,§4 step assessment glaucoma Correct Answer §always start by
assessing visual acuity. Document for both eyes
§examination with slit lamp or binocular loupe after Snellen
examination or penlight
§fluorescein staining is used to assess for corneal defects (last
part of exam)
§Lid eversion: flip the eyelid with cotton swab for suspected
foreign body; remove visible object using wet cotton swab
§Acute Rhinosinusitis (ARS): Maxillary tooth discomfort,
Facial pain, pressure worse with bending forward most highly
predictive of ARS Correct Answer §Inflammation of the
paranasal sinuses due to bacterial, viral, or fungal infection, or
allergic reaction
§Presentation
§Nasal congestion, obstruction
§Purulent nasal discharge
§Brushing with a fluoride toothpaste, check to see if you have
fluoride
§Apply a fluoride gel or varnish to tooth surfaces
§Prescribe fluoride tablets
§Recommend using a fluoride mouth rinse Correct Answer
well water??
§Clinical presentation
§Decreased vision
§Halos around lights
§Headache, eye pain
§Nausea and vomiting
§Complaints of Red eye
§Change in vision refer to ophthalmology
§FB sensation and cannot keep eye open-refer
§FB sensation, scratchy, gritty- not necessarily a need to refer.
Need to investigate
§Photophobic- refer Correct Answer refer or not?
§Epiglottitis Correct Answer §A life-threatening infection of
the epiglottitis and surrounding tissues which can cause sudden
and critical narrowing of the airway; a medical emergency;
cellulitis of the epiglottis
§Presentation
§Sore throat
§Fever
§Muffled voice
§Drooling
§Stridor
§Hoarseness
get X-ray stat
§Group A Strep
Most important and treatable
§Suppurative complications: sinusitis, retropharyngeal and
peritonsillar abscesses
§Non-Suppurative complications-acute rheumatic fever, acute
glomerulonephritis
, §Usually anterior adenopathy not posterior
§Screen adults with Centor score greater than or equal to 3 with
RADT Correct Answer Centor score 2 or greater: §Consider
screening
§Intermittent (seasonal) allergic conjunctivitis
§April/May: tree pollens; June/July: grass pollens; July/August:
mold spores and weed pollens; others dependent on local
environmental factors Correct Answer §IgE-mediated diseases
related to seasonal allergens
§Common triggers depend on time of year and geographic
location
"on and off April-August"
§Most S. pneumoniae is resistant to tobramycin, gentamicin
"A zit on your eye or Polymyxin wants a cracker" Correct
Answer Alternative tx conjunctivitis
Ophthalmology pearls...
§Suppurative conjunctivitis (non-gonococcal; non-chlamydial)
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