian glands
    Chalazion
  238. Underlying meibomitis
    Chalazion
  239. Stasis of the secretions leads to the contents of the glands (sebum) being released into the tarsus/ adjacent tissues to incite a noninfectious inflammatory reaction
    Chalazion
  240. often evolve from internal hordeola
    Chalazion
  241. Usually self limited; May impress on cornea; Incision and curettage
    Chalazion- treatment
  242. glands of Zeis
    External hordeolum (stye)
  243. stye
    External hordeolum
  244. meibomian glands
    Internal hordeolum
  245. Usually there is an underlying meibomitis; Stasis of the secretions leads to secondary infection
    Hordeolum
  246. Usually Staphylococcus aureus
    Hordeolum
  247. Usually self limited; Treatment: 4 levels[Eyelid hygiene- warm soaks & lid massages; Topical antibiotic ointment; Systemic antibiotics- If complicated by preseptal cellulitis; Incision & drainage if refractory to medical therapy]
    Hordeolum-treatment
  248. Infection limited to the eyelid
    Preseptal Cellulitis
  249. Infection involving the structures posterior to the orbital septum
    Orbital Cellulitis
  250. Signs include: proptosis, pain with eye movement, restricted motility, deceased vision, fever, decreased sensation along V1
    Orbital Cellulitis - signs
  251. An abnormal outward turning of the lid margin
    Ectropion
  252. Seen in elderly; Look for corneal drying; Can cause tearing, cosmetic problem; May require surgery
    Ectropion
  253. Seen in older people; Look for corneal abrasion from lashes; May need surgical correction
    Entropion
  254. Misdirection of the eyelashes toward the globe
    Trichiasis
  255. Epiphora (watering eyes); Usually in infants, but can occur in adults
    Lacrimal Duct Stenosis
  256. Infection of the Lacrimal sac
    Dacryocystitis
  257. Painful swelling in the lower nasal canthal area
    Dacryocystitis
  258. Infection of the Lacrimal gland
    Dacryoadenitis
  259. Painful swelling in the temporal upper lid
    Dacryoadenitis
  260. Usually staphylococcus
    Dacryocystitis
  261. May be acute or chronic; usually unilateral, Systemic antibiotics; May need surgery to relieve obstruction
    Dacryocystitis
  262. A red eye indicates
    ocular inflammation
  263. The redness is caused by
    blood vessel dilation
  264. Involves branches of the anterior ciliary arteries
    Ciliary Injection:
  265. Indicates inflammation of the cornea, iris or ciliary body
    Ciliary Injection:
  266. Mainly affects the posterior conjunctival blood vessels
    Conjunctival Injection:
  267. More superficial than ciliary vessels; Produce more redness; Move with the conjunctiva; Constrict with topical vasoconstrictors
    Conjunctival Injection:
  268. Inflammation of the eyelids; Often associated with conjunctivitis
    Blepharitis
  269. Mildly red eye (usually unilateral); Chronic, usually over age 50; “Pouting punctum”; Slight discharge- Discharge can be expressed from the punctum
    Canaliculitis
  270. Characterized by vascular, cellular infiltration, and exudation
    Conjunctivitis:
  271. More purulent discharge
    Conjunctivitis: Bacterial
  272. Follicles on palpebral conjunctiva; Preauricular node- large and tender
    Conjunctivitis: Viral
  273. Papillary reaction on palpebral conjunctiva; Pruritus; Hx of allergic disease
    Conjunctivitis: Allergic
  274. Localized pain, edema, and erythema (redness) over lacrimal sac at the medial canthus; Usually unilateral; Often purulent discharge from the puncta
    Dacryocystitis:
  275. Decreased vision and photophobia; Severe eye pain; Epithelial defect may be evident - may require fluorescein; May be accompanied by anterior chamber reaction; Any opacification of the cornea in a red eye
    Corneal inflammation or infection:
  276. Must be differentiated from injection of the more superficial conjunctival vessels and from deeper scleral vessels; Inflammation tends to be limited to an isolated patch; Hx of recurrent episodes is common; Mild to moderate tenderness
    Episcleritis
  277. Mild to moderate to severe pain; Eye should be stained with fluorescein to detect corneal abrasion; Lid should always be everted; Penetration of the globe must be excluded by slit lamp examination and dilation
    Superficial Foreign Body:
  278. On slit lamp examination: Cells and Flare in the anterior chamber
    Iritis:
  279. “Perilimbal flush” (cornea/scleral junction); DDX: conjunctivitis -where intensity of the vascular engorgement decreases toward the limbus; Usually unilateral; Direct and consensual photophobia
    Iritis:
  280. Slit lamp examination: Corneal edema, anterior chamber/corneal thickness ratio, mild cell and flare
    Acute angle-closure Glaucoma:
  281. Severe pain; Colored haloes around lights- common; Age- usually older than 50; Pupil may be: Mid-dilated, Vertically oval & Non-reactive to light; Nausea & vomiting common; IOP is elevated ( normal range- 21 and under)
    Acute angle-closure Glaucoma:
  282. Eyelids sticking together on waking; Itching and burning; Gritty foreign body sensation; Mucus /pus effects vision but visual acuity is normal; Photophobia is minimal
    Conjunctivitis
  283. Most commonly: staphylococcal & streptococcal
    Bacterial Conjunctivitis
  284. Preauricular adenopathy -sometimes occurs Chemosis( thickened, boggy conj.)- common Discharge- copious, thick and purulent Injection-moderate to marked
    Bacterial Conjunctivitis
  285. Microbial infection of the mucous membrane of the surface of the eye; Usually self limited and benign
    Bacterial Conjunctivitis
  286. STI: N. gonorrhea and Chlamydia -Sexual transmission; Newborns exposed during birth(Elderly pt: Increased susceptibility to infections)
    Bacterial Conjunctivitis
