Podcast
Questions and Answers
A patient presents with a nosebleed. Which of the following medications or substances in their history would be LEAST likely to be a contributing factor?
A patient presents with a nosebleed. Which of the following medications or substances in their history would be LEAST likely to be a contributing factor?
- Aspirin
- Anticoagulants
- Cocaine
- Vitamin C (correct)
After applying direct pressure to the nose of a patient with a nosebleed for several minutes, the bleeding continues. What is the next most appropriate step?
After applying direct pressure to the nose of a patient with a nosebleed for several minutes, the bleeding continues. What is the next most appropriate step?
- Administer an oral antihistamine to reduce nasal swelling.
- Pack the nasal cavity with petroleum-soaked gauze.
- Immediately cauterize the nasal mucosa with silver nitrate.
- Apply a nasal decongestant to shrink the nasal tissue. (correct)
A child presents with a small plastic bead lodged in their ear. Which of the following methods is MOST appropriate for initial removal attempts at home, assuming there's no suspicion of a perforated eardrum?
A child presents with a small plastic bead lodged in their ear. Which of the following methods is MOST appropriate for initial removal attempts at home, assuming there's no suspicion of a perforated eardrum?
- Tilting the head and pouring warm oil into the ear.
- Attempting to grasp the bead with tweezers if it's easily visible. (correct)
- Using a cotton swab to gently push the bead further in and then scoop it out.
- Irrigating the ear canal with cold water.
A child presents with fever, sore throat, and a rash on their hands and feet. Which condition is most likely?
A child presents with fever, sore throat, and a rash on their hands and feet. Which condition is most likely?
You suspect a patient has a cockroach stuck in their ear. What is the MOST appropriate initial intervention?
You suspect a patient has a cockroach stuck in their ear. What is the MOST appropriate initial intervention?
A patient presents with sudden onset of localized tenderness, redness, and swelling of the eyelid. Which of the following is the most appropriate initial treatment?
A patient presents with sudden onset of localized tenderness, redness, and swelling of the eyelid. Which of the following is the most appropriate initial treatment?
A patient presents with redness, swelling, and pain around their eye, and you suspect periorbital cellulitis. Which of the following findings would be MOST concerning and warrant immediate further investigation (e.g., CT scan)?
A patient presents with redness, swelling, and pain around their eye, and you suspect periorbital cellulitis. Which of the following findings would be MOST concerning and warrant immediate further investigation (e.g., CT scan)?
What is the most common etiological agent causing Hordeolum?
What is the most common etiological agent causing Hordeolum?
A patient has a painless lesion on their eyelid that has persisted for several weeks after an initial episode of localized tenderness and redness. Which of the following conditions is most likely?
A patient has a painless lesion on their eyelid that has persisted for several weeks after an initial episode of localized tenderness and redness. Which of the following conditions is most likely?
A patient has developed chronic recurrent chalazion in the same location. What is the most appropriate next step?
A patient has developed chronic recurrent chalazion in the same location. What is the most appropriate next step?
A patient presents with symptoms of burning, itching, tearing and crusting of the eyelids. Examination reveals flaking of the eyelid skin and red eyes. What initial assessment step is most important?
A patient presents with symptoms of burning, itching, tearing and crusting of the eyelids. Examination reveals flaking of the eyelid skin and red eyes. What initial assessment step is most important?
A 4-year-old child presents with a fever oral blistering, and a rash on their hands and feet. What is the MOST likely diagnosis and appropriate initial management?
A 4-year-old child presents with a fever oral blistering, and a rash on their hands and feet. What is the MOST likely diagnosis and appropriate initial management?
A patient is diagnosed with anterior blepharitis. Which of the following is LEAST likely to be an associated etiological factor?
A patient is diagnosed with anterior blepharitis. Which of the following is LEAST likely to be an associated etiological factor?
A child presents with rapid onset of ear pain, fever, and a bulging tympanic membrane. Which of the following is the MOST appropriate first-line treatment?
A child presents with rapid onset of ear pain, fever, and a bulging tympanic membrane. Which of the following is the MOST appropriate first-line treatment?
A patient diagnosed with infectious mononucleosis is being discharged. Which instruction regarding physical activity is MOST important to emphasize?
A patient diagnosed with infectious mononucleosis is being discharged. Which instruction regarding physical activity is MOST important to emphasize?
An adult patient with severe blepharitis, refractory to topical treatments and lid hygiene, is being considered for oral antibiotics. Which factor would MOST influence the choice between oral tetracycline/doxycycline and oral azithromycin?
An adult patient with severe blepharitis, refractory to topical treatments and lid hygiene, is being considered for oral antibiotics. Which factor would MOST influence the choice between oral tetracycline/doxycycline and oral azithromycin?
A patient with recurrent hordeola and facial seborrhea presents with blepharitis. Besides topical antibiotics and lid scrubs, which additional intervention is MOST appropriate?
A patient with recurrent hordeola and facial seborrhea presents with blepharitis. Besides topical antibiotics and lid scrubs, which additional intervention is MOST appropriate?
After recovering from acute otitis media, a patient still has fluid in their middle ear but no signs of active infection. Which of the following is the MOST likely cause?
After recovering from acute otitis media, a patient still has fluid in their middle ear but no signs of active infection. Which of the following is the MOST likely cause?
