Podcast
Questions and Answers
Which of the following medications is indicated as a treatment for idiopathic rhinitis?
Which of the following medications is indicated as a treatment for idiopathic rhinitis?
- Montelukast
- Antihistamines
- Cromolyn
- Ipratropium Bromide (correct)
What is a common complication that can arise from untreated rhinitis?
What is a common complication that can arise from untreated rhinitis?
- Increased risk of asthma exacerbations
- Increased risk of sleep apnea
- Increased risk of infection
- All of the above (correct)
What is the primary mechanism of action of cromolyn in the treatment of rhinitis?
What is the primary mechanism of action of cromolyn in the treatment of rhinitis?
- Inhibition of mast cell degranulation (correct)
- Anticholinergic effects
- Blocking leukotriene receptors
- Direct vasoconstriction
What does a patient with idiopathic rhinitis typically NOT exhibit?
What does a patient with idiopathic rhinitis typically NOT exhibit?
Which of the following medications is contraindicated for use in patients with narrow-angle glaucoma?
Which of the following medications is contraindicated for use in patients with narrow-angle glaucoma?
Which of the following factors can trigger idiopathic rhinitis?
Which of the following factors can trigger idiopathic rhinitis?
Which of the following medications can worsen idiopathic rhinitis?
Which of the following medications can worsen idiopathic rhinitis?
What is the primary pathophysiological mechanism thought to be responsible for idiopathic rhinitis?
What is the primary pathophysiological mechanism thought to be responsible for idiopathic rhinitis?
Which of the following is the second most common cause of sensorineural hearing loss?
Which of the following is the second most common cause of sensorineural hearing loss?
What is the most frequent cause of sensory hearing loss?
What is the most frequent cause of sensory hearing loss?
What is a common cause of referred otalgia?
What is a common cause of referred otalgia?
What is the main goal in treating sensorineural hearing loss?
What is the main goal in treating sensorineural hearing loss?
Which of the following conditions can cause persistent pain and discharge from the ear, requiring referral to a specialist?
Which of the following conditions can cause persistent pain and discharge from the ear, requiring referral to a specialist?
Which of the following is a common cause of earache?
Which of the following is a common cause of earache?
Which nerve(s) are involved in the sensory innervation of the ear?
Which nerve(s) are involved in the sensory innervation of the ear?
What is the first step in differentiating acute otitis media (AOM) from otitis externa (OE)?
What is the first step in differentiating acute otitis media (AOM) from otitis externa (OE)?
What is a common cause of serious otitis media in adults?
What is a common cause of serious otitis media in adults?
Which symptom is most indicative of patulous Eustachian tube?
Which symptom is most indicative of patulous Eustachian tube?
What is the primary treatment for acute otitis media?
What is the primary treatment for acute otitis media?
In what circumstances should one consider nasopharyngeal carcinoma when diagnosing eustachian tube dysfunction?
In what circumstances should one consider nasopharyngeal carcinoma when diagnosing eustachian tube dysfunction?
What finding is commonly associated with acute otitis media during a physical exam?
What finding is commonly associated with acute otitis media during a physical exam?
What is one major complication of untreated acute otitis media?
What is one major complication of untreated acute otitis media?
Which of the following is NOT a common cause of noninfectious conjunctivitis?
Which of the following is NOT a common cause of noninfectious conjunctivitis?
Which of the following is the most common cause of conjunctivitis in the pediatric population?
Which of the following is the most common cause of conjunctivitis in the pediatric population?
What should patients with a patulous Eustachian tube avoid during their condition?
What should patients with a patulous Eustachian tube avoid during their condition?
What is the most common causative organism of seasonal allergic conjunctivitis?
What is the most common causative organism of seasonal allergic conjunctivitis?
What characterizes the tympanic membrane during physical examination in cases of serious otitis media?
What characterizes the tympanic membrane during physical examination in cases of serious otitis media?
Which of the following is a clinical presentation of viral conjunctivitis?
Which of the following is a clinical presentation of viral conjunctivitis?
Which of the following is a characteristic of conjunctivitis from medication?
Which of the following is a characteristic of conjunctivitis from medication?
Which of the following is a priority differential for a patient presenting with conjunctivitis?
Which of the following is a priority differential for a patient presenting with conjunctivitis?
What is the mechanism behind auto-inoculation in viral conjunctivitis?
What is the mechanism behind auto-inoculation in viral conjunctivitis?
Which of the following is a recommendation for patients with conjunctivitis?
Which of the following is a recommendation for patients with conjunctivitis?
