caused by too much insulin (or missing a meal or snack) in the evening, which
results in hypoglycemia in the ear morning (2-3am). the body compensates by
secreting glucagon (from the liver) and epinephrine, which results in high blood
glucose levels in the morning.
Cushing's syndrome
~Ans~ ...
Treatment for mild allergic conjunctivits
~Ans~ Topical antihistamines/mast cell stabilizer
NSAIDs and topical corticosteroids are not first line
Pt with allergic conjunctivitis often produce inadequate amount of tears (oral
antihistamines may induce dry eye syndrome)
Oral hairy leukoplakia
~Ans~ elongated papilla of the lateral aspect on the tongue
What causes oral hairy leukoplakia?
~Ans~ EBV
Koplik's spot
~Ans~ clusters of small red papules with white centers located on the buccal
mucosa by the lower molars (o = kopliks)
Prodromic viral of measles appears 2-3 days before the rash
Geographic tongue
~Ans~ inflammatory disorder that usually appears on top and side of the tongue
multiple fissures and irreregular smoother areas on its surface that make it look like a
topographic map
Cheilosis
~Ans~ painful inflammation and cracking of the corners of the mouth
Peritonsillar abscess
~Ans~ severe sore throat, difficulty swallowing, trismus, and muffled "hot potato"
voice
abscess displaces the uvula
pterygium
~Ans~ yellow, triangular thickening of the conjunctiva that extends across the
cornea on the nasal side
Pinguecula
~Ans~ yellowish, raised growth on the conjunctiva next to the cornea
Chalazion
~Ans~ chronic inflammation of the meibomian gland
hordeolum (stye)
~Ans~ stye
abscess of a hair follicle and sebaceous gland on the eyelid
,High risk factors for hearing loss in premature baby
~Ans~ HEARS
Hyperbilirubinemia
Ear infection frequency
low Apgar scores
exposure to Rubella, cytomegalovirus (CMV), toxoplasmosis
Seizures
diabetic retinopathy
~Ans~ cotton wool spots
Normal intraocular pressure
~Ans~ 8-21mm Hg
Intermittent Esotropia
~Ans~ common in infants younger than 20 weeks
resolves spontaneously
refer if present after 20 weeks
Kawasaki Disease
~Ans~ high fever, enlarged lymph nodes, conjunctivitis, dry, cracked lips
strawberry tongue
most cases under 5 years of age
pharyngitis
~Ans~ acute infection of the pharynx
stuffy nose, rhinitis with clear mucus, and watery eyes
allergic rhinitis
~Ans~ inflammatory changes of the nasal mucosa due to an allergy response
most common sign: transverse nasal crease (allergic salute)
tonsillitis
~Ans~ inflammation of the tonsils
sore throat, difficulty swallowing, tender lymph nodes
Treatment for otitis externa
~Ans~ Use aluminum acetate solution PRN (provides soothing, effective relief of
minor skin irritations and inflammation)
keep water out of the ear
Polymyxin B-neomycin-hydrocortisone suspension drops QID x 7 days and/or
ofloxacin drops
Bullous Myringitis
~Ans~ small, fluid-filled blisters form on the eardrum
First permanent teeth to erupt
~Ans~ first molars at about 6 years of age
,viral keratoconjunctivitis
~Ans~ pink eye
treatment- symptomatic
cold compresses and slightly chilled artificial tears
avoid touching eyes, haring towels, frequent eye washing
children should not attend school until symptoms resolve
what causes viral keratoconjunctivits?
~Ans~ adenovirus
contagious for 10-12 days
self limiting
Transmission of sound through the ear
~Ans~ 1. sound waves are collected in the pinna
2. transmission of vibrations through the hammer, anvil and stirrup
3.nerve impulses stimulate in the inner ear
4. vibrations are transmitted of the cerebral cortex auditory center
5.sound is interpreted by the cerebral cortex
Ishihara chart
~Ans~ screening a patient for colour blindness
Tx for otitis media
~Ans~ 1st line- amoxicillin
blepharitis
~Ans~ chronic condition caused by inflammation of the eyelids
contact lens keratitis
~Ans~ eye pain, redness, excessive tearing, lesion on the cornea
1st line- topical abx
primary angle-closure glaucoma
~Ans~ sudden blockage of the aqueous humor
increased intraocular pressure
Acute Rhinosinusitis
~Ans~ inflammation of the mucosal lining of nasal passages, lasting up to 4 weeks,
caused by allergens
Acute Bacterial Rhinosinusitis
~Ans~ secondary bacterial infection, usually following viral URI
Diseases caused by S. pneumoniae
~Ans~ COMPS
Conjunctivitis
Otitis media
Meningitis
Pneumonia
Sinusitis
, Diseases caused by H. influenza
~Ans~ COMPS
Conjunctivitis
Otitis media
Meningitis
Pneumonia
Sinusitis
Common features of ABRS
~Ans~ fever and symptoms duration of more than 10 days
maxillary toothache
initial symptom improvement and then worsening of symptoms (double sickening)
cacosmia (sense of bad odor in the nose)
unilateral facial pain
7 day tx is the best
Tx for ABRS in adults
~Ans~ Initial therapy: amoxicillin or amox-clav
Beta-lactam allergy:
No anaphylaxis (cefdinir, cefpodoxime, cefuroxime)
anaphylaxis (levo, moxi, doxycycline)
*macrolide abx (azithro, clarithro, erythro) and TMX-SMX (Bactrim) not
recommended in ABRS tx
Doxycycline
~Ans~ pregnancy risk: Cat D
Resp fluroquinolones
~Ans~ pregnancy risk: Cat C
Normal hearing
~Ans~ no lateralization
AC>BC
Sensorineural hearing loss
~Ans~ lateralization to good ear (sound is heard louder in the normal ear)
AC>BC
Conductive hearing loss
~Ans~ lateralization to bad ear (sound is heard louder in the bad ear)
BC>AC
Allergic rhinitis
~Ans~ inflammatory, IgE mediated disease due to genetic and environmental
interactions and characterized by nasal congestion, rhinorrhea, sneezing, intraocular
and/or nasal itching
Allergic rhinitis treatment
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