  287. Minimal pain; Pruritus is common; Exposure HX: Clear watery discharge; epiphora or mucous; Occasionally severe photophobia and F/B sensation
    Viral Conjunctivitis
  288. also cause follicular conjunctivitis and preauricular adenopathy
    HSV and Chlamydia
  289. Associated viral illness; Preauricular adenopathy; Chemosis - variable; Discharge – copious, watery, scant exudate, Injection
    Viral Conjunctivitis
  290. Viral infection of the mucous membrane of the surface of the eye
    Viral Conjunctivitis
  291. Adenovirus- the most common; Herpes simplex (HSV)- the most problematic
    Viral Conjunctivitis
  292. Varicella-zoster (VZV); Poxvirus( molluscum contagiosum, vaccinia-rare now); Human immunodeficiency virus (HIV)
    Viral Conjunctivitis
  293. Usually acute, benign and self limited; Longer course than bacterial conjunctivitis(2-4 weeks)
    Viral Conjunctivitis
  294. Characterized by: Acute follicular reaction, Preauricular adenopathy
    Viral Conjunctivitis
  295. Acute or subacute onset; No pain; No exposure history; Pruritus- extremely common; Discharge- clear, watery, w/or w/out moderate mucus
    Allergic Conjunctivitis
  296. Pruritus; Preauricular adenopathy- absent; Discharge – moderate, stringy or sparse, clear; Injection-moderate
    Allergic Conjunctivitis
  297. Chronic wing shaped growth; Can become inflamed or grow into the visual axis
    Pterygium
  298. Treatment: topical; Topical antihistamines; Mast Cell Stabilizers; Corticosteroids; NSAIDS
    Allergic Conjunctivitis
  299. Yellowish conjunctival nodule; Usually on nasal side and bilateral; Commonly due to exposure to elements; Does not interfere with sight
    Pinguecula
  300. History of trauma; Recurrent erosions
    Corneal abrasion
  301. History of trauma
    Corneal foreign body
  302. Pain, tenderness, photophobia, tearing; Purulent or watery discharge; Infection; Trauma; Contact lens use; Exposure
    Corneal ulcer
  303. Dendritic ulcerations; Lid lesions; Reoccurrences; Corneal scarring; (Do not use corticosteroids: refer for treatment)
    Herpes simplex keratitis
  304. Frequently involves ophthalmic branch of trigeminal nerve; Neurotrophic keratitis; Chronic uveitis
    Herpes Zoster Ophthalmicus
  305. Inflammation of the uvea (iris, ciliary body, choroid)
    Uveitis
  306. iris, ciliary body, choroid
    uvea
  307. Symptoms: redness, pain, photophobia, decreased vision
    Uveitis
  308. The most treatable cause of blindness worldwide
    Cataracts
  309. A clouding (opacity) of the lens of the eye that typically occurs with age
    Cataracts
  310. Can also be found after trauma, congenitally, in association with other systemic (diabetes) or ocular disease, from medications (steroids) or radiation, UV light, cigarette smoking
    Cataracts
  311. No pain or redness; Gradual loss of vision
    Cataracts
  312. Gradual progressive thickening of the lens; Gradual progressive loss of transparency of the lens
    Senile cataract
  313. Treatment depends on severity of visual loss: Do nothing; Change glasses; Surgical removal
    Cataracts
  314. is responsible for the most acute vision, color perception
    Macula
  315. Early stages may produce reduction of vision or distortion rather than scotoma
    Macular Degeneration
  316. Leading cause of blindness in the USA over age 65; More common in Caucasians
    Macular Degeneration
  317. Complaints of: Blurred vision; Metamorphopsia (distorted visual loss); Central scotoma; Difficulty reading and recognizing faces
    Acute Macular Degeneration (AMD)
  318. When choroidal vessels penetrate damaged Bruch’s membrane, subretinal neovascularization occurs
    Acute Macular Degeneration (AMD)
  319. When leakage occurs, subretinal hemorrhage results
    Acute Macular Degeneration (AMD)
  320. Soft drusen; Chorioretinal atrophy, RPE hyperpigmentation
    Acute Macular Degeneration - Dry (non exudative) 90%
  321. Subretinal fluid/ hemorrhage; Choroidal neovascular membranes; Disciform scars; Primary cause of blindness in Acute Macular Degeneration
    Acute Macular Degeneration - Wet (exudative) 10%
  322. Amsler grid; Diet; fruits and vegetables; High in lutein and zeaxanthin (xanthophylls in macula); High LDL and low HDL cholesterol increase risk; Long chain omega 3 fatty acids; Supplements (Vit C, Vit E, Beta carotene, Zinc Oxide, Copper)
    Treatment Non exudative AMD :
  323. Laser; Photodynamic therapy; Intraocular injectables; Surgery (sub macular surgery, macular translocation)
    Treatment Exudative AMD
  324. Retinitis pigmentosa; Diabetic retinopathy (post PRP); Retinal detachment; Choroideremia
    Peripheral retinal diseases
  325. Complaints of new flashes, floaters, veil obscuring part or all of the vision
    Retinal Detachment
  326. “Curtain” spreading over vision
    Retinal detachment
  327. Usually due to retinal tear(s); Spontaneous, seen more likely over 50; “Curtain” spreading over vision; May have sudden loss of vision; No pain or redness; Surgical treatment(s); Refer emergently/urgently
    Retinal detachment
  328. African-Americans affected 4-5 times more frequently than Caucasians
    Glaucoma
  329. An optic neuropathy usually caused by elevated intraocular pressures
    Glaucoma
  330. Damage to retinal ganglion cells; Elevated IOP; Impeding axoplasmic flow within nerve or reduction of blood flow to the nerve
    Glaucoma
  331. vertical and horizontal dimensions (nl <0.4)
    Cup to disk ratio
  332. Progressive Visual Field loss
    Glaucoma
  333. Most common, chronic; Gradual loss of peripheral vision; Target IOP 30% reduction; Glaucoma suspect-Ocular hypertension & Abnormal nerve appearance; Vision loss is permanent; Normal tension glaucoma; Screening for this is crucial!