Which of the following is NOT typically a symptom associated with acute otitis media with effusion?
Which of the following is NOT typically a symptom associated with acute otitis media with effusion?
A 16-year-old presents with fever, pharyngitis, and fatigue. Examination reveals enlarged cervical lymph nodes. Which test would be MOST appropriate to confirm a suspected diagnosis?
A 16-year-old presents with fever, pharyngitis, and fatigue. Examination reveals enlarged cervical lymph nodes. Which test would be MOST appropriate to confirm a suspected diagnosis?
A patient with infectious mononucleosis is found to have splenomegaly on examination. What is the MOST appropriate next step in management?
A patient with infectious mononucleosis is found to have splenomegaly on examination. What is the MOST appropriate next step in management?
Which of the following is the MOST common bacterial cause of acute otitis media?
Which of the following is the MOST common bacterial cause of acute otitis media?
What is the MOST concerning complication of epiglottitis that requires immediate intervention?
What is the MOST concerning complication of epiglottitis that requires immediate intervention?
A patient presents with bilateral, copious purulent discharge and diffuse eyelid edema. Which of the following is the MOST likely cause?
A patient presents with bilateral, copious purulent discharge and diffuse eyelid edema. Which of the following is the MOST likely cause?
A patient with conjunctivitis also reports severe itching and tearing. Which treatment is MOST appropriate?
A patient with conjunctivitis also reports severe itching and tearing. Which treatment is MOST appropriate?
Which of the following instructions should be given to a patient diagnosed with viral conjunctivitis to prevent its spread?
Which of the following instructions should be given to a patient diagnosed with viral conjunctivitis to prevent its spread?
Why should primary care providers avoid prescribing topical glucocorticoids for conjunctivitis?
Why should primary care providers avoid prescribing topical glucocorticoids for conjunctivitis?
A nursing mother is diagnosed with bacterial conjunctivitis. Which medication should be avoided?
A nursing mother is diagnosed with bacterial conjunctivitis. Which medication should be avoided?
A patient reports pain when chewing, clicking in the jaw, and frequent headaches. Which condition is MOST likely?
A patient reports pain when chewing, clicking in the jaw, and frequent headaches. Which condition is MOST likely?
Which of the following factors is LEAST likely to contribute to TMJ disorders?
Which of the following factors is LEAST likely to contribute to TMJ disorders?
What is the PRIMARY goal of recommending a mouth guard for a patient experiencing TMJ symptoms?
What is the PRIMARY goal of recommending a mouth guard for a patient experiencing TMJ symptoms?
A patient presents with painful mouth sores, swelling, and difficulty swallowing. Which of the following is the MOST appropriate initial step in managing this patient?
A patient presents with painful mouth sores, swelling, and difficulty swallowing. Which of the following is the MOST appropriate initial step in managing this patient?
A patient complains of a foreign body sensation in their eye, accompanied by redness and tearing, after working in a woodworking shop without safety glasses. Which of the following actions should be taken FIRST?
A patient complains of a foreign body sensation in their eye, accompanied by redness and tearing, after working in a woodworking shop without safety glasses. Which of the following actions should be taken FIRST?
A child presents with small, blister-like bumps in the mouth and throat, accompanied by a fever and sore throat. The MOST likely diagnosis is herpangina. What is the MOST appropriate dietary recommendation for this child?
A child presents with small, blister-like bumps in the mouth and throat, accompanied by a fever and sore throat. The MOST likely diagnosis is herpangina. What is the MOST appropriate dietary recommendation for this child?
A patient with stomatitis is prescribed a new mouth rinse. Which ingredient in the mouth rinse would MOST likely be a cause for concern?
A patient with stomatitis is prescribed a new mouth rinse. Which ingredient in the mouth rinse would MOST likely be a cause for concern?
A patient presents with a red eye, foreign body sensation, and blurry vision. After examination, it's determined they have a simple, non-penetrating corneal foreign body. Which of the following is the MOST appropriate next step?
A patient presents with a red eye, foreign body sensation, and blurry vision. After examination, it's determined they have a simple, non-penetrating corneal foreign body. Which of the following is the MOST appropriate next step?
A patient is diagnosed with herpangina. Besides pharmacological treatment, what preventative measure is MOST effective in controlling the spread of the infection?
A patient is diagnosed with herpangina. Besides pharmacological treatment, what preventative measure is MOST effective in controlling the spread of the infection?
A patient reports painful mouth sores that have persisted for three weeks despite following recommended treatments for stomatitis. What underlying condition should be considered?
A patient reports painful mouth sores that have persisted for three weeks despite following recommended treatments for stomatitis. What underlying condition should be considered?
A construction worker presents to the clinic after getting a metal shard in his eye. Visual acuity testing demonstrates a significant decrease since baseline. What is the MOST appropriate course of action?
A construction worker presents to the clinic after getting a metal shard in his eye. Visual acuity testing demonstrates a significant decrease since baseline. What is the MOST appropriate course of action?
A patient presents with a severe headache, fever, and altered mental status. Physical exam reveals nuchal rigidity. Which of the following signs or symptoms would be MOST concerning for a potential progression to cavernous sinus thrombosis, warranting immediate neuroimaging?
A patient presents with a severe headache, fever, and altered mental status. Physical exam reveals nuchal rigidity. Which of the following signs or symptoms would be MOST concerning for a potential progression to cavernous sinus thrombosis, warranting immediate neuroimaging?
