Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
PANCE ENT
PANCE Opthalmology and Otolaryngology
| Question | Answer |
|---|---|
| Top drugs for ototoxicity? | Gent/Vanc/Erythro/Neomycins, Quinidine, Chemotx, Loops, ASA, Chloramphenicol. |
| Top reasons for conductive hearing loss? | WAX >> OE/OM, TM perf, foreign body (don't remove batteries, refer), otosclerosis, cholesteatoma. |
| Top reasons for sensorineural hearing loss? | PRESBYCUSIS >> Meniere's, Acoustic neuroma, acoustic trauma. Think "AMPLITUDE" for DDx. |
| How to discern vestibular neuritis from labrynthitis? | Hearing loss. VN does not, and labrynthitis does, have hearing loss (with acute vertigo and tinnitus s/p Otitis or viral infection -> meclizine, promethazine or dimenhydrinate). |
| How to discern Weber exam? | Lateralizes to bad ear = CHL Lateralizes to good ear = SNL |
| How to discern Rinne exam? | BC > AC = CHL AC > BC = SNL (though both AC and BC impaired) |
| Classic presentation for laryngeal cancer? | Ear pain with marked weight loss. |
| Most common site for retinal detachment? | Superior temporal retinal area. Spontaneous or 2/t trauma or severe myopia. Turn pt to affected side. |
| Classic causes and presentation of macular degeneration? | Age >> chloroquine or phenothiazine -> Drusen deposits in Bruch's membrane causing metamorphopsia w/ neovascularization (give anti-VEGF). *#1 cause of irreversable central vision loss.* |
| What is box-carring with a cherry-red spot? | CRAO. Painless and 2/t emboli, thrombosis and vasculidities. |
| What are blood and thunder retinas? | CRVO. Painless and 2/t thrombosis. |
| What is the leading cause of blindness in the US? | Retinopathies. Occur 2/t systemic DM and HTN >> pre/eclampsia, blood dyscrasias and HIV. |
| Median age and top offenders for orbital cellulits? | 7-12yo. Caused by S.aureus, S.pneumo, H.flu. Inc. MRSA and 2/t chronic sinusitis in adults (given viral sinusitis more common s/p URI). Can present w/ osteomyelitis or cavernous sinus thrombosis. |
| Treatment for orbital cellulitis? | Admit for broad spectrum IV abx while awaiting cx. |
| Median age and top offenders for dacrostenosis? | 9 months. Caused by S.aureus, GBHS, S.epi and Candida. |
| Effect of untreated blepharitis? | Blepharitis -> Chalazion both meibomian glands. |
| What does a hordeolum affect? | Glands of Moll and Zeis. |
| Most common cause of viral conjunctivitis? | Adenovirus 3, 8 or 19. Watery, not goopy, d/c -> saline otic lavage bid +/- antihistamines. |
| Top causes of bacterial conjunctivitis? | S. aureus, S. pneumo, Moraxella >> Chlamydia and Gonorrhea (Gram and Giemsa stain for PMNs & only Gonorrhea will show Gram - diplococci as Chlamydia will not). |
| Top causes of transient visual loss? | GCA/temporal arteritis (tender, fever, malaise, inc. ESR -> Pred), embolic amaurosis fugax or TIA. |
| Top causes of sudden visual loss? | CRAO, CRVO, optic neuropathy, papillitis and retrobulbar neuritis. |
| Top causes of gradual visual loss? | Macular degeneration, cataracts, glaucoma or tumors. |
| What does the cover-uncover test look for? | Eso vs. Exotropic Strabismus. |
| Blue or cyanotic sclera in infants is caused by what? | Osteogenesis imperfecta. |
| ENT reason for pain out of proportion to exam? | Bullous myringitis (other non-ENT reasons are mesenteric ischemia and compartment syndrome). |
| Top causes of infant and childhood hearing loss? | Asphyxia (think CP), erythroblastosis, MMR, pertussis, influenza, meningitis and labrynthitis. |
| Top causes and tx. of OM? | Esp. 4-24 months 2/t S.aureus, S.pneumo, M.cat, H.flu (and S.pyogenes). Rx. is amox / amox-clav / erythro+sulfonamide / Bactrim. PCN allergic: erythro or clarithromycins. IV abx for mastoiditis. |
| Top causes and tx. of OE? | Esp. children and teens 2/t Pseudomonas, Proteus, Enterobacteriaceae (or pre-existing eczema, seborrheic dermatitis or psoriasis). Rx. is otic abx + Burow's Solution lavage (acetic acid + AlSO4). CAUTIOUS polymixin B, aminoglycosides and aminoglycosides. |
| Do you give a Z-pack for acute sinusitis? | No! Wait until 12w to discern subacute vs. chronic. |
