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EO 005 Flashcards

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1
Q

[EO 005.03]

[What is laryngitis?

A

Inflammation of the larynx

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2
Q

[EO 005.03]

List some causes of laryngitis?

A
  1. Viral URTI
  2. Lower RTI (Bronchitis, pneumonia)
  3. Excessive use
  4. Allergic reactions
  5. GERD
  6. Bulimia
  7. Inhalatation injuries
  8. Bacterial laryngitis (rare)

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3
Q

[EO 005.03]

What is Reinke’s Oedema?

A

Watery swelling of both vocal cords

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4
Q

[EO 005.03]

List signs and symptoms of laryngitis.

A
  1. Change in voice (volume, quality)
  2. Dysphonia/Aphonia
  3. Tickling/irritating sensation in throat
  4. Fever, malaise
  5. Laryngeal edema/inflammation

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5
Q

[EO 005.03]

Describe a general treatment plan for a patient with laryngitis.

A
  1. Symptomatic treatment (up fluid intake, rest, steam/humidity, saltwater gargle)
  2. Prescriptions (analgesic, antipyretics, NSAIDs)
  3. MELs if needed
  4. Pt Education (lower caffeine, cease smoking, lower EtOH)

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6
Q

[EO 005.03]

What is pharyngitis and tonsillitis?

A

Inflammation/infection of the pharynx or tonsils respectively, AKA sore throat

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7
Q

[EO 005.03]

What are causes of pharyngitis/tonsillitis?

A
  1. Acute viral infection
  2. Acute bacterial infection
  3. (Rare pokemon) abscess or epiglottitis

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8
Q

[EO 005.03]

List signs and symptoms of pharyngitis

A
  1. Acute, severe onset sort throat
  2. Possible fever & body aches
  3. Uncommon to have nasal discharge/congestion

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9
Q

[EO 005.03]

What are red flags in pharyngitis?

A
  1. Stridor
  2. Drooling
  3. Muffled voice
  4. Visible bulge of pharynx
  5. Involvement of epiglottis

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10
Q

[EO 005.03]

What are signs and symptoms of tonsillitis?

A
  1. Fever
  2. Malaise/body aches
  3. Headache
  4. Halitosis
  5. Headache
  6. Edema of tonsils
  7. Pirulent exudate on tonsils
  8. Dysphagia

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11
Q

[EO 005.03]

What are the rare signs and symptoms that can occur with tonsillitis?

A
  1. Palatal petechiae
  2. Scarletiniform

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12
Q

[EO 005.03]

What are the main criteria for the Centor score (strep)?

A
  1. Fever
  2. Tonsillar exudate
  3. Absence of cough
  4. Tender ant. cerv. lymph nodes
  5. Age

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13
Q

[EO 005.03]

Describe a general treatment plan for a patient with pharyngitis/tonsillitis.

A
  1. Warm saltwater gargle
  2. Topical anesthetics
  3. ABX
  4. Analgesics and NSAIDs
  5. MELs and rest

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14
Q

[EO 005.03]

What are some diagnostic tools for pharyngitis/tonsillitis?

A
  1. Culture Swab
  2. Rapid strep test
  3. Centor score

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15
Q

[EO 005.03]

What is sinusitis?

A

Inflammation of paranasal sinuses, typically accompanied by rhinitis.

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16
Q

[EO 005.03]

What are signs and symptoms of sinusitis?

A
  1. Pirulent rhinorrhea
  2. Pressure/pain/tenderness in face
  3. Headache
  4. Nasal congestions/hyposomia
  5. Productive cough
  6. Fever and chills

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17
Q

[EO 005.03]

What are red flags of sinusitis?

A
  1. Visual changes
  2. Periorbital edema/erythema
  3. Altered mental status

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18
Q

[EO 005.03]

What are some diagnostic tools for sinusitis?

A
  1. Culture swab

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19
Q

[EO 005.03]

Describe a general treatment plan for sinusitis.

A
  1. Hydration
  2. Steam/humid inhalation
  3. Elevated head for sleep
  4. Avoid smoking and dehydrants
  5. Analgesics and NSAIDs
  6. Decongestants/nasal rinse
  7. ABX for bacterial infections

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20
Q

[EO 005.01] Pathology of Chalazion

A

An acute or chronic inflammation of the eye lid secondary to blockage of one of the Meibomian or Zeis glands in the tarsal plate

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21
Q

[EO 005.01] Which way will most chalazion lesions point

A

In the direction of the conjunctival surface causing redness and swelling.

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22
Q

[EO 005.01] Chalazion’s are most common in who

A

More common in people with Blepharitis, Acne Rosacea, and Seborrheic Dermatitis.

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23
Q

[EO 005.01] Chalazion clinical presentation

A

A painless lump that develops in the lid or the lid margin, with mild erythema.