An elderly patient reports gradual hearing loss in both ears over several years. They deny any history of noise exposure, ear infections, or medication use known to cause ototoxicity. Which factor is the MOST likely cause of their hearing loss?
An elderly patient reports gradual hearing loss in both ears over several years. They deny any history of noise exposure, ear infections, or medication use known to cause ototoxicity. Which factor is the MOST likely cause of their hearing loss?
A patient is being evaluated for suspected meningitis. While performing a physical examination, you passively flex the patient's neck towards their chest. The patient involuntarily flexes their hips and knees. Which of the following is the MOST appropriate interpretation of this finding?
A patient is being evaluated for suspected meningitis. While performing a physical examination, you passively flex the patient's neck towards their chest. The patient involuntarily flexes their hips and knees. Which of the following is the MOST appropriate interpretation of this finding?
A patient with a history of diabetes and hypertension presents with gradual, bilateral hearing loss. Which pathophysiological mechanism MOST likely contributes to their hearing loss?
A patient with a history of diabetes and hypertension presents with gradual, bilateral hearing loss. Which pathophysiological mechanism MOST likely contributes to their hearing loss?
A patient presents with new onset headache, fever, and signs of meningeal irritation. After further examination, the physician suspects bacterial meningitis. What is the MOST appropriate next step in management?
A patient presents with new onset headache, fever, and signs of meningeal irritation. After further examination, the physician suspects bacterial meningitis. What is the MOST appropriate next step in management?
A patient with a history of controlled hypertension presents with a nosebleed that started spontaneously. Besides applying direct pressure, which of the following interventions would be MOST appropriate as an initial step?
A patient with a history of controlled hypertension presents with a nosebleed that started spontaneously. Besides applying direct pressure, which of the following interventions would be MOST appropriate as an initial step?
A patient presents with a small, non-metallic bead lodged in their ear. After unsuccessful attempts to remove it at home, they seek medical attention. Assuming the tympanic membrane is intact, what is the MOST appropriate next step?
A patient presents with a small, non-metallic bead lodged in their ear. After unsuccessful attempts to remove it at home, they seek medical attention. Assuming the tympanic membrane is intact, what is the MOST appropriate next step?
A child with a history of recurrent nosebleeds due to nose-picking presents with a new episode. After controlling the active bleed, what is the MOST effective long-term strategy to prevent future occurrences?
A child with a history of recurrent nosebleeds due to nose-picking presents with a new episode. After controlling the active bleed, what is the MOST effective long-term strategy to prevent future occurrences?
A patient presents with periorbital swelling, redness, and pain around the eye, but visual acuity and extraocular movements are normal. The patient is afebrile and otherwise well. What is the MOST appropriate initial management strategy?
A patient presents with periorbital swelling, redness, and pain around the eye, but visual acuity and extraocular movements are normal. The patient is afebrile and otherwise well. What is the MOST appropriate initial management strategy?
A young child presents with suspected periorbital cellulitis. Which factor is the MOST important in differentiating periorbital from orbital cellulitis?
A young child presents with suspected periorbital cellulitis. Which factor is the MOST important in differentiating periorbital from orbital cellulitis?
A patient presents with periorbital cellulitis. Which symptom, if present, would MOST strongly suggest progression towards orbital cellulitis, requiring urgent intervention?
A patient presents with periorbital cellulitis. Which symptom, if present, would MOST strongly suggest progression towards orbital cellulitis, requiring urgent intervention?
A patient with a history of allergies and chronic nasal congestion presents with ear pain, a feeling of fullness, and popping sounds in their ears. Which of the following treatments would be the MOST appropriate INITIAL approach, considering the likely underlying cause?
A patient with a history of allergies and chronic nasal congestion presents with ear pain, a feeling of fullness, and popping sounds in their ears. Which of the following treatments would be the MOST appropriate INITIAL approach, considering the likely underlying cause?
A child presents with a runny nose, cough, sore throat, and low-grade fever for the past three days. Parents have been using over-the-counter decongestants and fever reducers. Which of the following is the MOST important advice to give the parents regarding the natural course of this illness?
A child presents with a runny nose, cough, sore throat, and low-grade fever for the past three days. Parents have been using over-the-counter decongestants and fever reducers. Which of the following is the MOST important advice to give the parents regarding the natural course of this illness?
A patient presents with pharyngitis, reporting a sore throat, fatigue, and mild headache. On examination, you note a clear nasal discharge. Which of the following is the MOST likely etiology?
A patient presents with pharyngitis, reporting a sore throat, fatigue, and mild headache. On examination, you note a clear nasal discharge. Which of the following is the MOST likely etiology?
A patient presents with moderate periorbital cellulitis. After initial treatment with oral antibiotics, when should the patient be reassessed to evaluate treatment effectiveness and rule out complications?
A patient presents with moderate periorbital cellulitis. After initial treatment with oral antibiotics, when should the patient be reassessed to evaluate treatment effectiveness and rule out complications?
A patient reports persistent ear pain and a sensation of fullness in their ear after recovering from a cold. They deny fever or drainage. Which of the following is the MOST likely underlying cause?
A patient reports persistent ear pain and a sensation of fullness in their ear after recovering from a cold. They deny fever or drainage. Which of the following is the MOST likely underlying cause?
