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9% of PANCE

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
How long to rinse chemical burns to eyes?   show
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show stain with fluorescein and observe area of uptake with wood's lamp.  
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show maxillary, palatine, and zygomatic  
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show swelling, misalignemtn, restricted globe movement (especially looking up), double vision, sub-q emphysema and exopthalmos. Should be sent immediately.  
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How does a corneal abrasion present?   show
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show partial to complete monocular blindness; curtain from top to bottom. Emergency consult is needed with good prognosis.  
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show gradual loss of central vision. Amslers grid may be helpful in diagnosis. Drusen deposits on Bruch's membrane. Wet and dry types. laser therapy may help early on.  
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show sudden painless unilateral loss of vision often caused by embolism. This is an emergency with poor prognosis. Vessel dilation and paracentesis are emergent therapies. Cholesterol mgmt is long term.  
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How does central retinal vein occlusion present?   show
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show chloroquine and phenothiazine  
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show corticosteroids and lovastatin  
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How do cataracts present?   show
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show painful unilateral loss of vision with steamy cornia, fixed mid-dilated pupil and decreased visual acuity. IOP is elevated and patients often n/v. Emergency consult needed. Give IV carbonic anhydrase inhibitor, topical b-blocker and osmotic diuresis.  
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show mydriatics  
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show increased IOP leading to optic nerve damage caused by blockage of canal of Schlemm.  
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show chronic, usually over 40 and AA. Asymptomatic but can cause blinding in long run. Typical take topical meds to keep pressures down.  
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show ptosis, eyelid edema, exophthalmos, purulent discharge and conjunctivitis. Usually -12 yo with fever and decreased ROM of EOM. This is an emergency requiring hospit.  
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What are the leading bugs of orbital cellulitis?   show
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What is dacrostenosis?   show
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What is blepharitis?   show
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show small painful nodule or pustule within a gland in upper or lower eyelid. External hordeola is also known as a STY. Usually caused by Staph aureus. Use warm compresses for 48 hours and possibly abx.  
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What is a chalazion?   show
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show eyelids and lashes roll inward  
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show eyelids and lashes roll outward, associated with age and bells palsy. Keep eye nice and hydrated.  
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show adenovirus 3, 8, or 19  
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How does viral conjunctivitis present?   show
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How does bacterial conjunctivitis present?   show
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What bugs cause bacterial conjunctivitis?   show
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What is a pinguecula?   show
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show slow growing thickening of bulbar conjunctiva growing from nasal to cornea. Consider operating whn interferring with vision. Comes back.  
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What is papilledema a sign of?   show
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show right complete blindness  
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show bitemporal heteronymous hemianopsia (bilateral loss of peripheral fields)  
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show Right nasal emianopsia (loss of right nasal field)  
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show left homonymous hemianopsia (loss of left/nasal visual fields in both right and left eye)  
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show misalignment of eyes that needs addressed before patients turn two else it will cause amblyopia (reduced visual acuity not correctable by glasses)  
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show osteogenesis imperfecta  
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What is a key clinical sign of uveitis?   show
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What is the Weber test?   show
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What is Rinne sign?   show
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What are the most common causes of conductive hearing loss?   show
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show presbyscusis, Meniere's dz, acoustic trauma, or acoustic neuroma  
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What is presbycusis?   show
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What is Meniere's disease?   show
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show shotgun, explosion, or chronic noise exposure leading to sensorineural hearing loss.  
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What are signs of acoustic neuromas (vestibular schwannoma)?   show
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show streptomycin, kanamycin, neomycin, ethacrynic acid, chloramphenical. Often high frequency loss which may or may not be reversible.  
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show measles, mumps, pertussis, meningitis, influenza, and labryinthitis  
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show streptococcus pneu, HIB, moraxella catarrhalis, staph aureus, strep pyogenes  
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what can OM lead to?   show
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What are 1st line treatments for OM?   show
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What is the usual bug in OE?   show
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How does peripheral vertigo present?   show
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show labyrinthitis, Meniere's dz, positioning, vestibular neuronitis  
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show slower-onset, nonfatigable nystagmus usually vertical.  
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show test for vertigo. Rotate pateint's head 90 degrees while patient is supine. Usually positive with peripheral vertigo.  
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show brain stem dz, tumors, MS, AV malformations.  
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How is vertigo treated?   show
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show small ruptures heal on own over time but larger ones may require tympanoplasty. Keep ear dry in meantime.  
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What is allergic rhinitis?   show
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show increased secretion of mucus from nose due to changes in temp/humidity/odor/etoh. Just avoidance.  
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What is Rhinitis medicamentosa?   show
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show fever >100.4, tender anteriaor cervical adenopathy, lack of cough, and pharyngotonsillar exudates. Score of 3+ highly suggestive of group A strep.  
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What to treat strept infections with?   show
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show canker sores, often on buccal mucosa. Red painful ulcers with red halo's. Topical steroids and anesthetics are helpful.  
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show burning in affected areas with white scrapable areas with raw erythematous friable bases. Treat with nystatin swish and swallow.  
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show painless white area of tongue, cheek/lip. Common in smokers, tobacco chewers, HIV, or etOH  
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show abrupt high fever, difficulty swallowing, sore throat, drooling, and child sitting in tripod/sniffing position. Most commonly caused by HIB, group a strep. Diabetics are higher risk. Thumbprint sign on lateral neck x-ray. Admit, intubate.  
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What is the most common location of a nosebleed?   show
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show Woodruff's plexus: uncommon and often result of signifcant trauma. Bleeding is arterial and blood is seen in posterior pharynx. May pack posteriorly while awating immediate consult.  
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Created by: uvafroboy