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H + P/EENT Still 2010
Definitions
127
Health Care
Graduate
08/30/2010

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Term
Erythema
Definition
Redness
Term
Trichotillomania
Definition
Pulling out own hair. Asymmetric irregularity
Term
Telogen effluvium
Definition
Loss of hair, stress response
Term
Pilar cysts
Definition
Scalp masses
Term
Facial telangiectasia
Definition
Spidery blood vessels, lateral nasal
Term
Hirsutism
Definition
Excessive facial/body hair
Term
Melasma
Definition
aka mask of pregnancy. Combined result of hormone changes/sun exposure
Term
Cushing's syndrome: PANCE
Definition
Moon facies
Term
Myxedema
Definition
Severe hypothyroidism. PANCE: loss of lateral 1/3 eyebrows
Term
Parkinsons: PANCE
Definition
Masklike fascies
Term
Parotitis
Definition
Pain with salivation
Term
Temporal Arteritis: PANCE
Definition
Temporal arteries "rope like" when palpated
New onset headache in patient over 50 yrs
Term
Ptosis
Definition
Drooping of upper eyelid
Term
Exopthalmos (proptosis)
Definition
Abnormal eye protrusion. Associated w/hyperthyroidism
Term
Xanthelasma
Definition
Raised yellowish plaques along nasal portion of eyelid (possible lipid disorder)
Term
Hordeolum
Definition
Stye, typically caused by Staph. aureus. Acute onset of pain and edema of eyelid.
Term
Chalazion
Definition
Painless, more internal protrusion nodule on eyelid. Granulomatous inflammation of meibomian gland
Term
Corneal arcus
Definition
Moon shaped whitish area
Term
Pterygium
Definition
Proliferation of fibro-vascular tissue w/in bulbar conjunctiva.Rx: artificial tears, topical vasocontrictor
Term
Miosis
Definition
constriction of pupils
Term
Mydriasis
Definition
dilation of pupils
Term
Scleral icterus
Definition
Yellow sclera
Term
Esotropia
Definition
medial eye deviation
Term
Exotropia
Definition
lateral eye deviation
Term
Nystagmus
Definition
fine rhythmic oscillations of the eyes
Term
Glaucoma
Definition
IOP increase as result of failure of Canal of Schlemm not draining
Open angle: chronic
Closed angle: acute, blurred vision
Term
Epiphora
Definition
Excess tearing of eye
Term
Keratitis
Definition
inflammation of cornea
Term
Arcus senilis
Definition
thin gray/white arc on edge of cornea caused by lipid deposits
Term
Strabismus
Definition
crossed eyes. Lack of parallelism of visual axis of eyes
Term
Amblyopia
Definition
Lazy eye, poor vision development in one eye
Term
Tonometry
Definition
Measure IOP, normal 10 to 24 mm Hg
Term
Chemosis
Definition
Swelling of bulbar conjunctiva, occurs w/allergic eye
Term
Hyperemia
Definition
Increased redness (conjunctivitis, corneal disorders, acute glaucoma, acute uveitis)
Term
Trichiasis
Definition
Rubbing of eyelashes against cornea (foreign body sensation)
Term
Photophobia
Definition
Sensitivity to light (corneal inflammation, iritis)
Term
Sjogren's disease
Definition
Scratching and burning signifying deficiency of tear film components
Term
Purulent eye discharge
Definition
Bacterial infection of conjunctiva/cornea/lacrimal sac
Term
Watery eye discharge
Definition
Viral conjunctivitis/Keratitis
Term
Tearing, ropy eye discharge
Definition
Allergic conjunctivitis
Term
Diplopia
Definition
Double vision (extraocular muscle imbalance)
Term
Physiologic anisocoria
Definition
Pupillary inequality of less than .5 mm
Term