In a community with a high prevalence of respiratory syncytial virus (RSV), which of the following preventative measures is MOST effective in reducing the spread of nasopharyngitis, especially among young children?
In a community with a high prevalence of respiratory syncytial virus (RSV), which of the following preventative measures is MOST effective in reducing the spread of nasopharyngitis, especially among young children?
A patient with recurrent tonsillitis is being evaluated for potential tonsillectomy. Besides the frequency and severity of infections, what other factor should significantly influence the decision to proceed with surgery?
A patient with recurrent tonsillitis is being evaluated for potential tonsillectomy. Besides the frequency and severity of infections, what other factor should significantly influence the decision to proceed with surgery?
A patient with suspected infectious mononucleosis (mono) is also diagnosed with streptococcal pharyngitis. Considering the potential complications, which antibiotic should be AVOIDED?
A patient with suspected infectious mononucleosis (mono) is also diagnosed with streptococcal pharyngitis. Considering the potential complications, which antibiotic should be AVOIDED?
A patient presents with a severely displaced uvula, fever, and difficulty swallowing. Which of the following management steps is MOST critical given these symptoms?
A patient presents with a severely displaced uvula, fever, and difficulty swallowing. Which of the following management steps is MOST critical given these symptoms?
A patient presents with redness, swelling, and tenderness around the mastoid bone, accompanied by fever and ear pain. Which of the following is the MOST appropriate initial diagnostic step?
A patient presents with redness, swelling, and tenderness around the mastoid bone, accompanied by fever and ear pain. Which of the following is the MOST appropriate initial diagnostic step?
During an examination of a patient with suspected mastoiditis, which finding would be LEAST consistent with the typical presentation of this condition?
During an examination of a patient with suspected mastoiditis, which finding would be LEAST consistent with the typical presentation of this condition?
A patient is diagnosed with a dental abscess. Besides antibiotics, what other treatment interventions might be required considering the patient's condition?
A patient is diagnosed with a dental abscess. Besides antibiotics, what other treatment interventions might be required considering the patient's condition?
A patient presents with a dental abscess and is allergic to penicillin. Which of the following antibiotics would be the MOST appropriate alternative as an initial treatment?
A patient presents with a dental abscess and is allergic to penicillin. Which of the following antibiotics would be the MOST appropriate alternative as an initial treatment?
A patient with a dental abscess reports throbbing pain that intensifies when lying down. What is the MOST likely reason for this phenomenon?
A patient with a dental abscess reports throbbing pain that intensifies when lying down. What is the MOST likely reason for this phenomenon?
A patient with a suspected peritonsillar abscess presents with increased saliva and a muffled "hot potato" voice. What is the underlying mechanism causing these symptoms?
A patient with a suspected peritonsillar abscess presents with increased saliva and a muffled "hot potato" voice. What is the underlying mechanism causing these symptoms?
A 6-year-old child presents with fever, sore throat, and painful mouth sores accompanied by a rash on their hands and feet. While complications are rare, which of the following would be the MOST concerning if observed?
A 6-year-old child presents with fever, sore throat, and painful mouth sores accompanied by a rash on their hands and feet. While complications are rare, which of the following would be the MOST concerning if observed?
A patient presents with localized tenderness, redness, and swelling of the eyelid margin near the base of an eyelash. Initial treatment should include all of the following EXCEPT:
A patient presents with localized tenderness, redness, and swelling of the eyelid margin near the base of an eyelash. Initial treatment should include all of the following EXCEPT:
You are evaluating a patient with a chalazion. Which historical finding should prompt a referral to ophthalmology?
You are evaluating a patient with a chalazion. Which historical finding should prompt a referral to ophthalmology?
A patient is diagnosed with stomatitis. Which of the following questions would be MOST important to ask to determine the etiology?
A patient is diagnosed with stomatitis. Which of the following questions would be MOST important to ask to determine the etiology?
A patient presents with a painless lump on their eyelid that has been present for several weeks. It does not appear infected, and the patient reports no vision changes. Initial management should include which of the following?
A patient presents with a painless lump on their eyelid that has been present for several weeks. It does not appear infected, and the patient reports no vision changes. Initial management should include which of the following?
A 25-year-old patient presents with sudden onset of bilateral copious purulent discharge, diffuse eyelid edema, and conjunctival injection. Which of the following historical findings would MOST strongly suggest the diagnosis of hyperacute bacterial conjunctivitis?
A 25-year-old patient presents with sudden onset of bilateral copious purulent discharge, diffuse eyelid edema, and conjunctival injection. Which of the following historical findings would MOST strongly suggest the diagnosis of hyperacute bacterial conjunctivitis?
A patient presents with allergic conjunctivitis and is already using topical antihistamine eye drops. However, they report persistent, bothersome itching. Which of the following would be the MOST appropriate next step in management?
A patient presents with allergic conjunctivitis and is already using topical antihistamine eye drops. However, they report persistent, bothersome itching. Which of the following would be the MOST appropriate next step in management?
A daycare worker is diagnosed with viral conjunctivitis. Besides proper hand hygiene, what is the MOST important instruction to prevent the spread of infection to the children?
A daycare worker is diagnosed with viral conjunctivitis. Besides proper hand hygiene, what is the MOST important instruction to prevent the spread of infection to the children?
