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FNP~EENT

Assess, Dx, Tx

QuestionAnswer
What is the normal shape of the "optic disc" doughnut-like with an orange/pink neuroretinal rim & a central white depression (physiologic cup)
cup/disc ratio cup should not be more than 1/2 size of disc diameter, if so consider glaucoma
T/F: arteries are brighter re and narrower than veins True
What is the A:V ratio 2:3 or 4:5
another name for "hordeolum" stye
What organism is usually responsible for a hordeolum/stye? Staphylococcus aureus
s/sx's of hordeolum/stye ~abrupt onset ~erythema of eyelid ~pain ~localized tender mass
Management of hordeolum/stye ~warm compress ~topical abx oint ~refer to opth if not resolved in 2 days
What is a "chalazion"? beady nodule on eyelid; infection or retention cyst of a meibomian gland
Differentiate between "chalazion" and "hordeolum" chalazion's are usually painless except for the initial tendereness when they swell up
s/sx's of a chalazion... ~swelling on eyelid ~tenderness ~sensitivity to light ~increased tearing ~if very large blurred vision due to pressure on the cornea
Management of a chalazion... ~warm compress ~MUST refer for surgical removal
What is "blepharitis"? staph infection or seborrheic dermatitis of the lid edge (eyelash roots)
s/sx's of blepharitis... ~red scaly, greasy flakes ~itching ~tearing ~thickened, crusted lid margins ~burning
Management of blepharitis... ~hot compress ~topical abx ~vigorous scubbing of lashes and lid margins with eyes closed followed by rinsing
What are some causes of conjunctivitis (pink eye)? ~allergies ~chemical irritation ~bacterial ~viral ~GC/CT infections
T/F: conjunctivitis is painful False
s/sx's of conjunctivitis... ~itching ~burning ~redness ~^tears ~blurred vission ~swellen eyelids ~sensation of foreign body in eye ~crust of sticky, micropurulent d/c
"bacterial" conjunctivitis d/c is... purulent
"GC/CT" conjunctivitis d/c is... copious, purulent
'allergic" conjunctivitis d/c is... stringy; ^tearing
"viral" conjunctivitis d/c is... watery
Treatment for "bacterial" conjunctivitis... ~*self-limiting ~*Abx drops: Levofloxacin, Ofloxin, Cipro, Tobramycin, Gent. opth gtts
Treatment for "GC/CT" conjunctivitis... ~GC: Ceftriaxone 250mg IM ~CT: EES oint, Oral EES, Azithro...***TCN, clarithro, doxy (not to be given to pregnant women)
Treatment for "allergic" conjunctivitis... ~oral antihistamines, i.e. benadryl
Treatment for "viral" conjunctivitis... ~symptomatic care
What are cataracts? clouding and opacification of the normally clear lens of the eye
s/sx's of cataracts... ~painless ~clouded, blurred or dim vision ~increasing difficulty with night vision ~sensitivity to light and glare ~halos around lights ~need for brighter light ~dbl vision in one eye ~fading or yellowing of colors ~frequent change in eyeglasses
Cataracts PE findings... ~no red reflex ~opacity
Management of cataracts... refer to opth.
What is chronic open- angle glaucoma? chronic, slowly progressive optic nerve damage associated with elevated IOP
What is primary closed-angle glaucoma? acute elevated intraocular pressure associated with closure of the filtration angel or obstruction in the circulating pathway of the aqueous humor
s/sx's of open-angle... ~^IOP >21 ~red eye ~restricted/constricted vision/field ~cupping of disc *ratio > 0.5 ~initially asymptomatic, until far advanced ~*painless
s/sx's of closed-angle... ~elevated IOP > 40 ~hazy cornea ~acute red eyes ~severe periocular pain ~blurred vision ~ cupping of disc *cup to disc ratio >0.5 ~"halos around lights"vomiting, unilateral H/A~*EMERGENCY
Management of "open-angle"... ~Miotic agents ~Timolol
Management of "closed-angle"... ~Diamox ~Mannitol IV ~Surgery
What is "conductive" hearing loss? physical problems with the movement of the sound wave through the ear (i.e. blockage of the ear canal) *air
Causes of "conductive" hearing loss... ~foreign body (*cerumen buildup most common cause) ~hematoma ~perforated TM ~otitits media ~otitis externa ~otosclerosis
What is "sensorineural" loss? damage to hair cells and/or nerves that sense sound waves
Causes of "sensorineural" loss... ~acoustic trauma ~barotrauma (usually in divers) ~head trauma ~ototoxic drugs ~Me'nier's dz ~acoustic neuroma ~infections: mumps, measles, herpes zoster, syphillis, meningitis, etc. ~presbycusis
Normal findings in "Weber" sound heard bilaterally equal, does NOT lateralize
Normal findings in "Rinne" AC > BC 2:1
Weber results in conductive hearing loss... sound lateralizes to the affected ear (i.e. stick finger in ear and talk)
Rinne results in conductive hearing loss... abnormal in the affected ear (i.e., AC < BC...because air can't get through
Weber results in sensorineural hearing loss... sound lateralizes to the unaffected ear
Rinne results in sensorineural hearing loss... normal in affected ear
Management of conductive hearing loss... ~clear canal ~treat underlying cause
Management of sensorineural loss... ~refer
Presentation of "uveitis"... pupil usually constricted, nonreactive, irregularly shaped, ciliary flush
Intervention for "uveitis"... Refer to Opth, Acute use of topical or systemic corticosteroids and cyclopegics
Cataracts affect distant/near vision... Distant vision is affected
Vision loss commonly reported in "macula degeneration"... Central vision affected, most debilitating
"Amsler Grid" (staring at the dots on the paper) is screening test for... macular degeneration testing
Etiology of "presbyopia"... hardening of the lens
"Presbyopia" results in... close vision problems
Etiology of "senile cataracts"... lens clouding
"Senile Cataracts" result in... progressive vision dimming, distance vision problems
Etiology of "hyposomia"... neural degeneration
"Hyposomia" results in... gradual decline in fine taste (largely a function of smell)
Etiology of "presbycusis"... loss of 8th cranial nerves sensitivity
"Presbycusis" results in... difficulty w/ conversation in noisy environment; can hear but cannot understand
Etiology of "cerumen impaction"... conductive hearing loss
"Cerumen Impaction" results in... general diminution of hearing
Created by: KimmiNP