    Primary Open Angle Glaucoma
  334. Acute, chronic, or intermittent; May be precipitated by medications; Anticholinergics and sympathomimetics; Pupillary dilation may precipitate
    Angle closure glaucoma
  335. Painful, red, congested eye; Nausea, vomiting; Blurred vision; Halos; Chronic may be asymptomatic; Occurs in small, hyperopic, older eyes, often female, Asian, Eskimo, Caucasian
    Acute Angle closure glaucoma
  336. High IOP (>30); Mid dilated sluggish pupil, Red eye; Corneal edema; Chronic/ intermittent may have peripheral anterior synechiae
    Acute Angle closure glaucoma
  337. decrease aqueous production
    Adrenergic agonists, Carbonic anhydrase inhibitors & Beta blockers
  338. Cholinergics
    increase trabecular outflow
  339. increase uveoscleral outflow
    Prostaglandin analogues
  340. Leading cause of blindness in ages 20-64
    Diabetic Retinopathy
  341. Symptoms: NONE; Blurring; Distortion of vision; Decreased night vision; Decreased color vision; Floaters
    Diabetic Retinopathy
  342. Microaneurysms; Dot and blot hemorrhages; Hard exudates; Venous beading; Intraretinal microvascular abnormalities; Cotton wool spots
    Diabetic Retinopathy - Non proliferative retinopathy:
  343. Neovascularization; Vitreous hemorrhage; Fibrous tissue along posterior vitreous adherent to the retina causing traction retinal detachment
    Diabetic retinopathy - Proliferative retinopathy
  344. Most common cause of loss of vision in diabetics
    Diabetic Macular Edema
  345. Retinal edema within 500 microns of fovea center
    Diabetic Macular Edema
  346. Hard exudates within 500 microns if associated with thickening
    Diabetic Macular Edema
  347. Treat with focal laser
    Diabetic Macular Edema
  348. Severe form of glaucoma; Difficult to treat. Requires extensive laser surgery; Often requires glaucoma surgery; Often results in blindness and pain
    Diabetic retinopathy -Neovascular glaucoma
  349. Prevention: Diabetic Control and Treatment Trial (DCCT); Glucose control; Blood pressure control; Lipid control
    Diabetic retinopathy: Treatment
  350. Cotton wool spots
    Hypertensive retinopathy
  351. Narrowing of the arterioles
    Hypertensive retinopathy
  352. Intraretinal hemorrhages
    Hypertensive retinopathy
  353. Retinal vein occlusion
    Hypertensive retinopathy
  354. Retinal artery occlusion
    Hypertensive retinopathy
  355. Retinal hemorrhages, retinal edema, cotton wool spots
    Branch retinal vein occlusion
  356. Dilated veins, swollen optic nerve, intraretinal hemorrhages, retinal edema; May lead to neovascularization
    Central retinal vein occlusion
  357. Sudden unilateral vision loss; No pain or redness
    Retinal Vein Occlusion
  358. Workup for hypertension, diabetes, hypercholesterolemia, blood dyscrasias, vasculitis
    Retinal Vein Occlusion
  359. Treat underlying disorder; Laser for macular edema; Laser for neovascularization
    Retinal Vein Occlusion
  360. Sudden unilateral vision loss; No pain or redness
    Retinal artery occlusion
  361. May see intraluminal plaque; Whitening of retina
    Branch retinal artery occlusion
  362. Sudden, severe, painless loss of vision; Must consider Giant Cell Arteritis
    Central retinal artery occlusion
  363. Pseudoephedrine
    Sudafed
  364. Oxymetazoline
    Afrin
  365. Phenylephrine
    Neo-Synephrine
  366. Diphenhydramine
    Benadryl
  367. Chlorpheniramine
    Chlor-Trimeton
  368. Loratadine
    Claritin
  369. Desloratadine
    Clarinex
  370. Fexofenadine
    Allegra
  371. Cetirizine
    Zyrtec
  372. Levocetirizine
    Xyzal
  373. Azelastine (also an antihistamine)
    Astelin (nasal spray)Optivar (ophthalmic solution)
  374. Epinastine
    Elestat (ophthalmic solution)
  375. Olopatadine
    Patanase (nasal spray)Patanol, Pataday (ophthalmic solution)
  376. Budesonide
    Rhinocort Aqua
  377. Ciclesonide
    Omnaris
  378. Fluticasone
    Veramyst
  379. Mometasone
    Nasonex
  380. Azithromycin
    AzaSite
  381. Ciprofloxacin
    Ciloxin
  382. Moxifloxacin
    Vigamox
  383. Tobramycin/dexamethasone
    TobraDex
  384. Brimonidine
    Alphagan P
  385. Dorzolamide/timolol
    Cosopt
  386. Bimatoprost
    Lumigan
  387. Latanoprost
    Xalatan
  388. Polymyxin B/Neomycin/Hydrocortisone(hydrochloric acid)
    Cortisporin Otic Solution
  389. Ciprofloxacin/dexamethasone
    Ciprodex Otic
  390. Class: Pseudoephedrine/ Sudafed
    Decongestants
  391. Class: Oxymetazoline/ Afrin
    Decongestants
  392. Class: Phenylephrine/ Neo-Synephrine
    Decongestants
  393. Class: Diphenhydramine/ Benadryl
    Antihistamines
  394. Class: Chlorpheniramine/ Chlor-Trimeton
    Antihistamines
  395. Class: Loratadine/ Claritin
    Antihistamines
  396. Class: Desloratadine/ Clarinex
    Antihistamines
  397. Class: Fexofenadine/ Allegra
    Antihistamines
  398. Class: Cetirizine/ Zyrtec
    Antihistamines
  399. Class: Levocetirizine/ Xyzal
    Antihistamines
  400. Class: Azelastine (also an antihistamine)/ Astelin (nasal spray) Optivar (ophthalmic solution)