| What is rebound congestion in vasomotor rhinitis? | Rhinitis medicamentosa. |
| Three types of rhinitis? | Allergic (IgE with *atopy of atopic dermatitis/eczema/asthma* +/- nasal polyps & ASA sensitivity, allergic salute and shiners), Vasomotor (boggy, stuffy and rhinorrhea) and Rhinitis medicamentosa (2/t oxymetolazine or phenylephrine). |
| What does "atypical lymphocytes" denote? | Either EBV or CMV mononucleosis. |
| Difference btw. viral and bacterial pharyngitis? Rule of thumb? | Viral lacks exudate, high fever and lymphadenopathy - whereas bacterial does. CENTOR criteria: .38/100.4, anterior cervical lymphadenopathy, lack of cough with pharyngotonsillar exudates. 3/4 = GABHS and 2/4 = r/o cx. TX IS PCN or Ertyhro. |
| Complications of untreated bacterial pharyngitis? | Ludwig's angina, rheumatic fever and (peri)tonsillar abscess. |
| What is an asymetric soft palate? | Peritonsillar abscess (r/o orbital cellulitis) -> Amox/Clav + Clinda. |
| Most common causes of epiglottitis? | GA(B)S, H.flu, S.pneumo, and S.aureus. Diabetics have inc. risk and if unimmunized close contact -> rifampin. |
| What to consider when noting nasal polyps? | Asthma, ASA sensitivity and allergic rhinitis (Rx is AZELASTINE). |
| 13yo w/ URI, HA, sore throat, pressure in ears? | Macrolide for (ascending) Mycoplasma pneumonia = Erythromycin. Amp is ineffective as there is no cell wall to inhibit. |
| Malignant OE vs. mastoiditis? | Malignant OE is Pseudomonal with necrotizing tissue common among DM and immunocompromised pts. Mastoiditis is from untreated acute OM. |
| Imaging to r/o chronic sinusitis vs. tumor? | MRI w/ contrast as more sensitive than CT to tell tumor from fluid, inflammation and inspissated mucus. |
| Tx. for allergic eye "disease" (not viral conjunctivitis)? | Cool compress with topical histamine H1 receptor antagonist. |
| Urgent need to intubate with peritonsillar abscess? | No, depending upon size of abscess, airway compromise with peritonsillar abscess is rare. Different from epiglottitis. |
| Best tx for dacrocystitis? | Dacryocystorhinostomy as recurrence is the rule despite responding to abx. |
| Normal intraocular pressure? | 10-20 mmHg (average 15.5 mmHg). |
| What structures are responsible for unilateral hearing loss? | Anything up to s. olivary nuclei: Organ of Corti ->spiral ganglion in cochlea ->CN VII -> cohlear nuclei (dorsal & ventral) [NOW BILATERAL ->s. olivary nuclei -> l. lemniscus -> inf. colliculus -> m. geniculate nucleus of thalamus (MGN) -> auditory corte |
| ABSENT MENSES/SMELL/TASTE, color blindness, and cleft lip? | KALLMANN Syndrome. |
| Rx. for amoxicillin-resistant AOM? | CEFLACOR (cephalosporin) for both S.pneumo (Gm + diplococci) and H.flu (Gm - rod). Note: sulfamethoxazole only works if with TMP or erythromycin. |
| What may one white and one black pupil indicate in a young child? | RETINOBLASTOMA -> emergent opthalmological consultation. |
| Contact lens ulcerations can be infected by what? | Acanthamoeba (ulcerative keratitis -> uveitis). CMV and HSV seen in immunocompromised AIDS pts. |
| Tx for chlamydia conjunctivitis? | Erythromycin w/ pneumonia prophylaxis (cefotaxime + macrolide + Levo). |
| TOP R/O for slight elevation of B-hCG 3w s/p D&C for hydatidiform mole? | Choriocarcinoma. 5% of hydatidiform moles progress to this and hallmark is plateau or slight elevation of B-hCG. Order CXR prior to mole removal to r/o distant mets. |
| What mild deformity must be r/o when evaluation a punched nose to prevent permanent destruction of the nasal septum? | Septal hematoma. |
| Difference btw. sialolithiasis and sialadenitis? | Sialolithiasis is salivary duct stone WITHOUT INFECTION and sialadenitis is an infection. |
| Diver descends 10ft and experiences N/V, severe otalgia, and vertigo. What is most likely cause? | DECREASING pressure in middle ear. Boyle's Law states the middle ear must decrease in pressure to equalize increasing pressure on external ear to maintain TM or risk hemotypanum or perforation. |
| What makes up the "magic mouthwash" for aphtous ulcers? | Viscous xylovaine, tetracycline, liquid diphenhydramine, and liquid antacid. |
Created by:
ed24