Kevin's Clin Med Exam 3 Guessing Game

Pt presents with: mild-moderate fever,

fatigue, myalgia, headache.

(mononucleosis)

CMV

Pt presents with: bull neck, grey membrane, sore throat

malaise, cervical lymphandentipathy

Diphtheria

Tripod position

stridor, coughing, fever

3 d's: Dysphagia, Drooling, Distress

Severe Sore Throat

Pain > exam

Epiglottitis

Coughing, conjunctivitis, rhinorrhea, headache, rash

Viral Pharyngitis

Acute onset fever, tonsular exudate,

cervical lymphandentopathy, scarlationiform rash

NO COUGH, NO RHINORRHEA

Bacterial Pharyngitis

Horseness of voice, sore throat, dry cough

(Acute/chronic) Laryngitis

Sore throat with pain on swallow, trismus, uvula deviation

Hot potato voice, drooling, cervical lymphandentopathy

Peritonsilar Abcess

Trismus, swelling below angle of the mandible

medial swelling of pharyngeal wall

fever or rigor

Deep neck space infection

Purulent discharge, sever nasal obstruction, facial pain,

pressure, fullness,

Acute Rhinosinusitis (ARS)

-Nasal congestion and obstruction

-Purulent nasal discharge

-Facial pain/pressure

-Maxillary tooth pain

-Headache

-Fever, fatigue, cough, hyposmia/anosmia, halitosis, ear pressure

-Hearing loss

-Tinnitus

Acute Viral Rhinosinusitis

(AVRS)

-Nasal congestion and obstruction

-Purulent nasal discharge

-Facial pain/pressure

-Maxillary tooth pain

-Headache

-Fever, fatigue, cough, hyposmia/anosmia, halitosis, ear pressure

-Hearing loss

-Tinnitus

Acute Bacterial Rhinosinusitis

(ABRS)

Bulge on the ear that is caused by

auricle trauma

Traumatic Auricular Hematoma

Erythmatous, painful around site of

infection (cut, scrape, etc.)

(usually on cartilage of ear)

fever

Perichondritis

Loss of hearing

hearing loss after cue tip use

pressure or pain

Cerumen Impaction

pt outdoors

Sudden ear pain or loss of hearing

Foreign Body

Pain on auricle manipulation

Erythema, edema, purulent exudate

Tragus and Pinna Tenderness

Fever

Erythematous TM

Osteomyelitis in immunecomp/diabetes

Otitis Externa

Diabetes

foul discharge

Granulation of ear canal

Deep Otalgia

Very Edematous

Malignant Otitis Externa

Aural Fullness/fullness of ear

muffled Hearing

Crescendoing pain

Popping or crackling when

swallowing

Retracted TM

pain on pressure changes

Eustachian Tube Dysfunction

Hearing loss

Otorrhea

tinnitus

visble perforation

Tympanic Membrane Perforation

Otalgia

fever

irritability

bulging TM

hearing loss

Ear discharge

pruritis

fever

Acute Otitis Media (OM)

Asymptomatic with middle ear fluid

Otitis Media W/ effusion

Child with recurrent ear infections,

Hearing Loss

otorrhia

TM perfusion

Chronic Otitis Media

Postauricular pain and swelling

Fever

Bulging TM

Protruding ear

tenderness

Mastoiditis

Painless otorrhea

Hearing loss

vertigo

facial weakness

Cholesteoma

Burning, irritation, gritty sensation

Eyelid, erythema

Flaking/crusting

chronic or recurrent

Blepharitis

Firm eyelid nodule usually painless Develops gradually follows previous hordeolum

Chalazion

Localized Erythematous tender

Acute Onset style

Hordeolum

Excess tearing dryness exposure irritation

Ectropion

Eyelashes entering eye

Entropion

"Pain and tenderness of eyelid

Eyelid swelling

Possible ptosis

May have pain with eye moment

Infectious or inflammatory etiology"

Dacryoadenitis

"Pain

Redness

Swelling over the medial canthus/

lacrimal sac

Tearing

Purulent material may reflux from

the punctum "

Dacryocystitis

"Persistant tearing

tear overflow

mucoid discharge

no marked tenderness and inflame

of acute dacryocystitis"

Dacryostenosis

"Dryness

burning

gritty or foreign body sensation

fluctuating blurry vision

Paradoxical tearing"

Keratoconjunctivitis Sicca

"Asymptomatic

visible fleshy, triangle

may cause redness, irritation, foreign

body sensation

Decreased vision"

Pterygium

"Eye pain and redness

photophobia

tearing or discharge

bliurred/decreased vision

white spots "

Infectious Keratitis

"Painful red eye

photophobia

reduced vision

Corneal epithelial defect"

Bacterial keratitis

Unilateral eye pain, irritation

Redness, photophobia

Tearing, blurred dendritic corneal ulcer

Herpatic Keratitis

Unilateral eye pain and redness

Photophobia

blurred/decreased vision

Ciliary flush

cells/flare

Anterior Uveitis/Iritis

"Severe, deep, boring eye pain

Pain often worsens with eye move

deep red

related to forehead, jaw, or face"

Scleritis

"Sudden, severe unilateral eye pain

halos around lights

mid-dilated, poorly reactive pupil

cloudy cornea"

Acute Angle-Closure Glaucoma

"usually asymptomatic in early dz

peripheral-field constriction

tunnel vision

painless slowly progressive"

Chronic Primary Open-Angle Glaucoma

"Rapid worsening eye pain

Hypopyon

Marked decreased vision

Redness, photophobia"

Endophthalmitis

"Pain

Red fluid floating in front

of pupils and cornea

eye feels pressure

Changes in vision"

Hyphema

"Intense pain

intraoccular pressure

photophobia

tearing sensation

Eye irritation

possible foreign body

kemosis"

Corneal abrasion

"Pain, redness,

photophobia,

tearing,

white corneal spot,

vision loss"

Corneal ulcer

"Ill appearing

eyelid swelling

Erythema and tenderness

No proptosis (forward projection

of eye) or

ophthalmoplegia (weakness)"

Preseptal cellulitis

"Ill appearing,

fever

proptosis

ophthalmoplegia

vision changes

pain on movement"

orbital cellulitis

"Preorbital swelling/hematoma

diplopia, enophthalmos

infraorbital numbness

restricted extraocular motility"

blowout fracture

"Redness, watery discharge

gritty foreign body

photophobia

unilateral -> bilateral"

viral conjunctivitis

"Redness, purulent discharge

eyelid matting on waking

moderate lid edema"

Bacterial conjunctivitis

"Intense itching

bilateral redness

watery/stringy discharge

Chemosis = swelling of clear

membrane that covers white

part of the eye

conjunctival papillae"

allergic conjunctivitis

"Severe pain and decreased

vision decrease

Peaked or irregular pupil

subconjunctival hemorrhage"

globe ruptute

"Sudden floaters and flashers

Progressive shadow over visual

fields

painless vision loss"

retinal detachment