UTA FNP 2 - Midterm, Module 1 - ENT/Upper Airway
Questions With Complete Solutions
Blepharitis, pharm
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
o 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
o 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
o 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
o 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
, o 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
o Pharm –
§ Topical vidarabine or trifluridine 5 times daily for 10 days
Conjunctivitis, Red Flags
· Red flags - diminished visual acuity, photophobia, foreign
body sensation, corneal opacity, fixed pupil, severe headache,
and proptosis.
Corneal Abrasion, pharm
· Pharm –
o Eye rx – Ciprofloxacin.
§ Want to use broad spectrum.
Cataracts, assessment
Questions With Complete Solutions
Blepharitis, pharm
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
o 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
o 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
o 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
o 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
, o 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
o Pharm –
§ Topical vidarabine or trifluridine 5 times daily for 10 days
Conjunctivitis, Red Flags
· Red flags - diminished visual acuity, photophobia, foreign
body sensation, corneal opacity, fixed pupil, severe headache,
and proptosis.
Corneal Abrasion, pharm
· Pharm –
o Eye rx – Ciprofloxacin.
§ Want to use broad spectrum.
Cataracts, assessment
