EENT 2

No

Does periorbital cellulitis cause elevations in intraocular pressure or neuritis?

No

Does periorbital cellulitis cause impaired vision or abnormal pupillary reactions?

Intact

The extraocular movements of the eye should be ___ with periorbital cellulitis

Periorbital cellulitis

Sinus tenderness, rhinorrhea, adenopathy, and other hallmarks of upper respiratory infections may be present in which condition?

Lumbar puncture

When considering Periorbital Cellulitis, consider ___ in all neonates and pts with s/s of meningitis (stiff neck, pain with head movement)

CT scan

Which diagnostic method is warranted when patient has pain on eye movement, afferent pupillary defect, limited extraocular movements, and resistance to retropulsion or protruding eyes?

Periorbital cellulitis

Empiric treatment of ___ is initial oral antibiotic therapy for 10 days

Admission and IV antibiotics

What treatment is indicated when pt fails to respond to outpatient tx in 48-72, or in younger children and more severe cases of Periorbital cellulitis?

Periorbital cellulitis

Pts with ___ should be evaluated daily for signs of relapse, including fever, erythema, edema, pain, and loss of vision

Pediatric

What population is periorbital cellulitis primarily a problem?

Orbital cellulitis

Infection of soft tissues of the orbit posterior to the orbital septum

Ethmoid sinusitis

What most commonly causes Orbital cellulitis?

Strep pneumoniae

What is the most likely pathogen of Orbital cellulitis?

Older children

What pt population is most commonly associated with Orbital cellulitis?

Orbital cellulitis

Sx include decreased vision, pain on eye movement, and red eye. Sxs advance rapidly at an alarming rate

Proptosis and ophthalmoplegia

What are the cardinal signs and symptoms of orbital cellulitis

Papilledema

This may indicate optic neuritis which is caused by increased intracranial pressure

Orbital cellulitis

Which cellulitis can present with papilledema?

Non contrast CT

What diagnostic method is essential for Orbital cellulitis?

MRI

What diagnostic method is helpful in orbital abscesses and in evaluating the possibility of cavernous sinus disease?

Tetanus prophylaxis

Treatment for post traumatic orbital cellulitis

Surgical drainage

With an orbital abscess, what is indicated if poor response to antibiotics after 48-72 hours, ct shows opacified sinuses, decreased vision, and afferent pupillary defect?

Blindness

What may occur secondary to elevated intraorbital pressure or direct extension of infection to the optic nerve from the sphenoid sinus?

Orbital cellulitis

Intracranial complications of ___ include meningitis, cavernous sinus thrombosis, or intracranial, epidural, or subdural abscess formation

Cavernous sinus thrombosis

What should be considered in a pt with orbital cellulitis and suspected in presence of rapid progression of clinical signs?

Adenoviral

Which conjunctivitis is the most common cause of viral conjunctivitis?

Viral

Which conjunctivitis has associated flu like symptoms?

Several days

What is the onset of viral conjunctivitis?

Photophobia

What symptom can occur with corneal involvement of viral conjunctivitis?

viral conjunctivitis

What condition can present with preauricular adenopathy?

Viral and chlamydial conjunctivitis

Which conjunctivitis appears with follicles on palpebral conjunctiva?

Clear, epithelial defects

In viral conjunctivitis, the cornea looks ___, and slit lamp with fluorescein stain shows ___

Clear

In viral conjunctivitis, the anterior chamber is ___

Mononuclear cells and lymphocytes

Giemsa staining of conjunctival scraping in viral conjunctivitis may show ___

Supportive

Treatment of viral conjunctivitis

Topical antihistamines

What would we use to relieve itching with viral conjunctivitis?

Topical corticosteroids

What can be used as adjunctive therapy for viral conjunctivitis?

Topical ganciclovir

Treatment for viral conjunctivitis with confirmed adenovirus

Rebound

Topical vasoconstrictors can redness with viral conjunctivitis, but prolonged use can cause ___

Glaucoma

Topical vasoconstrictors for viral conjunctivitis should not be used in patients with ___

2-4 weeks

Patients with viral conjunctivitis may get worse over the next few days before resolving in next ___

Viral conjunctivitis

Which conjunctivitis has purple conjunctiva with mucoid discharge?

Topical steroid

Treatment of epidemic keratoconjunctivitis (adenovirus 8 and 19) for corneal infiltrates

Bacterial conjunctivitis

What condition has common organisms of staph, strep pneumoniae, H flu, pseudomonas, and moraxella?

Bacterial conjunctivitis

What condition can infections occur by external contamination, spread from adjacent sites, or via a blood borne pathway?

Corneal involvement

Patients with bacterial conjunctivitis do not complain of photophobia unless there is ___

Few hours

Symptoms of bacterial conjunctivitis start in one eye and spread to other eye within ___

1-2 days

Onset of bacterial conjunctivitis

No, but grittiness

Is there pain with bacterial conjunctivitis?

No

Is bacterial conjunctivitis usually itchy?

Yes

Is there purulent drainage with bacterial conjunctivitis?

