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z Pediatrics - Final > A2 - Inflammation > Flashcards

A2 - Inflammation Flashcards

1
Q

Blepharitis

  • in children
  • signs/symptoms
A

Children: less common, causes chronic conj-itis

Signs/symp similar to results

  • ocular irritation
  • morning crusting
  • lid erythma
  • MG obstruction
  • intermittent blur
  • recurrent chalazion
  • inferior keratitis if severe
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2
Q

Blepharitis

-treatment

A

Warm compresses

Eyelid scrubs with baby shampoo

Topical antibiotic ointment

Oral erythromycin or tetracycline if severe
-caution due to dental staining with T

Caution with steroids in pts with corneal disease
-use only if K opacity is last part that hasn’t resolved

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3
Q

Blepharokeratoconjunctivitis

A

Secondary to chronic MGD

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4
Q

Ocular allergy

  • in children
  • associations
  • signs/symptoms
A

Common

Asthma, allergic rhinitis, atopic dermatitis

Itching
Bilateral chronic conj inflamm
Tearing, burning, photophobia
Immediate response to allergens

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5
Q

Ocular allergy

-seasonal allergic conj-itis

A

Spring and Fall

Triggered by environmental allergies (pollens, trees)

Red, watery, itchy
Blue-gray/purple discoloration of lower lids from eye rubbing

Tx: remove allergens, topical/oral meds

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6
Q 
Ocular allergy
-medications
—topical mast cell stabilizers
—mast cell + H1 blocker
—vasoconstrictors
—steroids
—NSAID
A

MCS: alamide, alamast

MSC/H1: pataday, bepreve

VC: opcon A, visine

S: FML, lotemax, alrex, pred

NSAID: acular

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7
Q

Vernal keratoconjunctivitis (VKC)

  • due to
  • who
  • when
  • forms (2)
A

Immediate and delayed hypersensitivity reactions

Males, first 2 decades of life

Spring and Fall

Limbal - esp African, Asian, hotter climates
Bulbar

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8
Q 
Vernal keratoconjunctivitis (VKC)
-signs/symptoms GENERAL
A

Commonly affects tarsal conj of upper lid

Initially diffuse injection, little discharge

Papillae multiply, cover tarsal with flat papules

Thick, ropy, whitish discharge may develop

Intense itching

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9
Q 
Vernal keratoconjunctivitis (VKC)
-signs/symptoms LIMBAL
A

Thickening and opacification of conj at limbus
-usually marked at upper margin of the K

Horner-Trantas dots

  • limbal nodules
  • gray, jelly-like bumps
  • whitish center, may appear to be raised with eosinophils
  • uncomfortable, dryness
  • persist as long as the season exacerbates it/until VKC resolves
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10
Q 
Vernal keratoconjunctivitis (VKC)
-corneal involvement
A

Punctate epithelial erosions (SPK)

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11
Q 
Vernal keratoconjunctivitis (VKC)
-treatment
A

Want a combo drop: MSC/H1

Severe cases get topical steroids

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12
Q

Papilloma

A

Benign epi proliferation

Look like masses at the limbus or pedunculated lesions of the caruncle, fornix, or palpebral conj

Transparent or pale

Resolve spontaneously

  • watch carefully so don’t miss anything
  • if severe enough laser/excise
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13
Q

Conjunctival epithelial inclusion cyst

A

Clear, fluid-filled conj cyst

Excise only for irritation

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14
Q

Conjunctival nevus

A

Common in children

Flat or elevated

Brown, non-pigmented, or pink

Can be noted at birth, develops more in childhood-puberty

Removal if significant growth
-dryness, scarring, etc.

Rarely transforms into malignancy

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15
Q

Ocular melanocytosis

A

Congenital

Unilateral gray/bluish patchy discoloration of sclera

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16
Q

Preseptal cellulitis

  • what
  • vs orbital cellulitis
A

Inflamm of tissues anterior to orbital septum
Eyelid edema - can extend to brow, forehead

No proptosis
No globe involvement
Full EOMS (-) pain

17
Q

Preseptal cellulitis

-causes

A

Trauma - laceration, insect bite, etc.

Infection - EKC, skin infection (herpes zoster)

Sinus infection

18
Q

Preseptal cellulitis

-treatment

A

Oral antibiotics - outpatient

Very young/sick children = inpatient care (send to hospital)
Need:
-cultures
-imaging of sinuses and orbits
-IV antibiotics
19
Q

Orbital cellulitis

  • what
  • associated with
  • cause
A

Infection of globe involving tissue posterior to orbital septum

Sinusitis

Penetrating injuries

20
Q

Orbital cellulitis

-signs/symptoms

A 
Fever
Lid edema
Orbital pain
HA
Proptosis
Chemosis
Limited EOMs (orbital involvement)
Venous congestion may -> incr IOP
21
Q

Orbital cellulitis

-treatment

A

Need imaging

  • confirm orbital involvement
  • R/O FB and bone tumors
  • view sinus involvement

Requires inpatient care, IV antibiotics

z Pediatrics - Final (17 decks)

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