    Mast cell stabilizers
  401. Class: Epinastine/ Elestat (ophthalmic solution)
    Mast cell stabilizers
  402. Class: Olopatadine/ Patanase (nasal spray)Patanol, Pataday (ophthalmic solution)
    Mast cell stabilizers
  403. Class: Budesonide/Rhinocort Aqua
    Intranasal Corticosteroids
  404. Class: Ciclesonide/Omnaris
    Intranasal Corticosteroids
  405. Class: Fluticasone/ Veramyst
    Intranasal Corticosteroids
  406. Class: Mometasone/ Nasonex
    Intranasal Corticosteroids
  407. Class: Azithromycin/ AzaSite
    Ophthalmic drops - Antibiotics
  408. Class: Ciprofloxacin/ Ciloxan
    Ophthalmic drops - Antibiotics
  409. Class: Moxifloxacin/ Vigamox
    Ophthalmic drops - Antibiotics
  410. Class: Tobramycin-dexamethasone/ TobraDex
    Ophthalmic drops - Antibiotics
  411. Class: Brimonidine/ Alphagan P
    Ophthalmic drops -Glaucoma
  412. Class: Dorzolamide-timolol/ Cosopt
    Ophthalmic drops -Glaucoma
  413. Class: Bimatoprost/ Lumigan
    Ophthalmic drops -Glaucoma
  414. Class: Latanoprost/ Xalatan
    Ophthalmic drops -Glaucoma
  415. Class: Polymyxin B/Neomycin/Hydrocortisone(hydrochloric acid)--Cortisporin Otic Solution
    Ophthalmic drops - Otic Drops
  416. Class: Ciprofloxacin-dexamethasone/ Ciprodex Otic
    Ophthalmic drops - Otic Drops
  417. vocal cords are _____ to breath
    abducted
  418. vocal cords are ____ to speak
    adducted
  419. Visualization of the larynx either indirectly or directly
    Laryngoscopy
  420. The use of an instrument (mirror, angulated scope, or flexible scope) to visualize an image or reflection of the larynx
    Indirect Laryngoscopy
  421. Straight visualization of the larynx (no reflections)
    Direct Laryngoscopy
  422. Examiner has laryngeal mirror, head mirror, light source, mirror warmer
    Mirror Laryngoscopy
  423. Patient is seated in the “sniffing” position.
    Mirror Laryngoscopy
  424. Grasp the tongue with gauze, elevate the upper lip with finger
    Mirror Laryngoscopy
  425. Warm mirror is placed on the soft palate and uvula without pressing against the back of the throat or tonsils.
    Mirror Laryngoscopy
  426. ADVANTAGES: Can be done in exam room; No anesthesia required; Quick
    Mirror Laryngoscopy
  427. DISADVANTAGES: Can cause gag reflex; Image is not high quality; Cannot see entire larynx
    Mirror Laryngoscopy
  428. Nasal passages are topically decongested and anesthetized
    Flexible Fiberoptic Laryngoscopy
  429. The scope is passed through the most patent nasal passage.
    Flexible Fiberoptic Laryngoscopy
  430. The scope is passed through the most patent nasal passage.
    Flexible Fiberoptic Laryngoscopy
  431. ADVANTAGES: more comfortable than mirror exam and avoids the gag reflex. Better visualization of the entire upper airway; Better image quality than mirror exam. Can be done quickly in the clinic or on the floor.
    Flexible Fiberoptic Laryngoscopy
  432. DISADVANTAGES: Medicine tastes bad; Anesthesia can give sensation of choking; Visualization only, biopsy not available. Exam does not give mid-line view of larynx; Quality not as good as direct laryngoscopy
    Flexible Fiberoptic Laryngoscopy
  433. The need for better visualization of the larynx
    Indications for Direct Laryngoscopy
  434. To palpate the vocal cords(to distinguish between paralysis and fixation)
    Indications for Direct Laryngoscopy
  435. Treatment of the larynx (injection, etc)
    Indications for Direct Laryngoscopy
  436. Biopsy of the larynx
    Indications for Direct Laryngoscopy
  437. Prior to laryngeal intubation
    Indications for Direct Laryngoscopy
  438. A curved laryngoscope can be used to aid in laryngeal intubation; Under anesthesia, Avoid the teeth (which can break) and the lips (which can be pinched); Usually only performed by skilled clinicians.
    Direct Laryngoscopy
  439. is an inflammation of the larynx. It causes hoarse voice or the complete loss of the voice because of irritation to the vocal folds ...
    Acute Laryngitis
  440. also known as polypoid degeneration, is the swelling of the vocal folds due to fluid collection (edema). often seen in smokers
    Reinke’s Edema
  441. Good for showing air fluid levels in the maxillary and frontal sinuses.
    X-Ray
  442. Not good for showing mucosal thickening and soft tissue abnormalities.
    X-Ray
  443. 2 standard views: Waters (Maxillary) & Caldwell (Frontal)
    X-Ray
  444. Not a preferred modality for sinus imaging. Does not image detailed bone structures well
    MRI Sinus
  445. Mucosa can also be improperly represented giving the impression of inflammation in a normal patient.
    MRI Sinus
  446. is good for evaluating soft tissue abnormalities such as neoplasms, mucoceles, and encephaloceles.
    MRI Sinus
  447. The study of choice to evaluate nose/sinus structures
    Computed Tomography
  448. Best done when patient is maximally treated to reduce inflammation and evaluate underlying structures.
    Computed Tomography
  449. shows the Osteomeatal Complex (OMC) best; in the plane of surgical approach.
