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86 Cards in this Set
- Front
- Back
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What are red flags for Headache? |
worst headache of my life |
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If patient had drooping on one side of side, unilateral, which cranial nerve (CN) would be effected?
What 2 disease processes can cause this? |
CN VII - facial nerve
CVA or Bell's palsy |
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If pt had trouble smelling, which CN would be effected? |
CN I |
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If pt had trouble seeing, which CN would be possibly effected? |
CN II |
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What is Hirsutism? What symptoms would you see? |
hair growth on women where men would usually get it. Red cheeks, moon face |
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What symptoms would you see with Nephrotic syndrome? |
Periorbital edema Puffy Pale Face Lips swollen |
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What symptoms would you see with mumps? |
Parotid gland enlargement and usually fever, swelling around jaw line |
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What symptoms would you see with acromegaly? |
Large features, enlarged soft tissues, prominent brow & jaw, heart murmur, abnormal ht rhythm |
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What would be some signs to look for with trauma that would immediately send to ER? |
Battle signs, bruising behind ear and around mastoid process. With c/o of HA, ER! |
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What diagnosis might you think with complete visual loss?
Clouding of vision? |
Retina detachment
Cataracts |
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What diagnosis might you think if you hear unilateral visual loss that is painless?
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vitreous hemorrhage, macular degeneration, retinal detachment, retinal vein or artery occlusion CVA, acute glaucoma attack, tumor, cataract
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What diagnosis might you think if you hear peripheral visual loss?
Floaters?
Glare? |
Optic nerve, brain lesion, bleed, tumor
Scomatas?
Exudate in vitruous humor
Glaucoma, cataracts |
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What is the term when there is lots of sclera showing and lids retracted? |
Exophthalmos |
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What is the term for when light is not reflecting off both eyes in same location?
What could this indicate a problem of? |
Strabismus.
Muscles of eye, CN problem
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What is the term when one upper eye lid droops lower than the other one?
What could this signify? |
Ptosis
ocular msc. problem, wkness, ocular motor, CN III |
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What does Cranial Nerve III control? |
Pupilary constriction, & conversion of eye and upper lid |
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A patient comes in with a yellow plaque on eyelids. What is this most likely? |
Xanthelasma - normal part of aging. Can be found in high lipid levels |
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A patient has an inward turning eyelid w/ lashes hitting the cornea. What is this called?
Outward turning of lower eye lid, doesn't allow for proper lubrication of eye, tearing/dry eyes |
Entropian
Ectropion |
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Patient has inflammation of eyelid at border...this is called? When there is clogging of sebaceous material at eyelid margin pointing outward...this is called? |
Blepharitis
Sty |
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What is Meibomitis?
What is a chalazion? |
Inflammation at meibomian glands area
Pointing inward sty |
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Which infection usually is culprit of blepharitis and meibomitis? |
Staph aureaus |
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What is conjuctivitis? |
vascularization of bulbar (sclera), discomfort but not painful |
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You notice a patient has an opacity of the lens and they have complained of blurry vision, sensitivity to light, unable to read well. What does patient likely have? What would you see in the eye?
What causes cataracts? |
Cataracts Blurry eyes protein clumping in the eye |
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What do you inspect the lacrimal apparatus for? |
Inspect & palpate gland and sac for tenderness, swelling, discharge |
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What do you inspect the cornea for? |
For opacities |
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What do you check the conjunctiva for? |
Palpebral and bulbar (covering the sclera) for color and vascular pattern |
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What do you check the pupils for? |
Size, shape, reaction to light (direct and consensual) |
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How would you inspect the palpebral conjunctiva? |
Evert the upper eyelid w/ qtip to make sure light pink and not pale |
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If a patient stated on the phone she thought she had conjunctivitis, what would you expect to see when she came in to see you?
Would you expect it to be painful? |
vascularization of bulbar conjunctiva, tearing, discharge
discomfort but not painful |
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With cataracts, is loss of vision sudden or gradual? Painful or painless Interferes w/ night driving or not Altered color perception or not? Double vision or no? |
Gradual
Painless Inteferes w/ night driving altered color perception double vision |
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If you noticed a patient had a corneal arcus, what blood levels might you check? |
cholesterol, triglyceride levels |
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What does PERRLA stand for? |
Pupils, equal, round, reactive to light, accomodating |
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Which CN is oculomotor? Light Reflex? |
CN III |
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what is accommodation with pupils? Which CN is it? |
When eyes converge on an object and pupils constrict
CN III |
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What is Pterygium?
What causes it?
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triangular thickening of bulbar conjunctiva that grows slowly across outer surface of cornea, usually from nasal side. May redden and interfere w/ vision as encroaches on pupil. Dry, dusty places like farms |
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What is Pinguecula? Is this normal or abnormal for the older adult? Does it interfere with vision |
yellowish plaque on bulbar conjuctiva abnormal no does not interfere |
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What doe 20/30 vision mean? At what age do kids have 20/20 vision? |
That a person sees at 20 feet what someone else sees at 30 feet. About age 4 or 5
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How do you test for near vision?
At what age does this usually happen? |
Have pt hold reading card 14 inches away from face, if they have to hold card farther away, have increasing presbyopia because lens can not accommodate early 40s |
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How do you test peripheral vision?
How do you test for confrontation?
