Med-Surg (EENT + Sleep)

Presbyopia

What is decreased accommodation with an increased sensitivity to glare

Presbycusis

What is age-related hearing loss called

Aqueous Humor

What are the clear watery fluids made up of, protein and water

Vitreous humor

What is the transparent gel-like substance in the posterior chamber of the eye that maintains the round shape of the eye

Cataracts

what is the opacity of the lenses called?

Congenital, aging, steroid use, trauma, UV light exposure, smoking/alcohol use, PT's with diabetes

what are the seven causes of Cataracts?

Slit lamp

What is the way that HCP's diagnose cataracts

blurry, hazy vision, decreased color perception, photophobia

What are the four S&Ss of cataracts

replace lenses, surgical removal, lens implant

what are the three treatments for cataracts

Corneal Transplant

What is the surgery where there is a replacement of a diseased cornea with donated cornea

graft rejection

What is the biggest risk for a patient that has a corneal transplant

redness, sensitivity to light, vision loss, pain

What are the four S&Ss of a corneal transplantation risk for graft infection

Diabetic Retinopathy

what is microvascular damage to the retina d/t uncontrolled hyperglycemia

Detached Retina

what is the separation of the retina from the choroid

tissue death

what does a detached retina lead to?

Aging, Cataract Extraction, Diabetic Retinopathy, eye trauma, personal or family history, severe myopia, sickle cell disease

what are the seven risk factors for a detached retina

shadow/curtain, photopsia, black spots/floaters, blurred vision

what are the four S&S's of a detached retina

Laser Photocoagulation

what is the surgical treatment where there is an intense precisely focused laser beam that goes to the tear causing an inflammatory reaction creating a seal over the tear

Cryopexy

what is the treatment where there is a probe outside the eye to create extreme cold causing an inflammatory reaction

Scleral buckling

what is the surgical treatment where the silicone implant causes the eye to buckle inward with an encircling band to push the sclera and choroid to connect with the retina again

Pneumatic Retinopexy

what is the surgical treament where there is an injection of a gas to create a temporary bubble inside the vitreous to seal the torn layers

Vitrectomy

What is the removal of the vitreous to relieve traction on the retina

Dry

What is the AMD where there is an accumulation of yellow deposits of the drusen

Wet

What is the type of AMD that comes after the dry and is much more severe

Scotomas

what are blind spots in the visual field called?

Metamorphopsia

What is the disorder where there are straight things are all distorted or wavy

Verteporfin

what is the drug given IV that has a laser light that activates in the eye to form blood clots on abnormal blood vessels

5 days

For patients taking verteporfin, how long should they avoid sunlight or intense light

Glaucoma

what is high IOP d/t more inflow of aqueous humor than outflow called?

10-21 mmHg

What is the normal IOP

eye exam, slit lamp, peripheral vision screening, tonometry

What are the four things way that one can diagnose glaucoma

Open-Angle Glaucoma

what is the type of glaucoma where the aqueous humor outflow through the trabecular meshwork is impaired

Chronic open-angle glaucoma

what is the most common Open-angle glaucoma

progressive loss of peripheral vision fields

what is the main S&S of open-angle glaucoma

Timolol

what is the beta blocker that is used to treat glaucoma that decreases aqueous humor production

Brimonidine

What is the alpha agonist that helps decrease aqueous humor production

Pilocarpine

What is the cholinergic that opens the trabecular meshwork to help facilitate the outflow

Argon Laser Trabeculoplasty

what is the treatment of glaucoma that helps open the outflow channels

Angle-closure Glaucoma

what is the type of glaucoma that is a medical emergency and the lens is bulging forward blocking off the outflow

excruciating eye pain, halo around lights, N/V, ocular redness

what are the four S&S's of Angle-closure glaucoma

Atropine, cold meds

what are the two types of drug treatments that should be avoided for patients with angle-closure glaucoma

Iridectomy

what is the treatment for glaucoma that causes a new opening of the iris to allow the outflow of the aqueous humor

Enucleation

what is the surgical removal of the eye

Trauma, cancer, injury

what are the three things that Enuclation is d/t

Chemical burns, thermal burn, foreign body, trauma

what are the four things that can cause eye trauma

Pain, photophobia, redness, bruising, swelling, fluid drainage, decreased vision

What are the seven S&Ss of eye trauma

Conductive

what is the type of hearing loss that is an outer or middle ear problem preventing sound transmission to the inner ear

Sensorineural

what is the type of hearing loss that is simply just damage to the inner ear or CN VIII

Mixed

what is the type of hearing loss that is both conductive and sensorineural and may be d/t otosclerosis

Otosclerosis

what is the fixation of the foot plate of the stapes?