    Coronal CT without contrast
  450. Fine cuts (0.5mm) recommended to avoid missing abnormalities.
    Computed Tomography
  451. sinuses: Frontal, Maxillary, Ethmoid, Sphenoid
    Evaluate Anterior to Posterior
  452. All newborns have screening
    ABR or OAE
  453. Retest all newborns who fail screening
    within 3 months
  454. Eight Cranial Nerve
    Wave I
  455. Cochlear Nucleus
    Wave II
  456. Olivary Nucleus
    Wave III
  457. Lateral Lemniscus
    Wave IV
  458. Inferior Colliculus
    Wave V
  459. Waves VI and VI
    Medial Geniculate
  460. To determine Conductive versus Sensorineural loss in unilateral loss
    Weber
  461. To compare patient’s air and bone Conduction hearing
    Rinne
  462. Fork Placement: midline
    weber
  463. Fork Placement: Alternately between patient’s mastoid and entrance to ear canal
    Rinne
  464. Normal Hearing: Midline sensation; tone heard equally in both ears
    weber
  465. Normal Hearing: Tone louder at Ear.(Air Conduct > Bone Conduct)
    Positive Rinne
  466. Tone louder in poorer ear
    Conductive Loss weber
  467. Tone louder on Mastoid. (Bone Conduct > Air Conduct)
    Conductive Loss: negative Rinne
  468. Tone louder in better ear
    Sensorineural Loss weber
  469. Tone louder at Ear.(Air Conduction > Bone Conduct)
    Sensorineural Loss: positive Rinne
  470. 0-25 dB
    Normal Hearing Loss
  471. 25-45 dB
    Mild Hearing Loss
  472. 45-65 dB
    Moderate Hearing Loss
  473. 65-85 dB
    Severe Hearing Loss
  474. 85+ dB
    Profound Hearing Loss
  475. Normal Tympanogram.
    Tympanometry Type A
  476. Flat Tympanogram indicates perforation or fluid (due to ETD)
    Tympanometry Type B
  477. Negative pressure indicates Eustachian Tube Dysfunction (ETD).
    Tympanometry Type C
  478. Normal pressure equalization with a rigid TM
    Tympanometry Type AS
  479. Normal pressure equalization with flaccid TM/ ossicle disarticulation
    Tympanometry Type AD
  480. How quiet a patient recognize speech
    Speech Reception Threshold (SRT)
  481. How well a patient understands speech
    Speech Discrimination
  482. Normal Speech Discrimination is considered
    >88%
  483. Hypertension, Atherosclerosis, Diabetes Mellitus, Stroke, Sickle Cell
    Vascular (SNHL)
  484. Lyme Disease, Syphilis, HIV, Labyrinthitis (Viral), Bacterial Toxins, HSV, Meningitis
    Infectious (SNHL)
  485. Acoustic Neuroma, Cancer Metastasis to Temporal Bone
    Neoplasm (SNHL)
  486. Ototoxicity, General Anesthesia
    Drugs (SNHL)
  487. Sudden Sensorineural Hearing Loss
    Idiopathic (SNHL)
  488. Absent 8th Cranial Nerve, Intrauterine Infection, Syndromes, Teratogens, Hypoxia, Prematurity, Low Birth Weight, Hyperbilirubinemia
    Congenital (SNHL)
  489. Multiple Sclerosis, Autoimmune Hearing Loss, SLE, Giant Cell Arteritis
    Autoimmune/Allergy (SNHL)
  490. Noise Induced Hearing Loss, Temporal Bone Fracture, Radiation Therapy
    Trauma (SNHL)
  491. Hypothyroidism, Ménière’s, Presbycusis, Cochlear Otosclerosis
    Endocrine/Metabolic/Misc (SNHL)
  492. Sudden SNHL
    Unilateral SNHL
  493. Acute Labyrinthitis
    Unilateral SNHL
  494. Acoustic Neuroma
    Unilateral SNHL
  495. Ménière's Disease
    Unilateral SNHL
  496. Intracranial (Trauma, CVA)
    Unilateral SNHL
  497. Noise Induced Trauma
    Unilateral or bilateral SNHL
  498. HTN, DM, Atherosclerosis
    Bilateral SNHL
  499. Ototoxic Medications
    Bilateral SNHL
  500. Hypothyroidism
    Bilateral SNHL
  501. Presbycusis
    Bilateral SNHL
  502. Lyme, HIV, Syphilis
    Bilateral SNHL
  503. Autoimmune
    Bilateral SNHL
  504. Cerumen impaction, Foreign Body, Neoplasm/mass, Exostosis, Edema from Otitis Externa, Otorrhea, Congenital Atresia/Stenosis
    External Auditory Canal CHL
  505. Tympanosclerosis, Perforation, Retraction (atelectasis)
    Tympanic Membrane CHL
  506. Otitis Media with effusion, Hemotympanum, Acute OM, Cholesteatoma
    Middle Ear Space CHL
  507. Ossicular discontinuity, Otosclerosis, Ossicular Fixation/Malformation
    Ossicles CHL
  508. Bilateral, high frequency SNHL
    Presbycusis
  509. Onset is subtle, gradual, stable; Difficulty with social situations; Better in quiet environments; Treat with hearing aids
    Presbycusis
  510. Sudden or prolonged Noise exposure
    Noise Induced Hearing Loss
  511. Notched Audiogram 3000-6000Hz
    Noise Induced Hearing Loss
  512. Recovery high frequency; Unilateral or Bilateral; Loss is permanent; Advise Hearing protection
    Noise Induced Hearing Loss
  513. Acute onset of SNHL (<72 hours), 30db loss in at least 3 frequencies
    Sudden SNHL
  514. Small Ear Canal Volumes Bilaterally
    Cerumen Impaction
  515. Normal Ear Canal Volumes Bilaterally; The Patient has history of allergic rhinitis and recent viral URI
    Eustachian Tube Dysfunction with Otitis Media with Effusion and Acute Otitis Media