Aniscoria greater in dim light
Definition
Issue w/sympathetic nervous supply
Term
Anisocoria greater in bright light
Definition
Issue w/parasympathetic nervous supply
Term
Argyll Robertson
Definition
Prostitute pupils: accommodate but don't react
Term
Adie's pupil
Definition
Tonic pupil: idiopathic, pupil large w/severely reduced and slow rxn to light
Term
Emmetropia
Definition
Normal state of refractive/accomodation
Term
Hyperopia
Definition
Farsightedness: parallel rays focus behind retina due to flattening of globe, correct w/convex lens
Term
Myopia
Definition
Nearsightedness: Unaccommodated eye brings into focus images of objects closer than infinity. Correct w/concave lenses
Term
Astigmatism
Definition
Refractive errors in horizontal and vertical axes differ
Term
Presbyopia
Definition
Natural loss of accommodative capacity w/age
Term
Meibomian glands
Definition
Tarsal glands. Secrete sebum, preventing evaporation of eye's tear film
Term
Glands of Zeis
Definition
Modified sebaceous glands, secretions flow to edge of eyelid into follicles of eyelashes
Term
Glands of Moll
Definition
apocrine sweat glands in dermis of eyelids
Term
Internal Hordeolum
Definition
Meibomian gland abscess (on margin)
Term
External Hordeolum
Definition
Caused by inflammation in glands of Moll or Zeis
Term
Blepharitis
Definition
Common chronic bilateral inflammatory condition of lid margins
Term
Anterior blepharitis
Definition
Involves eyelashes PLUS eyelid skin and assoc glands. Assoc with seborrhea
Term
Posterior blepharitis
Definition
Eyelids secondary to dysfunction of meibomian gland. Assoc w/rosacea.
Term
Entropion
Definition
Inward turning of eyelid and lashes
Term
Ectropion
Definition
Outward turning of lower lid (palsy assoc)
Term
Dacryocystitis
Definition
Infection of lacrimal sac due to obstruction of nasolacrimal. Infants/age over 40, unilateral.
Term
Acute dacryocystitis
Definition
Staph aureus, beta-hemolytic streptococci
Term
Chronic dacryocystitis
Definition
Staph epidermidis, anerobic strep., candida albicans
Term
Dacryoadenitis
Definition
Acute inflammation of lacrimal gland. Symptoms in outer 1/3 upper eyelid. Staph aureus, Neisseria gonorrhoeae, Epstein Barr, flu, herpes zoster
Term
Leukocoria
Definition
White light, abnormal for red reflex. Possibly retinoblastoma, tumor in eye found most often in children
Term
Papilledema
Definition
Swelling of optic disc and bulging of physiologic cup due to IOP. Flame hemorrhages, cotton wool
Term
Drusen
Definition
Undigested cellular debris assoc w/macular degeneration
Term
Keloid
Definition
Growth on helix associated w/ear piercings
Term
CNHC
Definition
Chodrodermatitis nodularis helices chronicus. "Hurts my ear when I sleep"
Term
Labyrinthitis
Definition
Inner ear infection
Term
Bacterial conjunctivitis
Definition
Staph aureus, Strep pneumoniae. Acute onset of copious, purulent, sticky discharge from both eyes worse upon wakening. Dx: H+P. Rx: sulfonamide
Term
Gonococccal conjunctivitis
Definition
Neisseria gonorrhoeae. Copious purulent discharge. Dx: Stained smear, culture. Rx: Rocephin, topical antibiotics
Term
Chlamydial conjunctivitis
Definition
Cause of blindness wolrd wide. Dx: Giemsa. Rx: anitbiotics
Term
Viral conjunctivitis
Definition
Adenovirus type 3. Present: pharyngitis, fever, malaise, preauricular adenopathy. Rx: topical sulfonamide.
