3P - HEENT Study Document
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Arizona State University *
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Course
636
Subject
Health Science
Date
Jan 9, 2024
Type
docx
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5
Uploaded by tdub17
3P – EENT content – 6 Questions
Cataract:
patho 2, assess 2
Hearing loss:
assess 3
Ototoxicity:
Pharm 4
Diabetic retinopathy:
assess 2
Papilledema:
patho 2 Pterygium:
patho 1
Vertigo:
Pharm 2
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• Eye, Ear, Nose, and Throat
: Visual acuity, cataract, vertigo, diabetic retinopathy, papilledema, hyperopia, rhinitis, hearing loss, pterygium, ototoxicity, and acute sinusitis, 1.
Eye findings in HTN and DM
2.
Tx of acute sinusitis in adults and pediatrics
3.
How to read/ interpret a Snellen chart
4.
What medications can cause ototoxicity
5.
Cataracts
6.
Eye emergencies (papilledema)
7.
Presentation with foreign body
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STUDY GUIDE:
WEEK 1:
Interview and Examination
●
Subjective and objective history components
●
Describe the following types of patients: talkative, angry, silent, and hearing impaired
●
Therapeutic communication – types and when to utilize
●
Know the meaning of the following terms: sensitivity, specificity, validity, prevalence, predictive value
●
What are the questions of the 5 As and their purpose?
●
Know techniques and indications for inspection, auscultation, palpation and percussion (some specifics are listed with each body system)
WEEK2 &3:
(HEENT) Problem-Focused Assessments I: Head, Eyes, and Ears
●
Describe consensual reaction and visual accommodation.
●
What does the Snellen chart test? What do the results mean?
●
Describe the technique for and significance of Confrontational Visual Field Testing.
●
Recognize abnormalities of an external eye exam and patient history that is required. ●
Age-related changes in sight and hearing, concerning circumstances, work up
●
Problems that cause diplopia.
●
Fundoscopic exam abnormal findings and their causes ●
Presentation and corresponding causes of changes in vision
●
Types of ear problems with needed history and exam findings
●
Indications and technique for Weber and Rinne tests
(HEENT) Problem-Focused Assessments II: Nose, Mouth, Throat and Neck
●
Presentation and exam findings for hypo and hyperthyroidism
●
Types of problems in oral cavity with needed history and exam findings
●
Types of nasal problems with needed history and exam findings
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HEENT:
Visual Acuity (Snellen Chart):
o
Normal Disc-Cup Ratio – 1:3
o
20/20 = average (normal)
Bottom number represents feet
EX:
20/60 = Patient’s vision at 20 feet, is the same as what normal vision could read at 60 feet (Bad vision)
20/10 = better than normal vision (good)
Cataracts:
o
Caused by damage to the lens
o
KEY EXAM FINDING: Diminished/Opacified red reflex
o
Treatment = surgery
Vertigo:
o
Self or surrounding moving
o
Meniere’s:
Lasts hours, tinnitus, nausea, vomiting
o
BPV:
Lasts minutes, nystagmus with head/position changes
No hearing changes
o
Treatment:
Meclizine
, scopolamine
Eye Cranial Nerves:
o
LR6 SO4 – everything elese 3
Presbyopia:
o
Vision loss (near vision) caused by age
Diabetic Retinopathy:
o
Microaneurysms = hallmark of diabetic retinopathy o
Tiny, round, red spots (in & around the macula)
Macular Degeneration:
o
Loss of central vision over several years
o
Associated with aging
Glaucoma:
o
Asymptomatic
o
Increased IOP
o
Gradual peripheral vision loss
o
Increased disc-cup ratio 1:2
Papilledema:
o
Indicates increased ICP
o
EYE EMERGENCY
o
Swollen optic disc
o
Engorged retinal veins
o
Loss of optic cup
Acute Closed-Angle Glaucoma:
o
Sudden rapid vision loss
o
Unilateral
o
Painful, throbbing pain with N/V, headache
o
Requires emergency treatment
Hyperopia:
Farsightedness (distant objects are seen more clearly than close ones)
Pterygium:
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o
Triangular thickening of the bulbar conjunctiva
o
Growth of fleshy tissue that starts as pinguecula (surfer’s eye) but then invades the cornea
o
Will effect vision
Eye findings in HTN and DM:
o
Flame hemorrhages:
HTN & DM
Moderate retinopathy microinfarctions/aneurysms
o
Cotton wool spots:
HTN & DM
Moderate retinopathy microinfarctions
o
AV Nicking:
HTN
Arteries are indent and displace veins
Milk retinopathy
Presentation with foreign body:
o
Exam:
SNELLEN
Slit light exam
Pen light
Florescein stain
Eyelid eversion
o
If NOT imbedded, try and remove FB with q-tip
o
If imbedded, eye patch, send to ophthalmology o
Update TDaP
Allergic Rhinitis:
o
Inflammatory IgE mediated
o
Clear bilateral discharge
o
Sneezing, stuffiness, pale, boggy mucosa
o
TX:
Avoid allergens
Nasal antihistamines, nasal steroids
, saline spray, decongestatnts (NOT if <6y/o)
Hearing loss:
o
Conductive:
Something occludes or blocks sound from traveling through external canal
or middle ear
o
Sensorineural:
Anything that prevents sound from traveling from inner ear or prevents CN 8 from functioning
Ototoxicity (what meds cause this?):
o
Ear poisoning
o
Causes:
ASA, Quinines, Loop diuretics, tonic water
Aminoglycosides (-cin) – EX: Gentamycin
Acute sinusitis (treatment in adults and peds):
o
Viral = symptom management o
Bacterial = >10 days, fever, sx worsened after initial improvement o
Amoxacillin or Augmentin = 1
st
line
o
PCN allergy = doxycycline, levofloxacin
Lymph Nodes:
o
Tender, mobile, enlarged – infection
o
Painless, immobile, hard – malignancy
Mononucleosis:
o
Caused by EBV
o
General sick feeling, HA, sore throat, enlarged tonsils, splenomegaly, rash
o
DX: mono-spot test
o
TX: Symptom management o
NO SPORTS (splenomegaly)
Pharyngitis/Tonsilitis:
o
Cough = viral o
No Cough = Strep o
Strep can lead to scarlet fever, rheumatic heart disease