Mixed hearing loss

what is the most common cause of hearing loss in young adults?

Central

what is the type of hearing loss where the brain cannot interpret sound?

stroke, trauma

central hearing loss is caused by what two things?

>40-50

hearing aids may be helpful if the hearing loss is above what levels?

Tinnitus

what is the first sign of hearing loss in older adults

behind the ear

what is the most powerful type of hearing aid?

Completely in the canal

which type of hearing aid is the smallest?

Cochlear implant

what is the hearing loss treatment that is used for severe or profound sensorineural hearing loss?

One who has learned speech and language

the ideal patient for a cochlear implant?

Tinnitus, vertigo, fluctuating hearing loss

What is the triad of Meniere's Disease?

Meniere Disease

what is the type of disease that is an idiopathic endolymphatic hydrops where there is excess endolymph in the inner ear

2 or more spontaneous episodes of vertigo, audiogram, glycerol test, electronystagmography

what are the four ways that one can diagnose Meniere Disease

Epley maneuver

what is the treatment for Benign Paroxysmal Positional Vertigo

Nystagmus, vertigo, nausea, lightheadedness, loss of balance

what are the five S&S's of Benign Paroxysmal Positional Vertigo

Hypothalamus

What is the sleep center in the body

Circadian Rhythm

what controls the timing of sleep?

Homeostatic Process

what controls the intensity of sleep?

Adenosine

what does the homeostatic process work with?

misalignment for timing of sleep and individual desires

sleep disorders are most commonly caused by what?

N1, N2, N3

what are the three stages of Non Rapid Eye Movement?

N1

What is the lightest stage of the non-rapid eye movement

N2

Which stage of non-rapid eye movement takes up most of the night's sleep, where there is relaxation, but is easily awakened

N3

which stage of non-rapid eye movement is the deepest sleep where the muscles are relaxed and they are difficult to arouse

memory storage, learning

rapid eye movement sleep is very important for what two things?

90-110 minutes

How long do sleep cycles last?

Sleep latency

what is the time it takes for one to actually fall asleep called?

6-8.5 hours

what are the sleep requirements for young adults

Nocturia

what is waking up to urinate called

Insomnia

What is the difficulty of falling asleep or staying asleep called?

Sleep apnea

what is a lack of airflow for 10 seconds or longer during sleep

Obstructive sleep apnea

which type of sleep disorder occurs from a relaxation of the oral cavity or throat that blocks the airways

Obesity, HTN, deviated septum, nasal polyps, enlarged tonsils, large neck, smoking/ETOH, >65

what are the 8 risk factors for Obstructive sleep apnea

loud snoring, excessive daytime sleepiness, frequent arousals during sleep, witnessed apneic episodes

what are the four S&S's of Obstructive Sleep apnea

HTN, MI, CVA

what are the 3 things that Obstructive sleep apnea increases the risk for?

Central sleep apnea

what is the sleep disorder that is described as a dysfunction in the brain's respiratory center

mild snoring, insomnia, fatigue, frequent awakenings

what are the four S&S's of central sleep apnea

CPAP

how is central sleep apnea treated?

Narcolepsy

What is the dysfunction of sleep-wake regulation

Cataplexy

what is the a sudden muscle weakness with intense emotion called?

stimulants, antidepressants, lifestyle modifications

what are the three treatments for narcolepsy

Parasomnias

What is an undesirable behavior that occurs during sleep called?

Somnambulism

what is type of parasomnia that is described as sleep walking

N3

which sleep stage does Somnambulism typically occur during?

REM sleep-behavior disorder

what is the type or parasomnia that occurs during the REM sleep and the patient acts out their dreams

Enuresis

what is the medical term for wetting the bed

Somniloquy

what is the medical term for sleep talking

Nightmares

what is the type of parasomnia where one has very vivid and complex plots as well as being able to recall disturbing dreams

REM

which cycle do Nightmares typically occur during?

Night terrors

What is the type of parasomnia where one does not remember the dream and is typically much more vague

non REM

what is sleep cycle that night terrors typically occur in