Sjvc-Pa Ad/med T1/eent

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Types of Hearing Loss

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Conductive & Sensorineural
Sensorineural {Sensori & Neural}

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Conductive Hearing Loss

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Results from dysfunction of Outer/Middle ear; eg-wax; otitis externa & OM; Otosclerosis

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Sensori Hearing Loss

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Due to dysfunction of Choclea or loss of hair cells in the organ of Corti; eg- Noise; head trauma; systemic diz

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Neural Hearing Loss

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Due to lesions on CN-8 or auditory cortex; eg- acoustic neuroma, MS, auditory neuropathy

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Types of disorders of Ear Canal

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Cerumen Impaction; OE & FB

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Cerumen Impaction

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Commonly self-induced via ill-advised ear cleaning; Tx-3% hydrogen peroxide, clean outer ear w/ wash cloth w/ index finger, irrigation w/ H2o @ room temp

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Otitis Externa / OE

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Infection of outer ear mainly CAUSED by Pseudomonas, proteus & Fungi; S/Sx- Pain @ Pinna & Tragus, erythema/edema of ear canal, drainage; Tx- avoid moisture, antibiotic drops (Neomycin+hydrocortysone, Cipro for Pseudomonas)

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Foreign Body / FB

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Common in young children; Tx- irrigate metal & beads EXCEPT beans, remove w/ currette or blunt hook, mineral oil for insects

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Most common cause of "Middle Ear"- Hearing Loss among "Young Adults"

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Otosclerosis; it is mainly Genetic NOT congenital; bilateral; pt hears better in Noise; Tx-Stapedectomy

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Triad in Meniere's Diz

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Vertigo-Tinnitis-Sensori Hearing Loss; usually Unilateral; mainly caused by Syphilis & Head Trauma

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Triad cause of OM-Acute

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Strep pneumoniae; Hemophilus influenza; Morexella catarrhalis

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Plugged ear feeling

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OM-Serous/Effusion; due to Blockage of Eustachian tube; Visualization of "Air-fluid" levels;

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Complications of OM

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Meningitis; mastoiditis; cholesteatoma; tympanosclerosis; TM perforation; facial paralysis

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Causes of Chronic-OM

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Staph aureus; Pseudomonas aeruginosa; Proteus; Tx-Avoid H2o, Ciprofloxacin for Pseudomonas, Surgical repair of TM is "definitve" tx

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Sinus X-Rays

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Caldwell-Frontal; Waters-Maxillary; Lateral-Sphenoid; Submentovertical-Ethmoid

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TX for Sinusitis

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Amoxicillin 250mg TID; Decongestants; Surgical drainage

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Tx for Nasal Hematoma

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Surgical Drainage; packing & antibiotics

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Tx for Epistaxis

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Anterior Pack

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Nasal polyps

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Peeled off grape; Tx- Nasal corticoids; surgical removal

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diff bet Canker Sores & Herpetci Gingivostomatitis

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Canker Sore=Common sores; no fever/lymphaddenopathy
Herpetic Gingivostomatitis= sore; sudden high fever; malaise; drooling

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Manifestations of Coxasackie Virus-A

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Herpangina (Viral Stomatitis) & Hand-Foot-Mouth diz

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Manifestations of Coxasackie Virus-B

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Resp Infections

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Pharyngitis / Strep Throat

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Viral or Bacterial; Bacterial=Grp A Beta-hemolytic Streptococci; soft palate petechiae; Tx- Penicillin or Erythromycin to cover Glomerulonephritis & Rheumatic fever

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CDC given Dx for Strep Throat

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Fever>102; Ant Cervical lyphadenopathy; Red swollen tonsils w/ exudates; dysphagia; absence of URI sx or cough

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Most common type of Pharyngitis?

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Viral

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Indications for Tonsillectomy

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Recurrent strep throat; Hx of peritonsillar abscess; OSA

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Most common cause of Croup / Laryngotracheobronchits

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Para-influenza virus;PE-subglottic edema; S/sx- barking cough or strider w/ "steeple sign or pencil shaped" CXR; Tx-O2; racemic epi; cool mist; decadron

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Cause of Epiglotitis

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Hemophilis influenza grp-B; Life threatening emergency; CXR- thumb print sign; Tx- IV antibiotics; traceostomy

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4Ds for Epiglotitis

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Distress; Dysphagia; Dysphonia; Drooling

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Most common cause of Laryngitis

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Viral URI

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Commmon cause of Orbital Cellulitis

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Paranasal Sinusitis-H. influenza
Complication:-Meningitis; optic neuritis

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Types of Blepharitis

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Ulcerative-Acute Bacterial
Seborrheic-Chronic Seborrheic dermatitis

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Cause of Hordeolum (Guharni)

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Staph infection; External:-Superficial
Internal:-Deep

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Diff bet Hordeolum & Chalazion

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Hordeolum is Painful & near eye lashes, but Chalazion is NOT painful & away from the eye lashes

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Diff bet Dacryostenosis & Dacryocystitis

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Dacryostenosis=Obstruction of Nasolacrimal duct
Dacryocystitis=2^o to dacryostenosis; pus regurgitation through the Punctum w/ pressure

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Cause of Trachoma / Chronic Chlamydial Conjuctivits

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Chlamyda trachomatis; Tx-doxycycline 100 mg BID x 4days

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Diff bet Allergic & Viral conjunctivitis

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Allergic= Red, ITCHY, watery
Viral=Red, BUMPY,watery w/ URIs

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Common cause of Viral Conjunctivits

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Adenovirus

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Diff bet Pterygium & Pinguecula

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Pterygium=Triangular fleshy growth ON the cornea; may SPREAD
Pinguecula=Raised yellowish-white growth ADJACENT to the cornea; DOESN'T SPREAD

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Arcus Senilis

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A gray-white arc/circle around the Limbus due to LIPID DEPOSIT; Benign-doesn't effect vision

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Diff bet Anterior & Posterior Uveitis

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Anterior=Iritis; Slit-lamp findings "cells & flare"
Posterior=Choroidits; White funny fundus lesions

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2nd most common cause of Blindness in US

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Glaucoma; Open Angle Glaucoma is the leading cause of blindness in Blacks

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Most common cause of Blindness in older people

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Macular degeneration

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Diff bet Retinal Artery & Vein Occlusion

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Artery/O=Cotton-wool spot; means No blood
Vein/O=Blood & Thunder optic fundus; means bloody veins in fundus

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Most common cause of blindness in middle adulthood

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Diabetic Retinopathy