What is the main cause of chronic issues associated with a squamous epithelium-lined sac?
What is the main cause of chronic issues associated with a squamous epithelium-lined sac?
Which diagnostic imaging is most useful in identifying mastoiditis?
Which diagnostic imaging is most useful in identifying mastoiditis?
What common complication may arise from severe petrous apicitis?
What common complication may arise from severe petrous apicitis?
What treatment is typically recommended for facial paralysis resulting from chronic otitis media?
What treatment is typically recommended for facial paralysis resulting from chronic otitis media?
Which bacterium is most commonly associated with otogenic meningitis following acute otitis media?
Which bacterium is most commonly associated with otogenic meningitis following acute otitis media?
What is a typical symptom of sigmoid sinus thrombosis?
What is a typical symptom of sigmoid sinus thrombosis?
Which treatment approach is not typically associated with managing mastoiditis?
Which treatment approach is not typically associated with managing mastoiditis?
What is the primary therapeutic goal for cholesteatoma-related chronic facial paralysis?
What is the primary therapeutic goal for cholesteatoma-related chronic facial paralysis?
Which of the following conditions is characterized by a rapid progression and may involve the cornea?
Which of the following conditions is characterized by a rapid progression and may involve the cornea?
What are some red flags that warrant an ophthalmologist referral for conjunctivitis?
What are some red flags that warrant an ophthalmologist referral for conjunctivitis?
Which of the following is a distinguishing characteristic of hyperacute onset conjunctivitis?
Which of the following is a distinguishing characteristic of hyperacute onset conjunctivitis?
In which age group is conjunctivitis caused by Haemophilus influenzae and Streptococcus pneumonia commonly found?
In which age group is conjunctivitis caused by Haemophilus influenzae and Streptococcus pneumonia commonly found?
Which of the following statements accurately describes the management of atopic conjunctivitis?
Which of the following statements accurately describes the management of atopic conjunctivitis?
Which of the following conditions is primarily associated with a history of asthma, allergic rhinitis, and atopic dermatitis?
Which of the following conditions is primarily associated with a history of asthma, allergic rhinitis, and atopic dermatitis?
What is the anatomical division used to classify periorbital infections?
What is the anatomical division used to classify periorbital infections?
Which of the following is true regarding the prevalence of periorbital infections?
Which of the following is true regarding the prevalence of periorbital infections?
Flashcards
Conjunctivitis
Conjunctivitis
Inflammation of the bulbar or palpebral conjunctiva.
Viral conjunctivitis
Viral conjunctivitis
An eye infection often caused by adenovirus, spread by direct contact.
Bacterial conjunctivitis
Bacterial conjunctivitis
Most common in children; caused by bacterial infection of the conjunctiva.
Allergic conjunctivitis
Allergic conjunctivitis
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Pathophysiology of conjunctivitis
Pathophysiology of conjunctivitis
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Suspect conjunctivitis causes
Suspect conjunctivitis causes
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Clinical Presentation of viral conjunctivitis
Clinical Presentation of viral conjunctivitis
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Examination for conjunctivitis
Examination for conjunctivitis
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Allegra-D
Allegra-D
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Claritin-D
Claritin-D
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Decongestant side effects
Decongestant side effects
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Intranasal agents
Intranasal agents
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Idiopathic Rhinitis
Idiopathic Rhinitis
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Montelukast
Montelukast
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Nasal eosinophils
Nasal eosinophils
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Allergy diary
Allergy diary
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Causative agents in children
Causative agents in children
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Causative agent in adults
Causative agent in adults
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Neisseria gonorrhoeae
Neisseria gonorrhoeae
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Shield ulcer
Shield ulcer
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Vernal conjunctivitis management
Vernal conjunctivitis management
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Atopic conjunctivitis
Atopic conjunctivitis
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Referral red flags
Referral red flags
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Preseptal and Orbital Cellulitis
Preseptal and Orbital Cellulitis
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Cholesteatoma
Cholesteatoma
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Mastoiditis
Mastoiditis
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Petrous Apicitis
Petrous Apicitis
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Facial Paralysis
Facial Paralysis
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Sigmoid Sinus Thrombosis
Sigmoid Sinus Thrombosis
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Otogenic Meningitis
Otogenic Meningitis
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Myringotomy
Myringotomy
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IV Antibiotics (IV abx)
IV Antibiotics (IV abx)
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Intranasal corticosteroids
Intranasal corticosteroids
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Patulous Eustachian Tube
Patulous Eustachian Tube
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Serous Otitis Media
Serous Otitis Media
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Acute Otitis Media
Acute Otitis Media
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Tympanic membrane signs
Tympanic membrane signs
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Eustachian tube obstruction
Eustachian tube obstruction
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Ventilating tube placement
Ventilating tube placement
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Common pathogens in otitis media
Common pathogens in otitis media
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Chronic Otitis Media (COM)
Chronic Otitis Media (COM)
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Symptoms of COM
Symptoms of COM
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Otitis Media vs. Otitis Externa
Otitis Media vs. Otitis Externa
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Herpes Zoster Oticus
Herpes Zoster Oticus
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Referred Otalgia
Referred Otalgia
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Sensorineural Hearing Loss
Sensorineural Hearing Loss
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Presbycusis
Presbycusis
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Noise Trauma
Noise Trauma
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Study Notes
Conjunctivitis
- Conjunctivitis is inflammation of the bulbar or palpebral conjunctiva.