Term
Keratoconjunctivitis sicca
Definition
Dry eyes. Aqueous layer affected primarily. Affected by age, environment, hormone. Rx: artificial tears
Term
Allergic conjunctivitis
Definition
Hallmark itching. Stringy discharge, conjunctival hyperemia, edema. Rx: anithistimines
Term
Vernal keratoconjunctivitis
Definition
COBBLESTONE PAPILLAE (PANCE). More aggressive allergic eye occurs bilaterally. Rx: Antihistimines
Term
Atopic keratoconjunctivitis
Definition
Chronic allergic eye. Fine papillary conjunctivitis w/fibrosis, entropion and trichiasis.Rx:Antihistimines
Term
Pinguecula
Definition
Degenerative lesion of bulbar conjunctiva. Presents on nasal side, yellow white nodule. Can become pterygium. Rx: artifical tears, topical vasoconstrictor
Term
Corneal ulcer
Definition
Herpes simplex most common cause.
Term
Bacterial keratitis
Definition
Contact wear. Psuedomonas aeruginosa most common pathogen. Agressive, yellow green/blue green nasty exudate. Hypopyon. Dx: gram. Rx: High conc topical antibiotics
Term
Hypopyon
Definition
Layer of white blood cells in inf or dep portion or ant chamber of eye
Term
HSV Keratitis
Definition
Most common cause corneal ulcers. HSV lives in trigeminal ganglion. Present: blepharitis w/vesicles. Dx: fluor. terminal bulbs. Rx: topical antivirals
Term
Herpes Zoster Ophthalmicus
Definition
2ndry to activation of zoster virus in ophthalmic division tirgeminal. Hutchinson's sign, lesion on tip of nose poses higher risk. Dx Fluoresceine stain (dendritic lesions).Dx: acyclovir
Term
Fungal keratitis
Definition
Plant material, indolent, loss in middle layer of cornea.
Term
Acanthamoeba keratitis
Definition
Protozoa forms cyst in corneal stroma, contact lens wearer (swimming). Present pain out of proportion. Rx topical treatment, epithelial debridement
Term
Rhynophyma
Definition
Enlargement of glandular component of skin on nose. Assoc w/rosacea, alcohol aggrevates
Term
Verrucae
Definition
Nose warts
Term
Herpes labialis
Definition
Cold sore on vermilllion border of lip
Term
Angular chelitis
Definition
Cracked corners of lips. AKA perleche, commissural cheilitis, angular stomatitis
Term
Actinic cheilitis
Definition
"chapped lips all the time". Precursor of squamous cell carcinoma.
Term
Lentigines
Definition
Giant freckles
Term
aphthous stomatitis
Definition
Canker sores
Term
Fordyce spots
Definition
Normal variant. Ectopic sebaceous glands in mouth, orange dots
Term
Torus palatinus/mandibularis
Definition
Harmless, benign, common rounded bony growths that vary in size and lobulation
Term
Induration
Definition
Hardening of a normally soft tissue or organ due to inflammation, infiltration of a neoplasm, or an accumulation of blood
Term
Exudative tonsillitis
Definition
Erythematous throat w/ white exudate on tonsils. Group A Strep or infectious mononucleosis
Term
Shotty nodes
Definition
Small, mobile, discrete, nontender lymph nodes. Healthy
Term
Soft thyroid
Definition
Grave's disease, autoimmune hyperthyroidism
Term
Firm Thyroid
Definition
Hashimoto's thyroiditis: autoimmune hypothyroidism
Term
Thyroiditis
Definition
Tender thyroid, inflammation
Term
Acute closed-angle glaucoma
Definition
Sx: Rainbow colored halos around light. N/v/ab pain. Cornea hazy/steamy. Globe rock hard. IOP >50. Crescent shadow on medial side of iris. Rx: Topical beta blocker timolol, acetazolamide, pilocarpine, laser peripheral iridotomy.
Term
Chronic glaucoma
Definition
Gradual loss. Cupping/pallor of optic disk. Open/closed/normal tension. Sx: Increased cup to disc ratio. Rx: topical beta-adrenergic blockers (timolol), carobinic anhydrase inhibitors, laser trabeculoplasty.
Term
Uveitis
Definition
Any combination of iritis, cyclitis, or choroiditis.Rx: topical cycloplegics, corticosteroids
Term
Flare
Definition
Inflammatory cells and proteins escaping from dilated vessels. Ant chamber appears gray/milky. IRITIS
Term
"Cells"
Definition
White blood cells escaping from dilated vessels. Appear as white dots. IRITIS
Term
Iritis
Definition
Sx: headlight in fog, flares, cells: dust in a movie projector light. Pain w/accommodation, consensual light reflex. Dx: topical cycloplegics and corticosteroids.