A pregnant patient presents with suspected bacterial conjunctivitis. Which of the following medications is MOST appropriate for treatment, considering potential risks?
A pregnant patient presents with suspected bacterial conjunctivitis. Which of the following medications is MOST appropriate for treatment, considering potential risks?
A patient presents with TMJ pain, frequent headaches, and notes that their jaw locks occasionally. They have tried over-the-counter pain relievers without relief. Which of the following is the MOST appropriate next step in management?
A patient presents with TMJ pain, frequent headaches, and notes that their jaw locks occasionally. They have tried over-the-counter pain relievers without relief. Which of the following is the MOST appropriate next step in management?
A patient with TMJ disorder reports increased pain and stiffness in the jaw, especially in the mornings upon waking. Which of the following is the MOST likely contributing factor?
A patient with TMJ disorder reports increased pain and stiffness in the jaw, especially in the mornings upon waking. Which of the following is the MOST likely contributing factor?
An adult patient is diagnosed with TMJ disorder. They have tried conservative treatments, including mouth guards, without significant pain relief. Given their history, which of the following comorbidities would MOST warrant further investigation and potentially influence the treatment approach?
An adult patient is diagnosed with TMJ disorder. They have tried conservative treatments, including mouth guards, without significant pain relief. Given their history, which of the following comorbidities would MOST warrant further investigation and potentially influence the treatment approach?
A patient presents with TMJ pain that radiates to the ear and is accompanied by tinnitus. Which of the following examination techniques would be MOST helpful in differentiating TMJ disorder from primary otologic pathology?
A patient presents with TMJ pain that radiates to the ear and is accompanied by tinnitus. Which of the following examination techniques would be MOST helpful in differentiating TMJ disorder from primary otologic pathology?
Flashcards
Epitaxis Risks
Epitaxis Risks
Nosebleed caused by factors like aspirin, NSAIDs, cocaine, hypertension, or anticoagulants.
Epitaxis Treatment
Epitaxis Treatment
Apply direct pressure, use nasal decongestants, and consider cauterization if needed.
Foreign Body - Ear Symptoms
Foreign Body - Ear Symptoms
Pain, itching, noise, redness, drainage, and hearing difficulties.
Foreign Body - Ear Treatment
Foreign Body - Ear Treatment
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Periorbital Cellulitis
Periorbital Cellulitis
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Acute Otitis Media (AOM)
Acute Otitis Media (AOM)
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First-line treatment for AOM
First-line treatment for AOM
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Acute Otitis Media with Effusion
Acute Otitis Media with Effusion
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Symptoms of OME
Symptoms of OME
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Infectious Mononucleosis
Infectious Mononucleosis
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Classic Triad of Mono
Classic Triad of Mono
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Hepatomegaly/Splenomegaly in Mono
Hepatomegaly/Splenomegaly in Mono
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Activity Restrictions in Acute Mono
Activity Restrictions in Acute Mono
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Bacterial Conjunctivitis
Bacterial Conjunctivitis
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Gonococcal Conjunctivitis
Gonococcal Conjunctivitis
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Gonococcal Conjunctivitis Treatment
Gonococcal Conjunctivitis Treatment
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Allergic Conjunctivitis
Allergic Conjunctivitis
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Allergic Conjunctivitis Treatment
Allergic Conjunctivitis Treatment
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Conjunctivitis Education
Conjunctivitis Education
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TMJ Disorders
TMJ Disorders
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TMJ Treatment
TMJ Treatment
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Hordeolum (Stye)
Hordeolum (Stye)
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Chalazion
Chalazion
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Stomatitis
Stomatitis
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Hordeolum Presentation
Hordeolum Presentation
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Chalazion Presentation
Chalazion Presentation
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Jaw Examination: Diagnosis
Jaw Examination: Diagnosis
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Blepharitis Definition
Blepharitis Definition
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Blepharitis: First-Line Treatment
Blepharitis: First-Line Treatment
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Hand-Foot-Mouth Disease Definition
Hand-Foot-Mouth Disease Definition
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Hand-Foot-Mouth Disease Prevention
Hand-Foot-Mouth Disease Prevention
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Stomatitis Symptoms
Stomatitis Symptoms
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Stomatitis Causes
Stomatitis Causes
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Stomatitis Treatment
Stomatitis Treatment
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Ocular Foreign Body
Ocular Foreign Body
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Ocular Foreign Body Symptoms
Ocular Foreign Body Symptoms
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Herpangina
Herpangina
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Herpangina Treatment
Herpangina Treatment
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Brudzinski's Sign
Brudzinski's Sign
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Kernig's Sign
Kernig's Sign
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Cavernous Sinus Thrombosis
Cavernous Sinus Thrombosis
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Hearing Loss
Hearing Loss
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Causes of Hearing Loss
Causes of Hearing Loss
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Epitaxis Presentation
Epitaxis Presentation
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First-line epitaxis treatment
First-line epitaxis treatment
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Periorbital Cellulitis Definition