  516. Eustachian Tube Dysfunction with Tympanic Membrane Retraction Pockets
    Normal Ear Canal Volumes Bilaterally
  517. Tympanic Membrane Perforation
    Large Ear Canal Volumes Bilaterally
  518. Slow growing non-cancerous tumors arising from Schwann cells on 7th/8th Nerve
    Acoustic Neuroma
  519. Causes Asymmetric SNHL (any slope possible)
    Acoustic Neuroma
  520. Early Symptoms: hearing loss, tinnitus, imbalance, poor speech discrimination
    Acoustic Neuroma
  521. Late Symptoms: Due to brainstem compression
    Acoustic Neuroma
  522. Diagnosed with MRI of Internal Auditory Canals with contrast
    Acoustic Neuroma
  523. Treatment includes: observation, stereotactic radiation, and/or surgery.
    Acoustic Neuroma
  524. A disorder of increased endolymphatic fluid pressure
    Ménière's Disease
  525. Classic Triad- Episodic SNHL, Vertigo, and Tinnitus
    Ménière's Disease
  526. SNHL is low-frequency, unilateral.
    Ménière's Disease
  527. Diuretics, Low sodium diet, Anti-vertigo medication, Surgery (to prevent vertigo)
    Ménière's Disease treatment
  528. Patient history of: TM perforation; Ear Surgery; Pressure Equalization Tubes; Retraction Pockets
    Cholesteatoma
  529. Progressive Hearing Loss on the right with a positive Family History; Moderate CHL with “Carhart” notch
    Otosclerosis
  530. Schwartze Sign
    Otosclerosis
  531. Most common cause is Group A Streptococcus
    Pharyngitis
  532. Amoxicillin may be used in place of penicillin V
    Pharyngitis
  533. IgE mediated reaction to allergens Usually immediate and late-phase reactions
    Allergic Rhinitis
  534. Symptoms include clear rhinorrhea, sneezing, nasal congestion, postnasal drip, pruritic eyes/ears/nose/palate
    Allergic Rhinitis
  535. Complications include AOM, chronic middle ear effusions, asthma, dental/orthodontic problems, asthma, sinusitis, nasal polyps
    Allergic Rhinitis
  536. Symptoms Controlled: Sneezing, rhinorrhea, itching, conjunctivitis
    Systemic Antihistamines
  537. Symptoms Controlled: Conjunctivitis
    Ophthalmic Antihistamines
  538. Symptoms Controlled: Sneezing, rhinorrhea, nasal pruritus
    Intranasal Antihistamines
  539. Symptoms Controlled: Nasal congestion
    Systemic Decongestants
  540. Symptoms Controlled: Nasal congestion, Don’t use more than 3 days
    Topical Decongestants
  541. Symptoms Controlled: Sneezing, rhinorrhea, itching, nasal congestion, Can use for seasonal & perennial rhinitis
    Intranasal Corticosteroids
  542. Symptoms Controlled: Sneezing, rhinorrhea, nasal congestion, Use prior to exposure; blocks both early and late phase reactions
    Mast Cell Destabilizers (Cromolyn)
  543. Symptoms Controlled: rhinorrhea; Used only when other therapies fail
    intranasal Anticholinergics (Ipratropium, Cromolyn)
  544. inflammation of the conjunctiva
    Conjunctivitis
  545. Redness and yellow, white, or green discharge unilaterally or bilaterally
    Bacterial conjunctivitis
  546. Purulent discharge at the lid margins and in the corners of the eye
    Bacterial conjunctivitis
  547. Erythromycin ophthalmic ointment
    Bacterial conjunctivitis
  548. Sulfacetamide ophthalmic drops
    Bacterial conjunctivitis
  549. adenovirus most commonly
    Viral conjunctivitis
  550. Clear watery, scant and stringy discharge; burning, sandy, or gritty feeling in one eye; second eye usually affected within 24-48 hours
    Viral conjunctivitis
  551. Pus does not appear continuously at the lid margin and in the corners of the eye
    Viral conjunctivitis
  552. No specific agents available; Symptomatic relief with OTC antihistamine/decongestant drops
    Viral conjunctivitis
  553. local mast cell degranulation and release of chemical mediators including histamine, eosinophil chemotactic factors, and platelet-activating factor
    Allergic conjunctivitis
  554. Contact of airborne allergens with the eye
    Allergic conjunctivitis
  555. bilateral redness, watery discharge, and itching
    Allergic conjunctivitis
  556. diffuse injection with a follicular appearance to the tarsal conjunctiva and profuse watery or mucoserous discharge
    Allergic conjunctivitis
  557. may have morning crusting, clinical findings similar to viral conjunctivitis except for ITCHING
    Allergic conjunctivitis
  558. Antihistamine/decongestant drops OTC
    Allergic conjunctivitis
  559. Mast cell destabilizer/antihistamine
    Allergic conjunctivitis
  560. cromolyn sodium (Crolom, Opticrom) 1-2 drops 4-6 times daily, NSAID ophthalmic drop
    Allergic conjunctivitis
  561. Group of eye diseases characterized by elevated Intraocular Pressure
    Glaucoma
  562. Optic neuropathy results in progressive loss of retinal ganglion cell axons to visual field loss to blindness
    Glaucoma
  563. obstruction of the outflow of aqueous humor through the trabecular meshwork
    Acute angle closure glaucoma or narrow angle glaucoma
  564. Acute presentation with redness of the eye and eye pain
    Acute angle closure glaucoma or narrow angle glaucoma
  565. most common glaucoma
    Wide or open angle – (Primary open angle glaucoma)
  566. Optic nerve takes a hollowed-out appearance on ophthalmoscopic exam (“cupping”)- associated with loss of ganglion cell axons
    Wide or open angle – (Primary open angle glaucoma)
  567. Occurs gradually, with blockage of aqueous outflow despite a seemingly open space (chamber angle) in the front of the eye
    Wide or open angle – (Primary open angle glaucoma)
  568. At least 2 of the following symptoms: Ocular pain; Nausea/vomiting; History of intermittent blurring of vision with halos
    Acute angle closure glaucoma or narrow angle glaucoma
  569. At least 3 of the following signs: IOP > 21 mm HG; Conjunctival injection; Corneal epithelium edema; Mid-dilated non-reactive pupil
    Acute angle closure glaucoma or narrow angle glaucoma
  570. Acetazolamide; Topical beta-blocker
    Acute angle closure glaucoma or narrow angle glaucoma
  571. To relieve pupillary block
    pilocarpine
  572. Caution: could increase axial thickness of lens and induce anterior lens movement, worsening situation
    pilocarpine
  573. Reduces rate of aqueous humor formation by direct inhibition of carbonic anhydrase on secretory ciliary epithelium, causing a reduction in IOP
    Carbonic anhydrase inhibitors
  574. Oral forms can cause transient myopia, nausea, diarrhea, loss of appetite and taste, paresthesias, lassitude, renal stones, and hematological problems.