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24
Q

[EO 005.01] What is a chalazion similar to

A

Similar to a Hordeolum

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25
[EO 005.01] Management of a chalazion
Warm compress several times/day followed by massaging eyelid towards lid margin referral to ophthalmologist if not resolved in a few days
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[EO 005.01] Hordeolum Pathophysiology
An acute bacterial infection (usually staph) of the follicle of an eyelash and the adjacent sebaceous glands (Zeis) or sweat glands (Moll)
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[EO 005.01] Hordeolum (External) location & common appearance
Eyelash line and has the appearance of a small pustule
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[EO 005.01] An internal Hordeolum affects what and located where
Meibomian glands associated with eyelashes and is located on the inner surface of the tarsal plate
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[EO 005.01] Hordeolum Clinical presentation
1. Pustule 2. Pain 3. Edema 4. Erythema of the eyelid
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[EO 005.01] Hordeolum management
1.Warm compress 2.Erythromycin ophthalmic ointment twice daily for 7 to 10 days 3.Referral to Ophthalmologist
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[EO 005.01] Why would a hordeolum require systemic antibiotics
Significant cellulitis of surrounding tissue
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[EO 005.01] What is a Hordeolum also known as
A Stye
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[EO 005.01] What is keratoconjunctivitis Sicca
A malfunction disease of the tears and ocular surface resulting in symptoms.
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[EO 005.01] Keratoconjunctivitis Sicca 2 different pathos
Aqueous tear deficient dry eye (inadequate tear production). & Evaporative dry eye (abnormality of tear production)
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[EO 005.01] Aqueous tear-deficient dry eyes patho
The lacrimal gland does not produce enough tears to keep the entire conjunctiva and cornea covered by a complete layer of tears
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[EO 005.01] Evaporative dry eye patho
Abnormality of tear composition that results in rapid evaporation, entire surface of the eye cannot be kept covered with a complete layer of tears during certain activities/environments.
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[EO 005.01] Factors effecting Keratoconjunctivitis Sicca
1. Can result in ocular surface damage and vision impairment 2. Ageing can be a factor with women being more at risk 3. Occupational risk factors (prolonged visual attention). 4. Environmental factors (heat, wind, low humidity, and pollution). 5. Diet deficiency with low vitamin A or omega-3 fatty acid. 6. Medication (anticholinergic), contact lens wearers.
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[EO 005.01] The 3 layers that compose the tear film
1. Mucous layer 2. Aqueous layer 3. Lipid layer
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[EO 005.01] Mucous layer produced where
Produced by goblet cells in the conjunctiva
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[EO 005.01] Mucous layer function
Coats the  cornea providing a hydrophilic layer which allows for even distribution of the tear film
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[EO 005.01] Aqueous layer produced where
The Lacrimal gland and is the thickest part of the tear film.
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[EO 005.01] Aqueous layer function
1. It hydrates the mucous layer, 2. Supplies oxygen, electrolytes to the ocular surface 3. Provides antibacterial defense 4. Wound healing
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[EO 005.01] Lipid layer produced where
Secreted by the meibomian glands and is the outermost layer of the tear film.
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[EO 005.01] Lipid layer function
1. Slows tear evaporation 2. Enhances tear film spreading 3. Provides a smooth optical surface
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[EO 005.01] Keratoconjunctivitis Sicca Clinical presentation
1. Foreign body sensation (sandy/gritty feeling) 2. Burning, itchy, tired sensation 3. Photophobia 4. Blurred vision 5. Redness 6. Discomfort 7. Difficulty moving lids 8. Increase tearing in windy conditions or when concentrating on tasks
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[EO 005.01] Keratoconjunctivitis Sicca Management
1. Reducing or eliminating environmental factors 2. Proper education on use of contact lenses 3. Artificial tears, ocular lubricants, or prescription options (consult with MO/PA) 4. Continue to monitor and adjust treatments as requiredMay require a referral to ophthalmology.
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[EO 005.01] Corneal Abrasions factors
1. Very painful 2. When damaged, it causes an entry for bacteria, viruses, and fungi 3. If not treated will develop into an associated inflammatory Iritis 4. Healing time is usually within 24-48 hrs
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[EO 005.01] Corneal Abrasions Clinical Presentation
1. FB Sensation 2. Photophobia 3. Redness 4. Swelling 5. Pain
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[EO 005.01] Corneal Abrasions Tx
1. Pain relief (Tetracaine) 2. Infection prevention(antibiotic eye drops) 3. Flourescein stain to confirm and examine with a Slit lamp 4. Caution with eye patch (if pt is comfortable).
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[EO 005.01] Blepharitis Pathophysiology
Inflammation of the eyelash follicles along the edge of the eyelid (secondary to another pathology)
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[EO 005.01] Blepharitis associated pathophysiology's
1. Seborrheic dermatitis 2. Atopic dermatitis, acne rosacea 3. Eyelash lice infestation
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[EO 005.01] Blepharitis Clinical presentation
1. Conjunctival injection 2. Crusting 3. Swollen, and pruritic eyelids 4. Possible eye pain 5. Chalazion or Hordeolum may also be present 6. Foreign Body Sensation
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[EO 005.01]Blepharitis Management
1. Tx of underlying condition 2. Warm compresses 3. Gentle scrubbing of the eyelid margins 4. Refer to MO/PA/Ophthalmologist 5. Mechanical expression done by an ophthalmologist 6. Aseptic technique 7. patient education
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[EO 005.01] What is Hyphema
Blood or blood clots in the anterior chamber of the eye.
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[EO 005.01] Types of Hyphema
1. Traumatic 2. Spontaneous
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[EO 005.01] Causes of Traumatic Hyphema
Usually results from a ruptured iris root vessel
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[EO 005.01] Causes of Spontaneous Hyphema
Usually associated with sickle cell disease
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[EO 005.01] Clinical presentations of Hyphema
1. Blurred vision 2. Pain 3. Photophobia 3. Blood may be visible behind the lower part of the cornea
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[EO 005.01] Hyphema important Hx questions
1. Is the pt on anticoagulant or anti-platelet medications 2. history of bleeding disorders
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[EO 005.01] Hyphema Management
1. Referral to MO/PA/ophthalmologist 2. Elevate the patients head to promote settling of suspended RBC’s. (This will prevent occlusion of the trabecular meshwork) 3. Avoid pupil activity (Dilation of pupils, use of eye patch, put in dark room).
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