Periorbital Cellulitis Definition
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Ear Foreign Body: Symptoms
Ear Foreign Body: Symptoms
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Foreign Body Ear Removal
Foreign Body Ear Removal
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Periorbital Cellulitis Treatment time frame
Periorbital Cellulitis Treatment time frame
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Eustachian Tube Dysfunction (ETD)
Eustachian Tube Dysfunction (ETD)
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Symptoms of ETD
Symptoms of ETD
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Nasopharyngitis
Nasopharyngitis
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Common Cold Symptoms
Common Cold Symptoms
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Nasopharyngitis Transmission
Nasopharyngitis Transmission
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Common Cold Treatment
Common Cold Treatment
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Hordeolum Symptoms
Hordeolum Symptoms
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Hordeolum Non-Pharmacologic Treatment
Hordeolum Non-Pharmacologic Treatment
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Chalazion Definition
Chalazion Definition
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Chalazion Treatment
Chalazion Treatment
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HFMD Symptoms
HFMD Symptoms
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Airway Obstruction Emergency
Airway Obstruction Emergency
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Mono & Amoxicillin Rash
Mono & Amoxicillin Rash
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Mastoiditis
Mastoiditis
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Mastoiditis Symptoms
Mastoiditis Symptoms
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Mastoiditis Treatment
Mastoiditis Treatment
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Peritonsillar Abscess Signs
Peritonsillar Abscess Signs
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Dental Abscess
Dental Abscess
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Dental Abscess Symptoms
Dental Abscess Symptoms
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Conjunctivitis Contagiousness
Conjunctivitis Contagiousness
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Conjunctivitis Referral Indicators
Conjunctivitis Referral Indicators
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Conjunctivitis: Avoid Steroids/Anesthetics
Conjunctivitis: Avoid Steroids/Anesthetics
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Conjunctivitis: Makeup & Contacts
Conjunctivitis: Makeup & Contacts
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Temporomandibular Joint (TMJ) Disorders
Temporomandibular Joint (TMJ) Disorders
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TMJ Disorder Symptoms
TMJ Disorder Symptoms
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TMJ Disorder Causes
TMJ Disorder Causes
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Initial TMJ Disorder Management
Initial TMJ Disorder Management
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Study Notes
Viral and Bacterial Sinusitis
- Maxillary and frontal sinuses most commonly affected after viral URI or allergic rhinitis.
- Fluid becomes trapped, leading to secondary bacterial infection involving S. pneumoniae and H. influenzae.
- Symptoms include unilateral facial pain, upper molar pain affecting the maxillary sinus, frontal sinus pain, along with nasal congestion lasting 10+ days and purulent nasal or postnasal drip.
- Diagnosed with examination revealing tenderness to palpation on the front cheek for maxillary sinus, or frontal sinus above the inner canthus of the eye and posterior pharynx purulent postnasal drip.
- Treat with antibiotics if symptoms worsen, present >10 days, involve severe symptoms like high fever, pain, or affect immunocompromised patients.
- First-line antibiotic for adults is amoxicillin-clavulanate for 7 days, while children receive amoxicillin, and those with penicillin allergies get levofloxacin, doxycycline, cefdinir, or cefuroxime.
- Hyposmia (reduced ability to smell) can occur; postnasal drip cough worsens in a supine position, and self-treatment with OTC cold remedies won't provide relief.
- Can be treated with oral decongestants like pseudoephedrine, topical decongestants limited to 3 days (Afrin), saline nasal spray, steroid nasal spray, mucolytics, cough suppressants, and pain/fever relievers.
- Complications include periorbital or orbital cellulitis with swelling, redness, double vision, meningitis, cavernous sinus thrombosis.
Hearing Loss
- Occurs when sound waves cannot reach the brain
- Can range from mild to severe, affecting one or both ears.
- Potential causes include aging, loud noise exposure, earwax buildup, ear infections, ruptured eardrum, medications (aminoglycoside antibiotics, loop diuretics, chemotherapy drugs), genetic conditions, and certain diseases (high blood pressure, diabetes, and strokes).
- Symptoms involve difficulty hearing conversational speech or loud sounds, muffled high-pitched tones, trouble understanding words in noise, and needing frequent repetition.
- Treatments include hearing aids, cochlear implants, surgery, and special training.
Allergic Rhinitis
- Involves inflammatory changes in the nasal mucosa due to an allergy.
- Presentation includes chronic or seasonal nasal congestion, clear mucus rhinorrhea or postnasal drip, cough worsening when supine and nasal or ocular itching/irritation.
- Signs include pale, boggy turbinates, clear rhinorrhea, possibly yellow or thick PND and "raccoon eyes"
- Children may have a transverse nasal crease from frequent rubbing, called an "allergic salute", and the posterior pharynx may show cobblestoning.
- Treatment includes daily nasal steroid sprays (fluticasone or triamcinolone), topical antihistamine nasal spray (azelastine), combination products (azelastine and Fluticasone), decongestants (pseudoephedrine) and antihistamines (cetirizine, loratadine).
- Complications include acute sinusitis, otitis media, and rhinitis medicamentosa from prolonged decongestant use causing rebound congestion.
Impacted Cerumen
- A buildup of ear wax that can cause hearing loss.
- Causes hearing loss, pain, itching or odor, ringing or fullness in the ear, earache and discharge.
- Typically, jaw movement expels earwax, but it doesn't always work.
- Symptoms include itching, odor, tinnitus, feeling of fullness, partial hearing loss, earache and discharge.
- Treatment include softening the wax with drops, irrigation with warm water, or manual removal by a professional.