    Carbonic anhydrase inhibitors
  575. lower IOP by suppressing aqueous humor production
    Beta-adrenergic blockers
  576. Side effects include ocular irritation and dry eyes
    Beta-adrenergic blockers
  577. lower IOP by suppressing aqueous humor production
    Alpha-adrenergic agonists
  578. do not use if pt has received MAO inhibitors, precipitate optic nerve ischemia in those with advanced glaucomatous optic neuropathy; Caution in patients with cerebral or coronary insufficiency, Raynaud’s, postural hypotension, hepatic or renal impairment
    Alpha-adrenergic agonists
  579. reduce ocular inflammation
    Steroids
  580. Caution in hyperthyroidism, osteoporosis, cirrhosis, nonspecific ulcerative colitis, peptic ulcer, diabetes, and myasthenia gravis
    Prednisolone
  581. pull the peripheral iris tissue away from the trabecular meshwork helping to eliminate obstructed aqueous humor flow
    Miotics
  582. Contraindicated in acute inflammatory disease of anterior chamber
    Miotics
  583. Used primarily to break an attack of acute angle-closure glaucoma and facilitate laser iridotomy
    Miotics
  584. increase serum osmolarity, causing a fluid shift from the eye into the vascular space; subsequent osmotic diuresis reduces IOP
    Hyperosmotics
  585. Topical agents; Systemic medications; Argon laser trabeculoplasty; Trabeculectomy
    Treatment of POAG
  586. Principles: Increasing aqueous outflow; Decreasing aqueous production
    Treatment of POAG
  587. Beta-adrenergic blockers; Alpha-adrenergic agonists; Carbonic anhydrase inhibitors
    Agents that suppress aqueous inflow
  588. Prostaglandin analogs; Alpha-adrenergic agonists; Cholinergic agents
    Agents that increase aqueous outflow
  589. Initial therapy: Topical beta-blocker (Unless cardiac or pulmonary contraindications) and/or Topical prostaglandins
    Treatment of POAG
  590. lower IOP by suppressing aqueous humor production
    Beta-adrenergic blockers
  591. most potent of IOP-lowering drugs available; reduce IOP by increasing uveoscleral outflow
    Prostaglandin analogues
  592. lower IOP by suppressing aqueous humor production
    Alpha-adrenergic agonists
  593. Reduces rate of aqueous humor formation by direct inhibition of carbonic anhydrase on secretory ciliary epithelium, causing a reduction in IOP
    Carbonic anhydrase inhibitors
  594. Side effects include fatigue, dizziness, and headache
    Carbonic anhydrase inhibitors
  595. increase cholinergic action by inhibiting cholinesterase; similar adverse effects as direct-acting miotics
    Cholinesterase inhibitors-
  596. Alpha/beta agonist, vasoconstrictor; stimulate alpha and beta receptors, resulting in an acute reduction in aqueous humor production (alpha-adrenergic stimulation of the ciliary body), followed later by an increase in outflow (alpha- and beta-adrenergic)
    Adrenergic Agonists
  597. dorzolamide/timolol
    Cosopt
  598. brimonidine/timolol
    Combigan
  599. Minor discomfort, pruritus
    Mild Otitis Externa
  600. Partially occluded canal, moderate pain/pruritus
    Moderate Otitis Externa
  601. Canal completely occluded, intense pain, possible auricular erythema
    Advanced Otitis Externa
  602. Canal completely occluded, severe pain, auricular erythema, periauricular erythema, possibly adenopathy, and fever
    Severe Otitis Externa
  603. Clean the ear canal thoroughly; Can irrigate with a 1:1 dilution of 3 percent hydrogen peroxide at body temperature if the tympanic membrane is visible and intact; Treat inflammation and infection, Control pain
    Otitis Externa: Treatment
  604. MZ is a 34 yo Caucasian male, computer technician job site and experienced sudden onset of fever, chills, and headache 2 days ago. He went home from work early, and has remained at home since with continued fevers (102.5°F), severe fatigue, and headache.
    flu
  605. TS is a 67 yo AA female, with a history of sickle cell anemia. She presents to the clinic today (January 4) with runny nose, sneezing, muscle aches and cough for the past 3-4 days.