Morning

What time of day do the eyelids get stuck together with bacterial conjunctivitis?

No

Is there a change in vision with bacterial conjunctivitis?bacterial conjunctivitis

bacterial conjunctivitis

Symptoms of this condition include patchy or diffuse conjunctival injection that is not localized to one section

No

Is there lymphadenopathy in bacterial conjunctivitis?

Refractory, STD

With bacterial conjunctivitis, conjunctival scrapings and cultures are only done in ___ cases and those with suspected ___ causes

Neutrophils

Gram staining bacterial conjunctivitis shows this

Topical antibiotic

Treatment of bacterial conjunctivitis

Endophthalmitis

Inflammation in the anterior and/or posterior chamber of the eye

Endophthalmitis

A possible complication of bacterial conjunctivitis with a history of a previous intraocular surgery

Ophthalmia neonatorum

Umbrella term to describe gonococcal and chlamydial conjunctivitis

Gonococcal conjunctivitis

Which conjunctivitis is an eye emergency?

Corneal perforation and blindness

Gonococcal conjunctivitis rapidly progresses to ___

Gram negative diplococcus

What is neisseria gonorrhoeae (the cause of Gonococcal conjunctivitis)?

Ophthalmia neonatorum

Which eye condition follows mucosal inoculation during vaginal, anal, or oral sexual contact, or by inoculation of mucosa by contaminated fingers or other objects?

2-5 days

Gonococcal conjunctivitis appears ___ after delivery

Gonococcal conjunctivitis

Symptoms of this in the anterior chamber include cellular flare, hypopyon, and endophthalmitis

Gonococcal conjunctivitis

Symptoms of this in the conjunctiva include chemosis, purulent exudate, and hemorrhages

Gonococcal conjunctivitis

Symptoms of this in the cornea include punctate epithelial keratitis, corneal infiltrates, ulcerations, perforation, or opacification

Maybe

Does Gonococcal conjunctivitis have adenopathy?

Ceftriaxone IV

Treatment of Gonococcal conjunctivitis

Cefotaxime IM

What do we give to treat Gonococcal conjunctivitis if patient has hyperbilirubinemia or IV calcium?

Doxycycline, cipro

To treat Gonococcal conjunctivitis, we can also give ___ in adults for chlamydial coverage and broad spectrum topical abx such as ___ for a week

Chlamydial conjunctivitis

Which conjunctivitis do adults usually have unilateral eye involvement with scant mucopurulent drainage?

5-14 days

Chlamydial conjunctivitis eye infection occurs ___ after delivery

Chlamydia

What condition should you think when a patient has recurrent conjunctivitis?

Trachoma

Chronic chlamydial infection of the eye

Chlamydial conjunctivitis

Prevention with 0.5% erythromycin ointment at birth is not effective for what?

Maybe

Does Chlamydial conjunctivitis present with adenopathy?

Chlamydial conjunctivitis

Giemsa stain shows basophilic inclusion bodies in this condition

Doxycycline or azithromycin

Treatment for Chlamydial conjunctivitis in adults.

Erythromycin

Treatment of Chlamydial conjunctivitis in children

Trachoma

Treatment of this is community wide azithromycin

Rhinoconjunctivitis

Type of allergic conjunctivitis that is associated with sneezing and other symptoms of hay fever

Allergic rhinitis

The same allergens that trigger ___ may be involved in the pathogenesis of allergic conjunctivitis

High seasonal allergies

Rhinoconjunctivitis is frequently and most commonly in these areas

Vernal keratoconjunctivitis (VKC)

Type of allergic conjunctivitis that is a hypersensitivity reaction characterized by giant cobblestone papillae of the upper palpebral conjunctiva

Vernal keratoconjunctivitis (VKC)

This is a more serious form of allergic conjunctivitis in which the stimulant is not known

Eczema, asthma, or seasonal allergies

Vernal keratoconjunctivitis is common in boys, particularly those younger than 10 who also have ___

Spring, fall and winter

Vernal keratoconjunctivitis typically reappears each ___ and subsides in the ____

Early adulthood

Many children outgrow Vernal keratoconjunctivitis by ___

Atopic Keratoconjunctivitis (AKC)

Type of allergic conjunctivitis that is associated with eczematous skin lesions

Giant papillary conjunctivitis (GPC)

Type of allergic conjunctivitis that is associated with contact lens wearers and inner lid 1-2mm diameter papillae

Contact allergy

Type of allergic conjunctivitis that is secondary to chemical agents

Itching

Most important feature of allergic conjunctivitis is ___

Allergic conjunctivitis

Other symptoms of this conjunctivitis include photophobia, foreign body sensation, tearing, and blepharospasm

Bilateral

Is allergic conjunctivitis usually unilateral or bilateral?

Allergic conjunctivitis

Physical exam of this conditions shows injected conjunctival vessels, chemosis, eyelid edema, cobblestone papillae, and stringy mucoid discharge

Viral or chlamydial

Which conjunctivitides have lower lid follicles?

Allergic or bacterial

Which conjunctivitides h