Epistaxis
- Anterior nosebleeds are more common than posterior bleeds.
- Risks include aspirin/NSAID use, cocaine abuse, hypertension, and anticoagulant use.
- Most nosebleeds are self-limiting.
- Presentation: acute onset of nasal bleeding, profuse bleeding may lead to vomiting blood.
- Treatment involves applying direct pressure for several minutes, using nasal decongestants, applying triple antibiotic ointment or petroleum jelly, or cauterization with silver nitrate.
Foreign Body in the Ear
- Its presence can cause pain, itching, or noise if an object is visible or hidden.
- Symptoms include pain, itching, noise, redness, drainage and hearing difficulties.
- Treatment involves tweezers to remove if the object is visible and easy to grasp.
- If there is no hole in the eardrum, flush with warm water using a rubber-bulb syringe.
- Extract insects by tilting the head and pouring warm oil or alcohol into the ear.
- Can use magnets if the object is metal and a suction catheter to pull the object out.
- Avoid cotton swabs or matchsticks.
- Don't use water to remove batteries, food, or plant material and don't use oil if there's a hole in the eardrum!
Periorbital Cellulitis
- Infection and inflammation of the eyelid and skin around the eye also known as preseptal cellulitis.
- Symptoms include redness around the eye, swelling of the eyelid, whites (sclera) of the eyes, surrounding area.
- Causes include bacterial infection Staphylococcus, streptococcus, or Haemophilus bacteriae, sinusitis, minor eye injury, spread of infection, and insect bites.
- Treatment: Oral antibiotics begin working within 24-48 hours and cool compresses reduce swelling.
- Untreated periorbital cellulitis can lead to orbital cellulitis and rare cases of meningitis, brain abscess, or cavernous sinus thrombosis.
- Seek immediate medical care when difficulty moving the eye, vision changes, symptoms worsen and/or the eye looks bulging.
Eustachian Tube Dysfunction (ETD)
- Occurs when the eustachian tubes get blocked.
- Symptoms include ear pain, fullness, tinnitus, popping sounds, hearing difficulty, dizziness, pulling or tugging.
- Causes include common colds, upper respiratory infections, allergies, mucus drainage and swelling.
- Treatment: yawning, eating, drinking, decongestants, nasal sprays and antihistamines.
Nasopharyngitis
- It's also known as the common cold and spread via air or contaminated objects.
- Symptoms include runny or stuffy nose, coughing, sore throat, sneezing, low-grade fever, headache and fatigue.
- Caused by Rhinovirus, RSV, Parainfluenza, adenovirus and coronaviruses.
- Treatment includes decongestants, antihistamines and anti-inflammatory drugs.
- Wash hands to prevent from touching your eyes, nose, or mouth.
Streptococcal Pharyngitis
- Common in children associated with fever, sore throat with swallowing, enlarged submandibular lymph nodes.
- Use CENTOR criteria – tonsillar exudate, anterior cervical adenopathy, history of fever, absence of cough.
- Examination: dark pink to bright red pharynx, adults usually afebrile or with mild fever, tonsillar exudate.
- First line treatment: Oral Penicillin V 500 mg BID to TID x 10 days.
Otitis Externa
- Also known as Swimmer's Ear which includes inflammation or infection of the external ear canal or auricle.
- Causes include excessive moisture, bacteria (Pseudomonas, Staphylococcus, Streptococcus), and fungi (Aspergillus, Candida albicans).
- Risk factors Prolonged water exposure (swimming), hearing aid and ear bud use.
- Assessment findings: movement pain, edema, redness, discharge, flaky debris and itching in the ear canal.
- Otic antibiotic can treat with a steroid combination to reduce inflammation.
Epiglottitis
- A life-threatening bacterial or viral infection that inflames the epiglottis.
- Symptoms include difficulty swallowing, drooling, hoarseness or abnormal voice, increased breathing rate and severe sore throat.
- Treat with emergency oxygen mask or breathing tube, Antibiotics administered intravenously.
- Causes include bacterial infection and throat injury, but Hib vaccine can prevent epiglottitis.
- It can lead to airway obstruction, breathing problems, and can worsen quickly.
Acute Otitis Media (AOM)
- Inflammation that causes bulging or full tympanic membrane and middle ear effusion and ear infection.
- Etiology from viruses/bacteria, S. pneumoniae, H. influenzae, rhinovirus, influenza.
- Symptoms include rapid onset of ear pain, fever, distorted TM landmarks, displaced light reflex, decreased TM mobility, cloudy/dull/opaque or erythematous TM and moderate to severe bulging TM.
- Treat with Amoxicillin, augmentin or cefdinir against the common bacteria affecting the ear.- Treat with
- Oral analgesics
- treat Eustachian tube dysfunction (swelling due to inflammation, lack of drainage) with NSAIDs
- antibiotic otic drops (Ciprodex, Floxin)
Infectious Mononucleosis
- Infection by the Epstein-Barr Virus (EBV) that presents with viral and strep symptoms.
- Shed through saliva resulting in Classic triad consists of fever, pharyngitis, and lymphadenopathy.
- Symptoms can last for several weeks and potentially months.
- After acute infection, EBV remains dormant in the oropharyngeal tissue
- Use the Monospot (heterophile antibody) test.
- Patients at risk of rupturing their spleen.