    common cold
  606. Rhinovirus, coronavirus, parainfluenzae and respiratory syncytial virus (RSV) indistinguishable
    common cold
  607. Useful for nonproductive cough
    Dextromethorphan
  608. Narcotic antitussive, More potent than codeine
    Codeine, Hydrocodone (Hycodan)
  609. Expectorant; May increase secretions, may have a role for productive cough
    Guaifenesin
  610. May block prostaglandins
    NSAIDS (sulindac, naproxen)
  611. Non-opiate antitussive
    Benzonatate (Tessalon)
  612. can also be administered to help decrease cough
    Naproxen
  613. Less rhinorrhea and sneezing; no change nasal congestion
    Ipratropium (Atrovent®)
  614. Onset of symptoms: Over a few days
    Cold
  615. Onset of symptoms: Sudden, worsening over 3-6 hours
    Flu
  616. Fever: Uncommon in adults, Children, as high as 102°F
    Cold
  617. Fever: Usually present ≥ 100 °F for 3-4 days
    flu
  618. Headache: Uncommon
    cold
  619. Headache: Common, sudden onset
    flu
  620. Chills: Uncommon
    cold
  621. Chills: Common
    flu
  622. Sore throat: Common
    cold
  623. Sore throat: Uncommon
    flu
  624. Muscle aches
    mild with cold, can be severe with flu
  625. fatigue, weakness
    mild with cold, common and severe with flu
  626. Stuffy nose & Sneezing
    common with colds, uncommon in flu
  627. Inflammation of the middle ear
    Acute Otitis Media (AOM)
  628. Fluid in middle ear plus signs or symptoms
    Acute Otitis Media (AOM)
  629. Anatomic or physiologic dysfunction of the eustachian tube; Secretions accumulate in the middle ear
    Acute Otitis Media (AOM)
  630. If a pathogen is present, suppuration occurs
    Acute Otitis Media (AOM)
  631. Streptococcus pneumoniae: Haemophilus influenzae: Moraxella catarrhalis: Streptococcus, Group A:
    Acute Otitis Media (AOM)
  632. Ear pain, ear drainage, hearing loss, Fever, lethargy, irritability, Bulging, cloudy tympanic membrane, Fluid in middle ear
    Acute Otitis Media (AOM)
  633. Amoxicillin remains drug of choice
    Acute Otitis Media (AOM)
  634. Azithromycin, clarithromycin; Clindamycin Less optimal: sulfamethoxazole/trimethoprim, erythromycin/sulfasoxazole
    Type I hypersensitivity: AOM - PCN allergic patient
  635. Cephalosporin: cefdinir, cefpodoxime, cefuroxime, ceftriaxone
    Non Type I: AOM - PCN allergic patient
  636. Acetaminophen; Antipyrine/benzocaine (Auralgan); Ibuprofen (Motrin)
    Analgesics in AOM
  637. Ciprofloxacin/hydrocortisone (Cipro HC Otic), Hydrocortisone/neomycin/ polymyxin B (Cortisporin Otic) Ofloxacin (Floxin Otic)
    Topical Agents in AOM
  638. Pneumococcal vaccines & Influenza vaccine
    Prevention Strategies for AOM
  639. Inflammation of the lining of the paranasal sinuses
    Rhinosinusitis
  640. symptoms lasting for 10 to 30 days, primarily infectious
    Acute Rhinosinusitis
  641. symptoms lasting from 4 to 12 weeks
    Subacute Rhinosinusitis
  642. symptoms lasting >3 months; infectious or noninfectious
    Chronic Rhinosinusitis
  643. S. pneumoniae: H. influenzae: M. catarrhalis:
    Rhinosinusitis
  644. Mucosal inflammation leads to obstruction of
    sinus ostia
  645. most commonly involved when osteomeatal complex is obstructed
    Maxillary and ethmoid sinuses
  646. Fluid trapped in the sinuses serves as a good medium for bacterial growth and proliferation
    Acute Rhinosinusitis
  647. Purulent nasal secretions more that 10 days, Worsening of symptoms after initial improvement; Also: Maxillary tooth or facial pain (especially when unilateral); Unilateral maxillary sinus tenderness
    Acute bacterial rhinosinusitis
  648. b-lactamase–producing H. influenzae and
    • M. catarrhalis; treat with amoxicillin
    • Acute bacterial rhinosinusitis
  649. Reduce mucosal inflammation
    Decongestants and topical vasoconstrictors
  650. Can clear inspissated secretions blocking sinus ostia
    Nasal saline sprays
  651. reduce inflammation
    Topical steroids
  652. for pain and fever
    NSAIDs
  653. Pseudoephedrine
    Sudafed
  654. Oxymetazoline
    Afrin
  655. Phenylephrine
    Neo-Synephrine
  656. Diphenhydramine
    Benadryl
  657. Chlorpheniramine
    Chlor-Trimeton
  658. Loratadine
    Claritin
  659. Desloratadine
    Clarinex
  660. Fexofenadine
    Allegra
  661. Cetirizine
    Zyrtec
  662. Levocetirizine
    Xyzal
  663. Azelastine
    Astelin (nasal spray); Optivar (ophthalmic solution)
  664. Epinastine
    Elestat (ophthalmic solution)
  665. Olopatadine
    Patanase (nasal spray); Patanol, Pataday (ophthalmic solution)
  666. Budesonide
    Rhinocort Aqua
  667. Ciclesonide
    Omnaris
  668. Fluticasone
    Veramyst
  669. Mometasone
    Nasonex
  670. Azithromycin
    AzaSite
  671. Ciprofloxacin
    Ciloxan
  672. Moxifloxacin
    Vigamox
  673. Tobramycin/dexamethasone
    TobraDex
  674. Brimonidine
    Alphagan P
  675. Dorzolamide/timolol
    Cosopt
  676. Bimatoprost
    Lumigan
  677. Latanoprost
    Xalatan
  678. Polymyxin B/Neomycin/Hydrocortisone (HCl)
    Cortisporin Otic Solution
  679. Ciprofloxacin/dexamethasone
    Ciprodex Otic
  680. Decongestants
    Sudafed; Afrin; Neo-Synephrine
  681. Antihistamines
    Benadryl; Chlor-Trimeton; Claritin; Clarinex; Allegra; Zyrtec; Xyzal; Astelin
  682. Mast cell stabilizers
    Nasal spray: Astelin, Patanase; Ophth soln: Optivar; Elestat; Patanol, Pataday
  683. Intranasal Corticosteroids
    Rhinocort Aqua; Omnaris; Veramyst; Nasonex
  684. Ophthalmic Abx drops
    AzaSite; Ciloxan; Vigamox; TobraDex
  685. Glaucoma
    Alphagan P; Cosopt; Lumigan; Xalatan
  686. Otic Drops
    Cortisporin Otic Solution; Ciprodex Otic

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