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Flashcards in ENT Deck (31)
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1

With chemical ophthalmic burns, what is the initial management?

sterile (if possible) irrigation for at least 30 minutes

2

What physical exam finding is most concerning for a blow out orbital fracture?

inability of the patient to look up due to an entrapment of the infraorbital nerve and musculature

3

What diagnosis is associated with a curtain being drawn over the eye from top to bottom?

Retinal detachment

4

what is the prognosis for retinal detachment?

80% will recover spontaneously, 15% require treatment, 5% will never recover

5

What is the major worrisome side effect of long term or high dose chloroquine use?

Macular degeneration

6

What is the leading cause of irreversible central visual loss?

Macular degeneration

7

What is the biggest risk factor for macular degeneration?

Age > 50

8

Patient presents with a gradual loss of central vision with wavy distorted remaining vision, unilaterally. Diagnosis?

Macular degeneration

9

How do you differentiate central retinal artery occlusion from giant cell arteritis?

GCA: fever, HA, jaw claudication

10

What is associated with unilateral visual loss/blurriness and a "blood and thunder" retina on fundoscopic exam?

Central retinal vein occlusion

11

What is the leading cause of blindness in the US?

diabetic retinopathy

12

Differentiate Macular degeneration from cataracts

Cataracts: usually bilateral, intact peripheral vision, non distorted

13

Describe a typical patient with open-angle glaucoma

African American with diabetes < 40 years old

14

What type of glaucoma is most common?

open-angle glaucoma

15

Patient presents with circumlimbal injection, seamy cornea, fixed mid-dilated pupil, decreased visual acuity and tearing. Patient has vomited once. Diagnosis? Treatment?

angle-closure glaucoma - anhydrase inhibitor (acetazolamide) + topical B-blocker + systemic diuresis (mannitol)

16

What are the typical pathogens in orbital cellulitis?

S. pneumoniae, S Aureus, H. Flu and Gram-negatives

17

9 yo F p/w ptosis, eyelid edema, exophthalmos, purulent conjunctivitis and fever. She has decreased EOM and sluggish pupil. She reports having had cold symptoms for the 2 previous weeks. Work up? Likely Dx? Tx?

CT for extent of infection, Orbital Cellulitis, IV abx for total 2-3 week course, initially nafcillin + flagyl or clinda

18

Conjunctivities with intracellular gram-negative diplococci seen on smear. What is the organism?

N. Gonorrhea

19

Blue sclera

osteogenesis imperfecta

20

Weber: lateralization to affected ear, Rinne: Bone>Air on affected side - What type of hearing loss?

Conductive

21

Weber: lateralization to the unaffected ear (better hearing), Rinne: air > bone in both ears - what type of hearing loss?

sensorineural

22

What is the most common etiology of sensorineural hearing loss?

Presbycusis - gradual impairment of higher sound frequencies occurring with increasing age

23

Pt presents with episodic vertigo over the past week, lasting several minutes, unilateral hearing loss and tinnitus. On exam caloric testing reveals loss of nystagmus on the side with hearing impairment. Diagnosis?

Meniere disease

24

What is the primary treatment of Meniere's disease?

diuretics (acetazolamide) and low-sodium diet

25

What are the most common ototoxic medications?

Aminoglycoside abx (mycins), lasix, chemotherapy

26

Child with h/o ear infections p/w painless ear discharge - what is the diagnosis? Likely PE findings? Tx?

Likely chronic otits media, perforated TM, will need abx drops/tubes

27

What is the differential of antibiotics for acute sinusitis?

10-14 days of symptoms - Amox or for PCN all Macrolides/Bactrim/Doxy -> Amp -> fq

28

What are the diagnostic criteria for strep throat? (4)

Fever > 100.4, tender anterior cervical lymphadenopathy, lack of cough, pharyngotonsillar exudate

29

Patient presents with painless white oral plaques, next step?

biopsy - likely leukoplakia 5% risk of SCC

30

Differentiate epiglottitis from peritonsilar abscess

No physically identifiable swelling or intra oral erythema in epiglottitis - just difficulty swallowing and/or breathing