Mastoiditis
- Infection of the mastoid bone that is commonly caused by middle ear that damages the bone and causes cysts.
- Symptoms: Redness, swelling, and tenderness around the bone, fever and ear pain.
- Treatment: CT scan referral, antibiotics, hospitalization.
Conjunctivitis
- Pink eye, is inflammation of the conjunctiva.
- Viral conjunctivitis is highly contagious within 24-48 hours, injected conjunctiva and profuse teating.
- Caused by Adenovirus, Coxsackie, Herpes simplex.
- Bacterial conjunctivitis involves purulent exudates, eyes are "sleepy" conjunctival erythema.
- STI Conjunctivitis (Chlamydia & Gonorrhea) is a common cause of neonatal conjunctivitis 5-14 days after birth.
- Allergic conjunctivitis: IgE or mast cell hypersensitivity reaction Environmental allergen that causes redness, severe itching, tearing and edema.
Temporomandibular Joint (TMJ) Disorders
- Conditions causing pain and dysfunction in the jaw joint and muscles, including pain, clicking, jaw locking and headaches.
- Symptoms include when chewing, and jaw locking, Ear aches, congestion, or ringing in the ears, Headaches, including migraines, Jaw locks, and jaw wont be able to close symmetrically.
- Injury to the temporomandibular joint, tension is spasming the muscles around the joint.
Blepharitis
- Inflammation of the eyelids with burning, itching, tearing, Lid crusting in the morning and flaking or scaling of eyelid and red eyes.
- Risk factors include frequent hordeola or chalzia.
- Treat with topical antibiotics and washing.
- Refer to ophthalmologist for severe infections or conditions which does not improve with treatment.
Hand-Foot-Mouth Disease
- Common in children under 5 years.
- Symptoms: fever, sore throat, Painful mouth sores that blister, Rash commonly found on the hands and feet.
Hordeolum (Stye)
- Acute inflamed eyelid caused by staphylococcus which causes Localized tenderness, redness, swelling of the eyelid.
- Do not express the hordeolum. Cleanse eyelids daily with Johnson's No Tears Baby Shampoo.
Chalazion
- Benign granulomatous inflammation, with a clinical presentation that appears painless.
- Topical ophthalmic antibiotic for secondarily infected chalazion
Stomatitis
- Inflammation that causes swelling, redness, and painful sores.
- Symptoms: Painful sores in the mouth or lips, Swelling and redness of the mouth lining,Difficulty eating.
- Treatment: treat any conditions, pain, and hygiene.
Ocular Foreign Body
- Feeling of "something is in my eye"
- Refer to ophthalmologist for all but simple non-penetrating injuries and any cases of visual acuity changes.
Herpangina
- Viral infection that causes painful sores in the mouth, throat, and sometimes on the hands,
- Symptoms: Small, blister-like bumps or ulcers in the mouth, throat, or roof of the mouth.
- Treatment: Rest, drink fluids, cough medicine, and oral topical anesthetics.
Iritis/Uveitis/Keratitis
- All are conditions of inflammation.
- If left untreated, iritis can lead to vision loss or blindness that includes presciption anti-inflammatory drugs.
- Uveitis: Inflammation of the uvea, Treat with prescription eye drops and anti-inflammatory drugs
- Keratitis: Inflammation of the cornea that shares similar symptoms and cause
Aphthous Ulcer
- Canker sores, are non-contagious painful sores and usually heal within 10–14 days.
- May be a sign of deficiency that causes yellow sores with a small red border, they can apear on the face and make it difficult to eat.
Acute Angle Closure Glaucoma
- Treat with immediate referral for sudden increase increase in intraocular pressure Pain.
- Symptoms: Sudden vision loss and pain.
Corneal Abrasion
- Clinical Presentation of Corneal Abrasion includes "gritty" feeling, or "something" in the eye, eye pain with opening or closing the eye and Haziness of cornea.
- Use Wood's Lamp indications Used and sterile eye drops.
Subconjunctival Hemorrhage
- A broken blood vessel in the eye that is not serious, but causes eye tearing.
Nasolacrimal Duct Obstruction Treatment
- Treat the infections that causes blockage with proper antibiotics.
Hyphema
- A condition occurs when blood enters the iris of the eye.
Retinal Detachment
- Symptoms include flashes of light, shower of floaters and visual field loss. At risk: myopia, trauma, glaucoma, PVD, hx of cataract surgery.
Dacryostenosis/Dacrocystitis:
- Dacryostenosis: Blocked lacrimal sac (tear duct). most common cause of ocular discharge in newborns, inferior turbinate fails to complete canalization Persistent overflow of tears (epiphora) Acute distention and inflammation of lacrimal sac, mucus with pressure Common; resolves in 6-9 months, refer if lasting longer than 9-12 months Treatment: massage duct 2-3 times per day
- Dacrocystitis:Infection of the lacrimal sac due to obstruction Pain, redness, and swelling over the inner aspect of the lower eyelid and watery eyes commonly caused by Staph aureus or Strep pneumoniae Treatment:warm compresses, oral antibiotics
Periorbital Edema
-
Concerning symptoms: diplopia, vision changes, preseptal cellulitis (acute eyelid erythema and edema) Concern is that abscess has formed and proximity to brain
-
Emergent referral for urgent CT and ophthalmology consultation
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