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55 Cards in this Set

  • Front
  • Back
Why should fluorescein staining of the cornea be performed in patients with suspected conjuctivitis?
to avoid missing abrasions, ulcers, and dendritic lesions
What is the treatment for bacterial conjuctivitis for a non-contact lens wearer? contact lens wearer? pt < 2 months?
• non-contact lens wearer: polymyxin B-trimethoprim
• contact lens wearer: ciprofloxacin, oflxacin, or tobramycin (to cover Pseudomonas)
• pt < 2 months: sulfacetamide
A patient presents with a conjuctivitis with a hyperacute onset (within 12-24 hrs) and a severe purulent discharge. What etiology should be considered?
gonococcal conjunctivitis
What are treatment options for gonococcal conjunctivitis?
• ceftriaxone
• ciprofloxacin
• tobramycin
• doxycycline
What medication can be used to relieve conjuctival itching or congestion?
What are treatment options for allergic conjunctivitis?
• elimination of the inciting agent
• cool compress
• artifical tears
• naphazoline/pheniramine
• diphenhydramine (in moderate to severe cases)
• fluorometholone (a mild topical steroid for severe cases)
What is the hallmark finding of herpes heratitis on slit lamp examination?
linear branching, epithelial defect with terminal bulbs that stain brightly with fluorescein dye
What type of medication should be strictly avoided in patients with herpes keratitis?
What is the herpes zoster ophthalmicus (HZO)?
shingles in a trigeminal distribution with ocular involvement
What is a Hutchinson sign?
• shingles involving the tip of the nose
• presence or eventual development of HZO should be suspected
What are characteristics of endophthalmitis?
• infection involving the deep structure of the globe (ex. anterior, posterior, & vitreous chambers)
• presents with pain and visual loss
• seen as a complication of globe violation from trauma or ocular surgery
What are pathogens that can cause endophthalmitis?
• Bacillus
• Haemophilus
• Staph
• Strep
What is the initial empiric treatment for endophthalmitis?
• vancomycin
• ceftazidime
What is the most important step in managing periorbital cellulitis?
to exlucude orbital cellulits
How can you clinically distinguish periorbital cellulitis from orbital cellulits?
periorbital cellulits has no:
• painful eye movement
• restriction of ocular motility
• acuity deficit
• impairment of pupillary function
• proptosis
What is the treatment for simple periorbital cellulitis in adults and children older than 5?
What is the treatment for periorbital cellulitis in children < 5 y/o OR patients with comorbidities?
• Ceftriaxone IV
• Vancomycin IV
Typically, orbital cellulitis spreads from where?
ethmoid sinuses
What is the treatment for conjuctival abrasions?

* should rule-out ocular foreign body
What is the test of choince to confirm the presence of an orbital fracture?
CT of the orbit and face
What needs to be ruled out in a patient that presents with hyphema?
• ruptured globe
• increased intraocular pressure
What are medical treatment options for increased intraocular pressure?
• timolol
• apraclonidine
• acetazolamide
• mannitol
What portion of the orbit are commonly fractured in an orbital blowout fracture?
inferior and medial wall
What is a Seidel test?
• a bright-green streaming appearance to fluorescein stain
• pathognomonic for ruptured globe
What is the most common cause of contact lens-related bacterial ulcers?
What is the most common form of glaucoma?
primary open angle glaucoma
What are signs and symptoms fo acute angle closure glaucoma?
• cloudy vision
• colored halos around lights
• conjunctival injection
• eye pain
• fixed mid-dilated pupil
• headache
• increased IOP
• nausea/vomiting
What are characteristics of optic neuritis?
• inflammation at any point along the optic nerve
• presents with acute vision loss (particularly reduction in color vision)
What test can be used to diagnose a decrease in color vision?
• Red desaturation test
• patient looks at a drak red object with one eye; the affected eye will see the object as pink or light red
A sudden painless loss of vision in one eye most likely represents what?
central retinal artery occlusion
What are classic signs of central retinal artery occlusion?
• complete or nearly complete vision loss
• afferent pupillary defect
• whitening of the retina in the posterior pole
• bright red macula ("cherry red spot")
Fundoscopic examin shows optic disc edema, cotton wool spots, and retinal hemorrhages in all 4 quadrants. These findings, described as "blood-and-thunder fundus" suggests what diagnosis?
central retinal vein occlusion
Bullous impetigo is caused by what pathogen?
Staph aureus
Non-bullous impetigo is caused by what pathogens?
• Strep pyogenes
• Staph aureus
What is the treatment for impetigo?
• mupirocin ointment (treatment of choice for localized infections)

• pediatric cases:
- dicloxacillin OR
- cephalexin OR
- augmentin
What pathogen causes erysipelas?
Strep pyogenes
What is the most common cause of viral parotitis in children < 15 y/o?
What is the incubation period for mumps?
2-3 weeks
What is the treatment of viral parotitis?
supportive tx (analgesics & antipyretics)
What is the most common extrasalivary manifestation of mumps?
This condition is a potentially fatal bacterial infection that occurs in patients with diminshed salivary flow?
suppurative parotitis
What are factors that lead to decreased salivary flow?
• advanced age
• dehydration
• medications (ex. diuretics, ß-blockers, antihistamines, phenothiazines, TCAs)
• prematurity
• recent anesthesia
• sialolithiasis
What are physical exam findings of suppurative parotitis?
• erythema, induration, & tenderness to palpation of the cheek and angle of the mandible
• pus from the Stensen duct
Most cases of sialolithiasis occur in which duct?
submandibular (Wharton) duct
What is the most common dislocation of the mandible?
anterior dislocation
What is the most common cause of sudden hearing loss?
What complication may result if a dental infection spreads to the ingraorbital space?
cavernous sinus thrombosis
How can a patient with a cavernous sinus thrombosis present?
• coma
• limitation of lateral gaze
• meningeal signs
• sepsis
What is the treatment for acute necrotizing ulcerative gingivitis ("Trench Mouth)?
• metronidazole
• chlorhexadine mouth rinses
What virus causes herpangina?
coxsackie A virus
How does herpangina present?
• presents with high fever, sore throat, headache, & malaise
• followed by eruption of oral vesicles which rupture to form painful, shallow ulcers
• soft palate, uvula, & tonsillar pillars are typically affected
• buccal mucosa, tongue, & gingiva are spared
What system is used to classify the anatomy of fractured teeth?
ellis system
Describe the classes of ellis fractures
• class 1: involve only the enamel of the tooth
• class 2: involves the creamy yellow dentin underneath the white enamel
• class 3: tooth-threatening pfractures that involve the pulp; indentified by a red blush on the exposed dentin OR a visble drop of blood after wiping the tooth
What is the most common cause of peritonsillar abscess (PTA)?
Patients with this type of abscess tend to gravitate toward a supine position, with the neck in slight extension to minimize compression of the upper airway.
retropharyngeal abscess