EENT Flashcards
Most common bacterial pathogens that cause conjunctivitis
h. flu, mcat, strep pneumo
Bacterial pathogen associated with conjunctivitis in contact lens wearers
pseudomonas
Most common viral cause of conjunctivitus.
adenovirus
Symptoms include redness, discharge, matted eyelids and mild photophobia. PE includes chemosis (edema of conjunctiva), injection of conjunctiva, edema of eyelids
conjunctivitis
Topical tx for bacterial conjunctivitis
polymyxin B-trimethoprim (Polytrim) drops, sulfacetamide 10% drops, erythromycin ointment
Describe the course and resolution of conjuctivitis related to limiting its spread
wash hands. End of bacterial conjunctivitis contagious period is 24 hrs after initiating tx. End of viral conjunctivitis contagious period is 7 days after onset. Children may return to school prior to resolution
Complication of sinusitis that follows bacterial spread into the orbit through the wall of the infected sinus
orbital cellulitis
Adverse outcomes related to orbital cellulitis
subperiosteal abscess, opthalmoplegia, cavernus sinus thrombosis, vision loss
Manifestations include orbital pain, proptosis, chemosis, limited EOM, diploplia, reduced vision
orbital cellulitis
Usually occurs in children <3yrs. No ptosis or opthalmoplegia. Associated w/skin lesion or trauma. Caused by s. aureus or group A strep
periorbital cellulitus (anterior to palpebral fascia)
Diagnostic method of choice for orbital cellulitis
CT scan (determines extent and need for surgical drainage)
Treatment for orbital cellulitis
parenteral vanco plus one of the following: ceftriaxone (Rocephin), cefotaxime (Clarofan), ampicillin-sulbactam (Unasyn), pipercillin-tazobactam (Zosyn)
often is used as an initial screen for strabismus. involves shining a light onto the eyes from a distance and observing the reflection of the light on the cornea with respect to the pupil. The location of the reflection from both eyes should appear symmetric
corneal light reflex
child is asked to visually fix on a target at distance or near. The examiner covers one eye while observing the opposite eye for movement. No movement is detected if the child has normal ocular alignment. Manifest strabismus (tropia) is present if the eye that is not occluded shifts to refixate on the target when the fellow, previously fixating eye, is covered.
cover test
a functional reduction in the visual acuity of an eye caused by disuse or misuse during the critical period of visual development
amblyopia
Deviations of the eye toward the nose, which are the most common type of strabismus in children
esodeviations
most common cause of esotropia in children. the physiologic convergence cannot be overcome by fusional divergence. occurs more commonly in children who have hyperopia (farsightedness)
Accommodative esotropia
treatment of accomodative esotopria
cycloplegic refraction and prescription of hyperopic spectacles
defined by moderate to severe bulging of the tympanic membrane (TM) or new onset of otorrhea accompanied by acute signs of illness and middle ear inflammation
acute otitis media
most frequent diagnosis in sick children visiting clinicians’ offices and the most common reason for administration of antibiotics
acute otitis media
decreased the incidence of AOM
Introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2000 and the 13-valent pneumococcal conjugate vaccine in 2010
Peak age of attacks for otitis media
6-18 mos
How does the presence of viruses effect otitis media?
increase middle ear inflammation, decrease neutrophil fxn, and reduce antibiotic penetration into the middle ear
Which three species account for most of the bacterial isolates from middle ear fluid?
Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis
