UTA FNP 2 - Midterm, Module 1 – ENT-
Upper Airway
Blepharitis, pharm - answer Antibiotic ointments - (BEQ)
o Bacitracin, erythromycin, and quinolone (any -floxacin).
o If infx doesn't respond to topical meds, if you have resistant infections - use oral
antibiotics.
· First line - doxycycline 100mg PO twice a day.
· Tetracycline 250 mg 4 times daily can also be given.
Blepharitis, anterior presentation - answero Staphylococcal blepharitis characterized by
scaling, crusting, and erythema of the eyelid margin, more common among women in
their 40s.
o Eyelid staph infection - Eyelash loss; crusting or matting of eyelashes upon waking;
flaking or scaling of eyelid skin.
Blepharitis, posterior presentation - answero Inflammation and dysfunction of the
meibomian gland within eyelid.
o Excess foamy discharge, chalazion (aka meibomian cyst, is a small, firm, painless
bump that develops on the eyelid), and ocular rosacea is common.
Conjunctivitis, bacterial, presentation - answero Sclera of the eye gets red, and
sometimes itchy, and sometimes there will be exudates.
§ Typically, if you see the exudates, it is bacterial conjunctivitis.
o The organisms that cause the bacteria are Staph, Strep, H flu, and M catarrhalis -
same as upper respiratory infx.
o Pseudomonas is another less likely cause and, of course, gonorrhea can cause it as
well.
Conjunctivitis, bacterial, pharm - answero Pharm -
§ Azithromycin 1% solution
§ Erythromycin 0.5% ointment
§ Gentamicin 0.3% solution
§ Sulfacetamide 10% (Bleph-10, Isopto Cetamide, or Sodium Sulamyd)
§ Tobramycin (Tobrex)
§ Bacitracin/polymyxin B 500 u/g ointment
§ Ciprofloxacin 0.3% (Ciloxan)
§ Ofloxacin 0.3% (Ocuflox)
§ Besfloxacin 0.6% suspension
§ Moxifloxacin 0.5% (Vigamox) (more severe cases)
§ Gatifloxacin 0.3% (Zymar) (more severe cases)
, Conjunctivitis, viral, assessment - answero Assessment findings are erythema, burning,
exudate, itching, sensation of foreign body, ocular exudate with matting, preauricular
adenopathy, tearing and dendrites are present in herpetic infections.
o Evaluate and treat for systemic herpes.
o You don't want them to get herpes in the eye, because it can cause blindness.
o If a fluorescein stain is done and you see dendrites, these patients need to be referred
immediately to an ophthalmologist.
Conjunctivitis, viral, pharm - answero Pharm -
§ Topical vidarabine or trifluridine 5 times daily for 10 days
Conjunctivitis, Red Flags - answer· Red flags - diminished visual acuity, photophobia,
foreign body sensation, corneal opacity, fixed pupil, severe headache, and proptosis.
Corneal Abrasion, pharm - answer· Pharm -
o Eye rx - Ciprofloxacin.
§ Want to use broad spectrum.
Cataracts, assessment - answer· Assessment -
o Opacification of the lens.
o Diminished red reflex and a white reflex.
o Blurred vision and see halo around lights.
o Diminished night vision, and diminished visual acuity.
Strabismus, different types/patterns - answer· Different types -
o Esotropia - where the eye drifts inward.
o Exotropia - where it drifts outward.
o Hypertropia - where it drifts upward.
o Hypotropia - where it drifts downward.
Glaucoma, excessive IOP value - answer>25mmHg
Glaucoma, tonometer use - answer· You take an average of three readings. Normal
pressure is 10 to 23. Anything 25 or greater is considered close angled glaucoma.
Glaucoma, categories of meds - answerbeta blockers (5), prostaglandin analogs (4),
carbonic anhydrase inhibitors (2), alpha adrenergic (2).
Glaucoma, open angle, beta blockers - answero Five beta blockers - betaxolol,
carteolol, levobunolol, metipranolol, and timolol.
§ These medications decrease aqueous humor production. Can have systemic side
effects typical of beta blockers if there is enough systemic absorption.
Glaucoma, open angle, prostaglandin analogs - answero latanoprost, travoprost,
bimatoprost, and tafluprost.
Upper Airway
Blepharitis, pharm - answer Antibiotic ointments - (BEQ)
o Bacitracin, erythromycin, and quinolone (any -floxacin).
o If infx doesn't respond to topical meds, if you have resistant infections - use oral
antibiotics.
· First line - doxycycline 100mg PO twice a day.
· Tetracycline 250 mg 4 times daily can also be given.
Blepharitis, anterior presentation - answero Staphylococcal blepharitis characterized by
scaling, crusting, and erythema of the eyelid margin, more common among women in
their 40s.
o Eyelid staph infection - Eyelash loss; crusting or matting of eyelashes upon waking;
flaking or scaling of eyelid skin.
Blepharitis, posterior presentation - answero Inflammation and dysfunction of the
meibomian gland within eyelid.
o Excess foamy discharge, chalazion (aka meibomian cyst, is a small, firm, painless
bump that develops on the eyelid), and ocular rosacea is common.
Conjunctivitis, bacterial, presentation - answero Sclera of the eye gets red, and
sometimes itchy, and sometimes there will be exudates.
§ Typically, if you see the exudates, it is bacterial conjunctivitis.
o The organisms that cause the bacteria are Staph, Strep, H flu, and M catarrhalis -
same as upper respiratory infx.
o Pseudomonas is another less likely cause and, of course, gonorrhea can cause it as
well.
Conjunctivitis, bacterial, pharm - answero Pharm -
§ Azithromycin 1% solution
§ Erythromycin 0.5% ointment
§ Gentamicin 0.3% solution
§ Sulfacetamide 10% (Bleph-10, Isopto Cetamide, or Sodium Sulamyd)
§ Tobramycin (Tobrex)
§ Bacitracin/polymyxin B 500 u/g ointment
§ Ciprofloxacin 0.3% (Ciloxan)
§ Ofloxacin 0.3% (Ocuflox)
§ Besfloxacin 0.6% suspension
§ Moxifloxacin 0.5% (Vigamox) (more severe cases)
§ Gatifloxacin 0.3% (Zymar) (more severe cases)
, Conjunctivitis, viral, assessment - answero Assessment findings are erythema, burning,
exudate, itching, sensation of foreign body, ocular exudate with matting, preauricular
adenopathy, tearing and dendrites are present in herpetic infections.
o Evaluate and treat for systemic herpes.
o You don't want them to get herpes in the eye, because it can cause blindness.
o If a fluorescein stain is done and you see dendrites, these patients need to be referred
immediately to an ophthalmologist.
Conjunctivitis, viral, pharm - answero Pharm -
§ Topical vidarabine or trifluridine 5 times daily for 10 days
Conjunctivitis, Red Flags - answer· Red flags - diminished visual acuity, photophobia,
foreign body sensation, corneal opacity, fixed pupil, severe headache, and proptosis.
Corneal Abrasion, pharm - answer· Pharm -
o Eye rx - Ciprofloxacin.
§ Want to use broad spectrum.
Cataracts, assessment - answer· Assessment -
o Opacification of the lens.
o Diminished red reflex and a white reflex.
o Blurred vision and see halo around lights.
o Diminished night vision, and diminished visual acuity.
Strabismus, different types/patterns - answer· Different types -
o Esotropia - where the eye drifts inward.
o Exotropia - where it drifts outward.
o Hypertropia - where it drifts upward.
o Hypotropia - where it drifts downward.
Glaucoma, excessive IOP value - answer>25mmHg
Glaucoma, tonometer use - answer· You take an average of three readings. Normal
pressure is 10 to 23. Anything 25 or greater is considered close angled glaucoma.
Glaucoma, categories of meds - answerbeta blockers (5), prostaglandin analogs (4),
carbonic anhydrase inhibitors (2), alpha adrenergic (2).
Glaucoma, open angle, beta blockers - answero Five beta blockers - betaxolol,
carteolol, levobunolol, metipranolol, and timolol.
§ These medications decrease aqueous humor production. Can have systemic side
effects typical of beta blockers if there is enough systemic absorption.
Glaucoma, open angle, prostaglandin analogs - answero latanoprost, travoprost,
bimatoprost, and tafluprost.