Term
Cataract
Definition
Sx: red reflex absent, white pupil, glare. Rx: cataract surgery for > 20/40 acuity, reduced vision due to glare.
Term
Retinal Detachment
Definition
Most common site detachment=superior temporal retinal area. Sx: New onset of floaters, flashing light. Pt sees shadow or curtain. Rx: cryosurgery or laser. pt should remain supine /w head turned ipsilateral to detachment.
Term
Vitreous hemorrhage
Definition
Sx: inability to see fundal details. Pt sudden visual loss, floaters.
Term
Macular degeneration
Definition
Sx Drusen (hard or soft).
Term
CRAO
Definition
Sx: sudden painless unilateral loss of vision. Pale retina w/cherry red spot. Rx: lay pt flat, high conc O2, topical beta blocker, ocular massage. DDx: temporal arteritis
Term
CRVO
Definition
Sx: sudden, but more gradual, unilateral painless loss of vision. Blood and thunder fundus. Rx: NO ocular massage.
Term
Amaurosis Fugax
Definition
Cause: retinal emboli from ipsilateral carotid disease. Sx: curtain effect on vision.
Term
Diabetic Retinopathy: nonproliferative
Definition
Leading cause new blindness 20-65, NIDDM Sx: any of dilation of veins, capillary microaneurysms, flame, splinter/dot/blot hemorrhages, retinal edema, hard exudates. Rx: treat blood glucose and any hypertension
Term
Diabetic Retinopathy: proliferative
Definition
Leading cause blindess 20-65. Sx: soft exudates, intraretinal microvascular abnormalities, venous beading. "Cotton wool spots". Rx: treat blood glucose and any hypertension
Term
Hypertensive retinopathy
Definition
Sx: Copper/silver wiring (torturous arteries). Ateriovenous nicking.
Term
Cytomegalovirus retinitis
Definition
In Aids pt whn CD4 counts down. Sx: cotton wool, retinal hemorrhages, microaneurysms. Pt floaters, scintillating scotoma, metamorphopsia. "Pizza pie, cheese and ketchup". Rx: Ganciclovir, foscarnet, cidofovir.
Term
Optic neuritis
Definition
Inflammation usually retro bulbar.Sx: Sudden monocular loss of vision. Pain c eye movements and palpitation of globe. Central scotoma, loss color vision. Rx: IV steroids
Term
orbital cellulitis
Definition
Sx fever, proptosis, ocular signs. Sinusitis usually underlying cause. Rx: IV antibiotics, broad spectrum.
Term
Chemical conjunctivitis
Definition
Dx: nitrazine paper. Rx: irrigation w/ LR. 1 ltr acid, 2 ltrs if alkaline. Prophylactic topical antibiotics
Term
Hyphema
Definition
injury to ant chamber, disrupts vasculature supporting iris/ciliary body. Sx meniscus. Pain, photophobia, blurred vision, n/v. Rx: supine w/head elevated, fox metal eye shield. NO NSAIDS
Term
Corneal abrasion
Definition
Sx: tearing, photophobia, blepharospasm. Dx fluorescein- Seidel's test. Rx: cycloplegic to reduce spasm, topical antibiotic drops.
Term
Ultraviolet keratitis
Definition
aka diffuse punctate keratopathy/welder's flash. Sx agonizing pain severe photophobia. Diffuse punctate lesions. Rx: cyclopentolate.
Term
Perforated globe
Definition
Sx: teardrop. Rx. remain still, refer.
Term
Blow out fracture
Definition
Sx: binocular diploplia, restricted eye mvmnt, decreased sensation over inf orbital rim, enopthalmos.Dx: waters/caldwell xray "opaque teardrop hanging frm roof of antrum". If air in orbit black eyebrow sign.
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