1
MIDTERM STUDY GUIDE: PART-1
TOPICS Covered
o Chalazions
o Blepharitis
o Conjunctivitis
o Hand-foot-mouth syndrome
o Strep pharyngitis
o Kawasaki disease
o Rheumatic fever
o Milia
o Port-wine stain/Nevus flammeus
o Salmon patch
o Café-au lait spot
o Impetigo
o Molluscum Contagiosum
o Verruca Vulgaris
o Herpetic Whitlow
CHALAZIONS – Benign, chronic lipogranulomatous inflammation of the eyelid
Causes – blockage of the meibomian cyst
Risk – hordeolum or any condition which may impede flow through the
meibomian gland. Also mite species that reside in lash follicles
Assessment – PAINLESS, NOT INVOLVING LASHES
Lid edema, or palpable mass
Red or grey mass on the inner aspect of lid margin
Prevention – good eye hygiene
,2
Treatment – warm, moist compresses 3x per day
Antibiotics not indicated because chalazion is granulomatous
condition, if secondarily infected consider SULFACETAMIDE, ERYTHROMYCIN
Follow up – 2-4 weeks, if still present after 6 weeks follow up with
ophthalmologist
BLEPHARITIS – Inflamation/infection of the lid margins (chronic problem)
2 types – seborrheic (non ulcerative) : irritants (smoke, make up, chemicals)
s&s – chronic inflammation of the eyelid, erythema, greasy
scaling of anterior eyelid, loss of eyelashes, seborrhea dermatitis of eyebrows and
scalp
Ulcerative- infection with staphylococcus or streptococcus
s&s – itching, tearing, recurrent styes, chalazia,
photophobia, small ulceration at eyelid margin, broken or absent eyelashes
• the most frequent complaint is ongoing eye irritation and conjunctiva
redness
Treatment – clean with baby shampoo 2-4 times a day, warm compresses, lid
massage (right after warm compress)
For infected eyelids – antistaphyloccocal antibiotics BACITRACIN, ERYTHROMYCIN
0.05% for 1 week AND QUIONOLONE OINTMENTS
For infection resistant to topical – TETRACYCLINE 250 MG PO X4
,3
DOXYCYCLINE 100 MG PO X2
CONJUCTIVITIS – inflammation or irritation of conjuctiva
Bacterial (PINK EYE) – in peds bacteria is the mosts common cause, contact
lens, rubbing eyes, trauma,
S&S – purulent exudate, initially unilateral, then bilateral
Sensation of having foreign body in the eye is common
Key findings – redness, yellow green, puru,ent discharge, crust and matted eyelids
in am
Self limiting 5-7 days. Eye drops – polytrim, erythromycin, tobramycin or cipro
Improvement 2-4 days
Most common organism H. influenza <7
Viral – adenovirus, coxsackie virus, herpes, molluscum
S&S – profuse tearing, mucous discharge, burning, concurrent URI,
enlarged or tender preauricular nose
Antihistamines/decongestant
Improvement, self limiting, 7-14 days
Chlamydial – chlamydia trachomatis
S&S – profuse exudate, associated with genitourinary symptoms, 1-2
weeks after birth
Gonococcal – 2-4 days after birth, most concern can cause blidness
PO azithromycin, doxycycline (tetracyclines increase photosensitivity, don’t use in
pregnancy)
Improvement 2-3 weeks
Allergic – IgE mast cell reaction, environmental, cosmetics
S&S – marked conjuctival edema, severe itching, tearing, sneezing
, 4
Topical antihistamine or topical steroids
Improvement 2-3 days
Chemical –thimerosal, erythromycin, silver nitrate
S&S conjuctival erythema, 30 minutes afer prophylactic antibiotics drops
Avoid contact
Can consider steroids
Conjunctivitis never accompany vision changes
Diagnostic studies: swap and scraping must be done, gram and Giemsa staining,
ELISA, PCR testing, newborn < 2 weeks needs to be tested for gonorrhea
Non –pharm – clean towels, change pillows, warm compress, no contacts, no eye
make up – mascara
Gonococcal conjunctivitis: newborn – give Ceftriaaxone IM once (don’t give if
hyperbilirubinemia,
Non-gonococcal – erythromycin 0.5% ointment
Consider fluorescein staining if abrasion suspected
CDC recommends prophylactic administration of antibiotic eye ointment
(ERYTHROMYCIN) 1 hour after delivery
Refer to ophthalmologist if herpes, hemorrhagic conjunctivitis or ulcerations
present
May return to work/school 24 hours after topical
HAND-FOOT-AND-MOUTH DISEASE – HIGHLY CONTAGIOUS, viral illness
