Eyes, Ears, Nose, Throat - James Ward

Front 1

Blepharitis

Back 1

"dandruff" of the eye
Tx with warm compresses and baby shampoo

Front 2

Stye

Back 2

Staph infection to external or internal lid margin
Tx: warm compresses and topical Abx

Front 3

Chalazion

Back 3

Chronic inflammation of Meibomian gland
Not acutely painful
Warm compresses
No abx

Front 4

Conjunctivitis viral vs. bacterial

Back 4

both erythematous
Viral: has only minimal D/C. Preauricular node. URTI
Bacteria: has ++ D/C.

Front 5

Iritis/uveitis/choroiditis

Back 5

decreased visual acuity
painful, red eye, photophobia
Dx: perilimbic flush
Cell and flare on slitlamp exam

Front 6

Corneal Abrasion

Back 6

abrasions on cornea
pain relieved with topical anesthetics (proparacaine or tetracaine)
if metal on metal get orbit Xray to rule out intra ocular FB
Tx: erythromycin ointment

Front 7

Keratitis

Back 7

S&S:
photophobia
visual changes
eye pain
Types: punctate lesions (welding)
Tx: topical erythromycin, natural tears, cycloplegia
Ulceration (bacteria, HSV)
Tx: Abx ointment, refer to optho

Front 8

Differentiate orbital vs periorbital cellulitis

Back 8

pain with EOM

Front 9

Hypopyon

Back 9

WBCs settled in anterior chamber of eye

Front 10

Orbital Blowout Fracture

Back 10

Orbital floor weakest and prone to fracture
Emergent repair only if EOM entrapment

Front 11

Retrobulbar hemorrhage

Back 11

S&S: Exopthamus after trauma
pupil is dilated and non-reactive
Tx: lateral canthotomy

Front 12

Retinal detachment

Back 12

Flashes of light
floaters or spider webs
curtain falling on visual field
Dx: Ultrasound
Tx: urgent optho referral for surgery

Front 13

alkali/acid burns to eye

Back 13

Tx: irrigate with morgan lens until pH 7.4

Front 14

Globe rupture

Back 14

S&S: Tear drop pupil
fluid leaving from eye seen with flouresceine stain
Tx: don't touch
cover with hard patch or shield
give Td and IV antibiotics

Front 15

pinguecula

Back 15

raised mass on conjuctiva (chronic)
Asymptomatic but are visibly disturbing to pt
No tx needed

Front 16

Acute angle glaucoma

Back 16

S&S:
acute pain after entering dim light
H/A with N/V
injected
fixed mid-dilated pupil
IOP >30 (normal is <20)
Tx: emergent Optho consult
acetazolamide
timolol drops
pilocarpine drops
mannitol

Front 17

Optic Neuritis

Back 17

Acute onset vision loss
eye pain with EOM
associated with MS

Front 18

Central retinal artery occlusion

Back 18

sudden painless vision loss
"cherry red spot" on fundoscopy
Tx: emergent optho referral

Front 19

Central retinal veinous occlusion

Back 19

sudden painless vision loss
See dilated viens and hemorrhages on fundo
Better prognosis than artery occlusion

Front 20

Vertigo central vs peripheral

Back 20

Peripheral:
Sudden onset, tinnitus, hearing loss, horizontal nystagmus, fatigueable nystagmus, normal neuro exam
Central:
Gradual onset, vertical nystagmus, nystag not fatigueable, other neuro findings

Front 21

Labrynthitis

Back 21

Sudden onset vertigo with hearing loss or tinnitus
usually preceeded by URTI
Tx: self resolving

Front 22

Meniere's disease

Back 22

progressive vertigo, hearing loss, and tinnitus

Front 23

Accoustic Neuroma

Back 23

Slow growing benign tumour
progressive vertigo, hearing loss
Diagnosis on MRI
Requires surgical excision

Front 24

AOM causes and Tx?

Back 24

Cause: viral, Strep pneumo, H. Influenza, M. Cattarhalis
Tx:
>6 months: analgesia and F/U in 2 day
Treat if ++ pain, fever >40, poor f/u
<6 months: treat with 90mg/kg amoxicillin divided BID x7d

Front 25

Complications of Otitis Externa

Back 25

Mastoiditis- CT to diagnose
Malignant otitis externa- involvement of cartilage and skull base. More common in diabetics. May develop CN palsies.

Front 26

Cavernous sinus thrombosis

Back 26

Complication of facial infection
fever
facial/eye edema
CN palsies

Front 27

Herpangina etiology, S&S and Tx?

Back 27

Tender ulcers in pediatric mouth associated with fever and sore throat
coxsackie virus
Tx: supportive and avoid dehydration

Front 28

Ludwig's angina

Back 28

polymicrobial
painful edema in submandibular area
tongue displaced
IV Abx and manage airway

Front 29

retropharyngeal abscess

Back 29

throat pain and fever
neck pain
dysphagia
voice changes
airway difficulties
Tx: IV Abx

Front 30

Epiglotittis

Back 30

fever
dysphagia
drooling
tripoding
voice change
Dx: soft tissue neck XRay
Direct visualize with fiberoptic scope

Front 31

Centor criteria

Back 31

fever >38.0
anterior Cerv adenopathy
No cough
exudate on tonsil
Score of 3 or 4 = Tx
Score 2 culture
Score 1 no culture or Tx

Front 32

Le Fort fractures: classification, S&S, and Tx?

Back 32

I: upper jaw mobile
II: upper jaw and nose mobile, CSF rhinorrhea
III: upper jaw, nose, maxilla, zygoma mobile. CSF rhinorrea

At require Abx and surgery

Front 33

sialoadenitis

Back 33

swelling, pain to parotid or submandibular glands
Et: viral (mumps), sialolithiasis, bacterial

Front 34

Corneal Ulcer?

Back 34

Refer optho and start antibiotic ointment

Front 35

Herpes symplex keratitis

Back 35

decreased visual acuity
FB sensation
injected, painful eye
dendritic pattern on fluorosceine stain
start antivirals and urgent optho consult

Front 36

Herpes Zoster opthalmicus

Back 36

Hutchinson sign (shingles on tip of nose)
FB sensation
Decreased visual acuity
injected, painful eye
Pseudodendritic pattern on fluoresceine stain
Tx: acyclovir and urgent optho

Front 37

Dacrocystitis?

Back 37

infection of lacrimal duct
Tx: oral and topical abx

Front 38

Iritis/Uveitis: S&S, Tx?

Back 38

Photophobia
Painful
Injected
Decreased visual acuity
Cell and Flare on slit lamp
Tx: Mydriatics
Consider antibiotics