- Up to 70% of infectious conjunctivitis is viral.
- Adenovirus is the most common cause of viral conjunctivitis.
- Bacterial conjunctivitis is most common in children.
- Allergic conjunctivitis is the most common cause of noninfectious conjunctivitis.
- Viral conjunctivitis is spread through direct contact with infected individuals.
- Bacterial conjunctivitis is spread through transferring organisms from the nose and sinus to the eye.
- Seasonal allergic conjunctivitis, commonly called hay fever, is typically secondary to environmental allergens, with ragweed being the most common (75%).
Pathophysiology
- Viral conjunctivitis spreads through direct contact.
- Bacterial conjunctivitis is often from transfer of organisms through contact.
- Seasonal allergic conjunctivitis is an immunoglobulin E mast cell-mediated hypersensitivity.
- Vernal conjunctivitis and atopic conjunctivitis are chronic, mast cell, and lymphocyte-mediated immune responses.
- Conjunctivitis from medications is due to prolonged use of eye drops (>1 month), particularly those containing benzalkonium chloride.
Clinical Presentation
- Viral conjunctivitis: often follows recent upper respiratory infection.
- Early signs include redness and excessive watery discharge.
- Classically begins in one eye, then spreads to the other.
- Examination should include palpation of the anterior cervical lymph nodes; preauricular lymph nodes are often tender (50% of patients).
- Herpes simplex virus (HSV): often follows antecedent respiratory infection.
- Can involve vesicular skin lesions.
- Adenoviral conjunctivitis: may have three forms
- Adenoviral conjunctivitis: follicles (clear bumps ranging in size), injected conjunctival vessels.
- Pharyngoconjunctival fever: presents with systemic disease—fever, headache, and sore throat.
- Epidemic keratoconjunctivitis: bilateral conjunctival hyperemia, chemosis, and petechial and larger sub conjunctival hemorrhages.
Clinical Presentation Continued
- Bacterial Conjunctivitis: Thick, purulent discharge, worse in the morning, eyes appear sticky or glued shut.
- Symptoms can occur over several days in children.
- Bacterial conjunctivitis in adults is often caused by S. aureus.
- Hyperacute onset of purulent discharge (12-24 hours) suggests Neisseria gonorrhoea, potentially from maternal-neonatal transmission.
- Chlamydial conjunctivitis: present in sexually active adults with symptoms that fluctuate, lasting weeks or longer.
Clinical Presentation Continued 2
- Molluscum contagiosum: characterized by umbilicated nodules on eyelid margin
- Should be considered in children and HIV infected adults.
Clinical Presentation and PE of other conjunctivitis diseases
- Allergic Conjunctivitis: Itching, watery discharge (clear or stringy/white), and boggy appearance of conjunctiva
- Periorbital skin can be discolored, thickened, and erythematous. Periorbital venous congestion can present as dark circles under the eyes
- Vernal conjunctivitis: Giant papillary conjunctivitis, eversion of upper eyelid reveals cobblestone appearance
- Shield ulcer, corneal defect in the superior cornea
- Atopic conjunctivitis: Severe itching, burning, and tearing. White, thick, ropy discharge
Management
- Viral conjunctivitis: self-limiting (5-14 days), supportive care with artificial tears and cool compresses.
- Bacterial conjunctivitis: antibiotics (topical), refer to ophthalmologist if high risk patients are present.
- Allergic conjunctivitis: avoidance of allergens, antihistamines (oral and topical), mast cell stabilizers.
- Vernal conjunctivitis: mast cell stabilizers, topical anti-inflammatory medications.
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