MIDTERM STUDY GUIDE: PART-1
TOPICS Covered
o Chalazions
o Blepharitis
o Conjunctivitis
o Hand-foot-mouth syndrome
o Strep pharyngitis
o Kawasaki disease
o Rheumatic fever
o Milia
o Port-wine stain/Nevus flammeus
o Salmon patch
o Café-au lait spot
o Impetigo
o Molluscum Contagiosum
o Verruca Vulgaris
o Herpetic Whitlow
CHALAZIONS – Benign, chronic lipogranulomatous inflammation of the eyelid
Causes – blockage of the meibomian cyst
Risk – hordeolum or any condition which may impede flow through the
meibomian gland. Also mite species that reside in lash follicles
Assessment – PAINLESS, NOT INVOLVING LASHES
Lid edema, or palpable mass
Red or grey mass on the inner aspect of lid margin
Prevention – good eye hygiene
,2
Treatment – warm, moist compresses 3x per day
Antibiotics not indicated because chalazion is granulomatous
condition, if secondarily infected consider SULFACETAMIDE, ERYTHROMYCIN
Follow up – 2-4 weeks, if still present after 6 weeks follow up with
ophthalmologist
BLEPHARITIS – Inflamation/infection of the lid margins (chronic problem)
2 types – seborrheic (non ulcerative) : irritants (smoke, make up, chemicals)
s&s – chronic inflammation of the eyelid, erythema, greasy
scaling of anterior eyelid, loss of eyelashes, seborrhea dermatitis of eyebrows and
scalp
Ulcerative- infection with staphylococcus or streptococcus
s&s – itching, tearing, recurrent styes, chalazia,
photophobia, small ulceration at eyelid margin, broken or absent eyelashes
• the most frequent complaint is ongoing eye irritation and conjunctiva
redness
Treatment – clean with baby shampoo 2-4 times a day, warm compresses, lid
massage (right after warm compress)
For infected eyelids – antistaphyloccocal antibiotics BACITRACIN, ERYTHROMYCIN
0.05% for 1 week AND QUIONOLONE OINTMENTS
For infection resistant to topical – TETRACYCLINE 250 MG PO X4
,3
DOXYCYCLINE 100 MG PO X2
CONJUCTIVITIS – inflammation or irritation of conjuctiva
Bacterial (PINK EYE) – in peds bacteria is the mosts common cause, contact
lens, rubbing eyes, trauma,
S&S – purulent exudate, initially unilateral, then bilateral
Sensation of having foreign body in the eye is common
Key findings – redness, yellow green, puru,ent discharge, crust and matted eyelids
in am
Self limiting 5-7 days. Eye drops – polytrim, erythromycin, tobramycin or cipro
Improvement 2-4 days
Most common organism H. influenza <7
Viral – adenovirus, coxsackie virus, herpes, molluscum
S&S – profuse tearing, mucous discharge, burning, concurrent URI,
enlarged or tender preauricular nose
Antihistamines/decongestant
Improvement, self limiting, 7-14 days
Chlamydial – chlamydia trachomatis
S&S – profuse exudate, associated with genitourinary symptoms, 1-2
weeks after birth
Gonococcal – 2-4 days after birth, most concern can cause blidness
PO azithromycin, doxycycline (tetracyclines increase photosensitivity, don’t use in
pregnancy)
Improvement 2-3 weeks
Allergic – IgE mast cell reaction, environmental, cosmetics
S&S – marked conjuctival edema, severe itching, tearing, sneezing
, 4
Topical antihistamine or topical steroids
Improvement 2-3 days
Chemical –thimerosal, erythromycin, silver nitrate
S&S conjuctival erythema, 30 minutes afer prophylactic antibiotics drops
Avoid contact
Can consider steroids
Conjunctivitis never accompany vision changes
Diagnostic studies: swap and scraping must be done, gram and Giemsa staining,
ELISA, PCR testing, newborn < 2 weeks needs to be tested for gonorrhea
Non –pharm – clean towels, change pillows, warm compress, no contacts, no eye
make up – mascara
Gonococcal conjunctivitis: newborn – give Ceftriaaxone IM once (don’t give if
hyperbilirubinemia,
Non-gonococcal – erythromycin 0.5% ointment
Consider fluorescein staining if abrasion suspected
CDC recommends prophylactic administration of antibiotic eye ointment
(ERYTHROMYCIN) 1 hour after delivery
Refer to ophthalmologist if herpes, hemorrhagic conjunctivitis or ulcerations
present
May return to work/school 24 hours after topical
HAND-FOOT-AND-MOUTH DISEASE – HIGHLY CONTAGIOUS, viral illness