If pt has problem w/ peripheral vision, what might be the problem? |
By testing bilaterally in temporal fields then one eye at a time by confrontation
By covering both practitioner's eye and patient's eye and moving fingers in and see if you and pt see fingers in periphery at same time Glaucoma |
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If a pt performs all EOM appropriately, then what CN do you know are intact |
III, IV, VI |
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What would be the characteristics to alert you of a tumor HA, abscess, or mass lesion? |
New HA, persisting, progressively severe |
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With a HA that is worse when a pt coughs, sneezes, or changes positions of the head can signal what? |
brain tumor or sinusitis |
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If pt states she has had bilateral gradual visual loss, what types of eye abnormalities are you thinking? |
Cataracts or macular degeneration |
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If pt states there is blurring in middle field of vision, you think what? |
macular degeneration |
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Pt states there are moving specks or strands where pt can not see. What does this make you think?
Or it is fixed and doesn't move, what does this make you think? |
Vitreous floaters
Scotomas |
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What are some of the causes of diplopia? |
brain lesions or weakness/paralysis in 1 or more Extraocular muscles from CN III, IV, or VI |
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What does seeing a red reflex mean? |
That light is reflected back from the retina. |
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Where do problems with conductive hearing loss originate?
What about sensorineural loss?
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External or middle ear
Inner ear, cochlear nerve, or brain |
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Which type of hearing loss do noisy environments help? |
Conductive |
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which medications can affect hearing? |
aminoglycosides, ASA, NSAIDS, quinine, furosemide |
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Pain in the ear w/o resp. infection often signifies inner or outer ear? |
outer |
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A ringing in the ear with some trouble hearing and spinning suggests what? |
Menieres's Dz |
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What happens when eyes accommodate? |
The eyes increase convexity of lens by contracting ciliary muscles to bring near objects into focus. Can not be seen by examiner |
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What happens when the eyes converge? |
Both eyes move inward to view an object |
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Central visual loss |
? |
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If patient states they have unilateral vision loss that is painful, what should you think about? |
corneal ulcer, acute glaucoma, optic neuritis from MS - referral required |
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If pt states sudden bilateral, painless visual loss, think?
If pt states bilateral, painful loss think? |
medications such as cholinergics, antichol, steroids
chemical or radiation exposures |
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If onset of bilateral visual loss is gradual, you think? |
cataracts, mac degeneration |
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If patient states slow central loss, think? |
mac degeneration |
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If pt states loss of peripheral vision, think? |
open angle glaucoma |
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If pt states moving specks or strands, what does pt most likely have?
If you ask if these shift with gaze or are they fixed, an answer of fixed (scotomas) |
Vitreous floaters
lesions in retina or visual pathways |
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If patient answers yes to seeing light flashing across field of vision with our without moving specks/strands, most likely is... |
Detachment of retina - prompt referral |
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A blind spot suggests a problem with what nerve?
What conditions can have this? |
Optic nerve
Glaucoma Optic neuritis Papilledema |
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What condition, hyper or hypothyroidism has poor convergence? |
Hyperthyroidism |
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What color should the optic disc be? |
Yellowish orange to creamy pink |
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What color should the physiologic cup be? |
yellowish white |
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What kind of glaucoma does an enlarged physiologic cup suggest? |
Chronic open angle glaucoma |
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What would the direct and consensual reaction to light be if a light is shined in a blind eye? |
No response in either eye |
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What would the direct and consensual reaction to light be if a light was shined in a normal eye but the other eye is blind? |
Normal response of direct reaction in normal eye and consensual response in blind eye |
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What causes a developmental dysconjugate gaze?
What are the 2 types? |
Ocular muscle tone, can be hereditary
Esotropia & Exotropia |
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Would corneal reflections in esotropia be symmetric or asymetric? |
Asymetric |
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What test would you be doing if you observed quadrantic defects, homonymous hemianopsia, or bitemporal hemianopsia? |
Confrontation |
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Which fields are affected in quadrantic defects Bitemporal hemianopsia Homonymous hemianopsia |
Left or Right superior quadrants Temporal half of each field vertically Same side either L or R of each eye and half of field vertically |
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A patient exhibiting ptosis and pupillary dilation and an eye that is pulled outward might have paralysis of what CN? |
3 |
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Why does sound lateralize to the impaired ear in the Weber test with conductive hearing loss? |
Because room noise not heard well and vibration improves |
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Does sound lateralize to impaired ear or good ear with sensorineural loss? |
Lateralize to the good ear because cochlear nerve damage impairs transmission to affected ear |
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With the Rinne test, is bone conduction or air conduction longer in conductive loss? |
BC is longer b/c vibrations thru the bone bypass problem to cochlea |
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With the Rinne test, is air conduction or bone conduction longer in sensorineural loss? |
AC is longer, normal pattern prevails b/c inner ear or cochlear nerve less able to transmit impulses regardless of how the vibrations reach cochlea |
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On examination, the ear canal is swollen, narrowed, pale, and tender, Possibly reddened. This is indicative of what? |
Otitis externa |
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If the skin of ear canal is thickened, red, itchy, indicates what? |
Chronic Otitis externa |
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A red, bulging ear TM is indicative of what? |
Otitis media |
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A hole in the eardrum is indicative of what? |
Perforated eardrum |
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Viral rhinitis is more reddened and swollen or pale and bluish? |
Reddened and swollen |
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Enlargement of a supraclavicular node, especially on the left suggests what? |
possible metastasis from thoracic or abdominal surgery |
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Tender nodes suggest what? |
Inflammation |
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Discharge of mucopurulent fluid from puncta suggests what? |
An obstructed nasolacrimal duct |
