AHN 577 Test 1 Guide With
Complete Solution
Viral Conjunctivitis SSX - ANSWER Usually bilateral
Copious watery discharge
Foreign body sensation
Follicular conjunctivitis
Viral Conjunctivitis TX - ANSWER IF HSV infection: Topical Ganciclovir gel or
oral Acyclovir
Cold compresses/Symptomatic care
Sulfonamides - prevent secondary infection
Allergic Conjunctivitis - ANSWER Itching, increased tearing, redness
Stringy discharge
Possible photophobia and visual loss
Allergic Conjunctivitis TX - ANSWER OTC: Naphazoline drops
Antihistamines - H1 receptor antagonists
- Ketotifen
- Loratadine
- Fecofenadine
,- Cetrizine
NSAIDS
Bacterial Conjunctivitis SSX - ANSWER No blurred vision
Purulent discharge
Mild discomfort
Bacterial conjunctivitis TX - ANSWER Gentamycin drops while awake
Neomycin drops
Polymxin ointment
Sulfacetamide Na or Ofloxin
Cipro and Levofloxacin
Chlamydia Conjunctivitis SSX - ANSWER #1 cause of blindness
Copious amounts of purulent discharge
Conjunctivitis general SSX - ANSWER Itching, burning
Redness, increased tears
Blurred vision, Foreign body sensation
Swelling of eyelid (Chemosis)
? Crusty sticky mucopurulent discharge on lids
Otitis Externa SSX (Swimmers Ear) - ANSWER Pain (otalgia) increase w/
manipulation of tragus or pinna
Decreased hearing or sense of fullness in ear
,Fever, lymphadenitis, itching
Canal/outer ear edema or exudate
Otorrhea: Purulent
TM normal, erythematous or dull
Otitis Externa Tx - ANSWER Gentle suction/removal of debris
Drops
- Polymyxin B/Neomycin/HC (Cortisporin Otic)
- Cipro HC Otics
Cotton gauze if severe edema (remove 2-3 days after insertion)
Warm compresses to outer ear
- Cipro PO per culture
- Aminoglycoside and anti-inflammatories
Corticosteroid (Medrol Dosepak) for edema and pain
Analgesics: Tylenol, NSAIDS, Opioids (Lortab)
50/50 Rubbing alcohol and white vinegar to affected ear as preventative
F/U in 1 week
Otitis Media SSX - ANSWER Throbbing pain (Otalgia)
Hearing loss - conductive
Vertigo w/ N/V
Otorrhea: pulsatile
, TM: retracted, opaque, and dull w/ decreased movement
Bony landmarks obscurred
Occasional bullae
Otitis Media TX - ANSWER Amoxicillin
PCN allergy: TMP/SMX (Bactrim) or Azithromycin
Cefdinir, Cefuroxime, or Cefpodoxime
W/ perforation: Cortisporin Otic drops
Analgesics for pain - NSAIDS
Serous Otitis Media SSX - ANSWER Hearing loss, sense of fullness
Popping Sounds w/ pressure
Air bubbles posterior to TM
Severe pain w/ sudden relief and immediate release of fluid (Tympanic
membrane rupture)
TM: Red, dull and bulging w/ pressure sensation in ear and decreased
mobility
Changes in Rinne/Weber test = Conductive hearing loss.
When to refer patient to ENT for Otitis media - ANSWER If recurrent: 3-4x in
6 months; > 3 months bilat, or > 6 months unilat, or if tympanic membrane
perforated, hearing loss of 20 dB or more following TX.
Serous Otitis media TX - ANSWER Oral Decongestants
Cholesteatoma (Chronic Otitis media) SSX - ANSWER Hearing loss
Complete Solution
Viral Conjunctivitis SSX - ANSWER Usually bilateral
Copious watery discharge
Foreign body sensation
Follicular conjunctivitis
Viral Conjunctivitis TX - ANSWER IF HSV infection: Topical Ganciclovir gel or
oral Acyclovir
Cold compresses/Symptomatic care
Sulfonamides - prevent secondary infection
Allergic Conjunctivitis - ANSWER Itching, increased tearing, redness
Stringy discharge
Possible photophobia and visual loss
Allergic Conjunctivitis TX - ANSWER OTC: Naphazoline drops
Antihistamines - H1 receptor antagonists
- Ketotifen
- Loratadine
- Fecofenadine
,- Cetrizine
NSAIDS
Bacterial Conjunctivitis SSX - ANSWER No blurred vision
Purulent discharge
Mild discomfort
Bacterial conjunctivitis TX - ANSWER Gentamycin drops while awake
Neomycin drops
Polymxin ointment
Sulfacetamide Na or Ofloxin
Cipro and Levofloxacin
Chlamydia Conjunctivitis SSX - ANSWER #1 cause of blindness
Copious amounts of purulent discharge
Conjunctivitis general SSX - ANSWER Itching, burning
Redness, increased tears
Blurred vision, Foreign body sensation
Swelling of eyelid (Chemosis)
? Crusty sticky mucopurulent discharge on lids
Otitis Externa SSX (Swimmers Ear) - ANSWER Pain (otalgia) increase w/
manipulation of tragus or pinna
Decreased hearing or sense of fullness in ear
,Fever, lymphadenitis, itching
Canal/outer ear edema or exudate
Otorrhea: Purulent
TM normal, erythematous or dull
Otitis Externa Tx - ANSWER Gentle suction/removal of debris
Drops
- Polymyxin B/Neomycin/HC (Cortisporin Otic)
- Cipro HC Otics
Cotton gauze if severe edema (remove 2-3 days after insertion)
Warm compresses to outer ear
- Cipro PO per culture
- Aminoglycoside and anti-inflammatories
Corticosteroid (Medrol Dosepak) for edema and pain
Analgesics: Tylenol, NSAIDS, Opioids (Lortab)
50/50 Rubbing alcohol and white vinegar to affected ear as preventative
F/U in 1 week
Otitis Media SSX - ANSWER Throbbing pain (Otalgia)
Hearing loss - conductive
Vertigo w/ N/V
Otorrhea: pulsatile
, TM: retracted, opaque, and dull w/ decreased movement
Bony landmarks obscurred
Occasional bullae
Otitis Media TX - ANSWER Amoxicillin
PCN allergy: TMP/SMX (Bactrim) or Azithromycin
Cefdinir, Cefuroxime, or Cefpodoxime
W/ perforation: Cortisporin Otic drops
Analgesics for pain - NSAIDS
Serous Otitis Media SSX - ANSWER Hearing loss, sense of fullness
Popping Sounds w/ pressure
Air bubbles posterior to TM
Severe pain w/ sudden relief and immediate release of fluid (Tympanic
membrane rupture)
TM: Red, dull and bulging w/ pressure sensation in ear and decreased
mobility
Changes in Rinne/Weber test = Conductive hearing loss.
When to refer patient to ENT for Otitis media - ANSWER If recurrent: 3-4x in
6 months; > 3 months bilat, or > 6 months unilat, or if tympanic membrane
perforated, hearing loss of 20 dB or more following TX.
Serous Otitis media TX - ANSWER Oral Decongestants
Cholesteatoma (Chronic Otitis media) SSX - ANSWER Hearing loss
