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55 Cards in this Set
- Front
- Back
Why should fluorescein staining of the cornea be performed in patients with suspected conjuctivitis?
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to avoid missing abrasions, ulcers, and dendritic lesions
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What is the treatment for bacterial conjuctivitis for a non-contact lens wearer? contact lens wearer? pt < 2 months?
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• non-contact lens wearer: polymyxin B-trimethoprim
• contact lens wearer: ciprofloxacin, oflxacin, or tobramycin (to cover Pseudomonas) • pt < 2 months: sulfacetamide |
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A patient presents with a conjuctivitis with a hyperacute onset (within 12-24 hrs) and a severe purulent discharge. What etiology should be considered?
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gonococcal conjunctivitis
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What are treatment options for gonococcal conjunctivitis?
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• ceftriaxone
• ciprofloxacin • tobramycin • doxycycline |
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What medication can be used to relieve conjuctival itching or congestion?
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Naphazoline/pheniramine
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What are treatment options for allergic conjunctivitis?
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• elimination of the inciting agent
• cool compress • artifical tears • naphazoline/pheniramine • diphenhydramine (in moderate to severe cases) • fluorometholone (a mild topical steroid for severe cases) |
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What is the hallmark finding of herpes heratitis on slit lamp examination?
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linear branching, epithelial defect with terminal bulbs that stain brightly with fluorescein dye
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What type of medication should be strictly avoided in patients with herpes keratitis?
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steroids
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What is the herpes zoster ophthalmicus (HZO)?
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shingles in a trigeminal distribution with ocular involvement
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What is a Hutchinson sign?
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• shingles involving the tip of the nose
• presence or eventual development of HZO should be suspected |
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What are characteristics of endophthalmitis?
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• infection involving the deep structure of the globe (ex. anterior, posterior, & vitreous chambers)
• presents with pain and visual loss • seen as a complication of globe violation from trauma or ocular surgery |
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What are pathogens that can cause endophthalmitis?
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• Bacillus
• Haemophilus • Staph • Strep |
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What is the initial empiric treatment for endophthalmitis?
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• vancomycin
• ceftazidime |
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What is the most important step in managing periorbital cellulitis?
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to exlucude orbital cellulits
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How can you clinically distinguish periorbital cellulitis from orbital cellulits?
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periorbital cellulits has no:
• painful eye movement • restriction of ocular motility • acuity deficit • impairment of pupillary function • proptosis |
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What is the treatment for simple periorbital cellulitis in adults and children older than 5?
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Augmentin
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What is the treatment for periorbital cellulitis in children < 5 y/o OR patients with comorbidities?
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• Ceftriaxone IV
• Vancomycin IV |
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Typically, orbital cellulitis spreads from where?
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ethmoid sinuses
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What is the treatment for conjuctival abrasions?
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erythromycin
* should rule-out ocular foreign body |
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What is the test of choince to confirm the presence of an orbital fracture?
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CT of the orbit and face
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What needs to be ruled out in a patient that presents with hyphema?
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• ruptured globe
• increased intraocular pressure |
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What are medical treatment options for increased intraocular pressure?
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• timolol
• apraclonidine • acetazolamide • mannitol |
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What portion of the orbit are commonly fractured in an orbital blowout fracture?
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inferior and medial wall
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What is a Seidel test?
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• a bright-green streaming appearance to fluorescein stain
• pathognomonic for ruptured globe |
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What is the most common cause of contact lens-related bacterial ulcers?
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Pseudomonas
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What is the most common form of glaucoma?
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primary open angle glaucoma
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What are signs and symptoms fo acute angle closure glaucoma?
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• cloudy vision
• colored halos around lights • conjunctival injection • eye pain • fixed mid-dilated pupil • headache • increased IOP • nausea/vomiting |
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What are characteristics of optic neuritis?
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• inflammation at any point along the optic nerve
• presents with acute vision loss (particularly reduction in color vision) |
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What test can be used to diagnose a decrease in color vision?
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• Red desaturation test
• patient looks at a drak red object with one eye; the affected eye will see the object as pink or light red |
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A sudden painless loss of vision in one eye most likely represents what?
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central retinal artery occlusion
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What are classic signs of central retinal artery occlusion?
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• complete or nearly complete vision loss
• afferent pupillary defect • whitening of the retina in the posterior pole • bright red macula ("cherry red spot") |
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Fundoscopic examin shows optic disc edema, cotton wool spots, and retinal hemorrhages in all 4 quadrants. These findings, described as "blood-and-thunder fundus" suggests what diagnosis?
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central retinal vein occlusion
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Bullous impetigo is caused by what pathogen?
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Staph aureus
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Non-bullous impetigo is caused by what pathogens?
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• Strep pyogenes
• Staph aureus |
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What is the treatment for impetigo?
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• mupirocin ointment (treatment of choice for localized infections)
• pediatric cases: - dicloxacillin OR - cephalexin OR - augmentin |
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What pathogen causes erysipelas?
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Strep pyogenes
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What is the most common cause of viral parotitis in children < 15 y/o?
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mumps
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What is the incubation period for mumps?
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2-3 weeks
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What is the treatment of viral parotitis?
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supportive tx (analgesics & antipyretics)
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What is the most common extrasalivary manifestation of mumps?
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epididymoorchitis
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This condition is a potentially fatal bacterial infection that occurs in patients with diminshed salivary flow?
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suppurative parotitis
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What are factors that lead to decreased salivary flow?
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• advanced age
• dehydration • medications (ex. diuretics, ß-blockers, antihistamines, phenothiazines, TCAs) • prematurity • recent anesthesia • sialolithiasis |
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What are physical exam findings of suppurative parotitis?
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• erythema, induration, & tenderness to palpation of the cheek and angle of the mandible
• pus from the Stensen duct |
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Most cases of sialolithiasis occur in which duct?
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submandibular (Wharton) duct
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What is the most common dislocation of the mandible?
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anterior dislocation
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What is the most common cause of sudden hearing loss?
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idiopathic
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What complication may result if a dental infection spreads to the ingraorbital space?
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cavernous sinus thrombosis
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How can a patient with a cavernous sinus thrombosis present?
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• coma
• limitation of lateral gaze • meningeal signs • sepsis |
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What is the treatment for acute necrotizing ulcerative gingivitis ("Trench Mouth)?
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• metronidazole
• chlorhexadine mouth rinses |
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What virus causes herpangina?
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coxsackie A virus
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How does herpangina present?
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• presents with high fever, sore throat, headache, & malaise
• followed by eruption of oral vesicles which rupture to form painful, shallow ulcers • soft palate, uvula, & tonsillar pillars are typically affected • buccal mucosa, tongue, & gingiva are spared |
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What system is used to classify the anatomy of fractured teeth?
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ellis system
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Describe the classes of ellis fractures
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• class 1: involve only the enamel of the tooth
• class 2: involves the creamy yellow dentin underneath the white enamel • class 3: tooth-threatening pfractures that involve the pulp; indentified by a red blush on the exposed dentin OR a visble drop of blood after wiping the tooth |
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What is the most common cause of peritonsillar abscess (PTA)?
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GABHS
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Patients with this type of abscess tend to gravitate toward a supine position, with the neck in slight extension to minimize compression of the upper airway.
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retropharyngeal abscess
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