EYE DISEASES
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RETINAL ARTERY OCCLUSION
Sudden loss of vision in one eye.
On fundoscopy : Cherry red spot
Sudden loss of vision in one eye.
On fundoscopy : Cherry red spot
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RETINAL VEIN OCCLUSION
Fundoscopy: Multiple hemorrhages and exudates
Seen in DM, HTN, glaucoma
Treatment: if new vessel growth, may do laser. If untreated can cause vitreous hemorrhage and glaucoma.
Fundoscopy: Multiple hemorrhages and exudates
Seen in DM, HTN, glaucoma
Treatment: if new vessel growth, may do laser. If untreated can cause vitreous hemorrhage and glaucoma.
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HERPES ZOSTER OPHTHALMICUS (Pic from Annals of Internal Medicine)
Ophthalmologic emergency
Ophthalmologic emergency
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HSV KERATITIS
Acute pain, blurred vision, and eye weeping; chemosis and conjunctivitis.
It is not associated with a cutaneous eruption in a dermatomal pattern.
Treatment: Topical trifluridine or acyclovir
Acute pain, blurred vision, and eye weeping; chemosis and conjunctivitis.
It is not associated with a cutaneous eruption in a dermatomal pattern.
Treatment: Topical trifluridine or acyclovir
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PSEUDOMONA KERATITIS
Suspect of this when patient is intubated and develops red eye with white cornea.
Also in pt with contact lenses that develops conjunctivitis
Treatment: topical and iv antipseudomonals
Suspect of this when patient is intubated and develops red eye with white cornea.
Also in pt with contact lenses that develops conjunctivitis
Treatment: topical and iv antipseudomonals
DRUG INDUCED OPTIC NEUROPATHY
- Linezolid
- sildenafil
- Ethambutol
- Infliximab
- Amiodarone
- Linezolid
- sildenafil
- Ethambutol
- Infliximab
- Amiodarone
NOSE
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VASOMOTOR RHINITIS
It is caused by increased sensitivity to irritants in the air.
Symptoms: nasal congestion and rhinorrhea after exposure to odors, humidity, temperature change, and alcohol.
Treatment: Topical intranasal corticosteroids, topical intranasal antihistamine, and topical ipratropium .
It is caused by increased sensitivity to irritants in the air.
Symptoms: nasal congestion and rhinorrhea after exposure to odors, humidity, temperature change, and alcohol.
Treatment: Topical intranasal corticosteroids, topical intranasal antihistamine, and topical ipratropium .
CHRONIC COUGH (>8weeks)
3 most common causes:
- Upper airway cough syndrome (post nasal drip)
- Asthma
- GERD
* If pt taking ACEi, Tx: d/c ACEI
* ? pulmonary parenchyma: do CXR
If CXR normal empiric 1st generation antihistamines for post nasal drip +/- nasal steroids
3 most common causes:
- Upper airway cough syndrome (post nasal drip)
- Asthma
- GERD
* If pt taking ACEi, Tx: d/c ACEI
* ? pulmonary parenchyma: do CXR
If CXR normal empiric 1st generation antihistamines for post nasal drip +/- nasal steroids
MISCELLANEOUS
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ANKLE SPRAIN
Otawa ankle rules if negative no need of xray
Pic from BMJ
http://www.bmj.com/content/326/7386/417
Otawa ankle rules if negative no need of xray
Pic from BMJ
http://www.bmj.com/content/326/7386/417
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PYRIFORMIS SYNDROME
Pain on sciatic notch
Pain on sciatic notch
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OLECRANON BURSITIS
Pain only on full flexion of the elbow, most likely because this movement causes tautness of the bursa and surrounding soft tissue. No pain on passive movements
Pain only on full flexion of the elbow, most likely because this movement causes tautness of the bursa and surrounding soft tissue. No pain on passive movements
GERIATRICS
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Disequilibrium in the Elderly
It is often multifactorial: peripheral neuropathy, visual loss, a decline in bilateral vestibular function, deconditioning, autonomic neuropathy, and medication side effects.
Treatment: reducing polypharmacy, installing safety features in patients’ homes, providing assistive devices, correcting eyesight and hearing , and physical therapy to improve muscle strength.
It is often multifactorial: peripheral neuropathy, visual loss, a decline in bilateral vestibular function, deconditioning, autonomic neuropathy, and medication side effects.
Treatment: reducing polypharmacy, installing safety features in patients’ homes, providing assistive devices, correcting eyesight and hearing , and physical therapy to improve muscle strength.
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HEARING
Frequently underdiagnosed.
Diagnosis: The whispered-voice test . A battery-powered handheld audioscope is an acceptable alternative screening modality.
Frequently underdiagnosed.
Diagnosis: The whispered-voice test . A battery-powered handheld audioscope is an acceptable alternative screening modality.
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