EENT

Question 1

Most concerning presentation of strabismus

Answer 1

unilateral esotrophia (medial deviated) as the normal eye becomes preferred and amblyopia occurs

Question 2

Best initial test strabismus

Answer 2

-corneal light reflex

Question 3

Best test to compare heterophoria vs heterotropoia (constant strabisumus

Answer 3

-cover test; cover eye and if no movement of non covered eye then no strabisumus

Question 4

Best initial treatment strabismus

Answer 4

cover good eye

Question 5

What is amblyopia

Answer 5

decrease in visual acuity 2/2 absence of good retinal image during visual develoopment

Question 6

When should nasolacrimal duct obs resolve? What do if not?

Answer 6

1 year; nasal duct prob

Question 7

What is hordeolum? Cause? Tx?

Answer 7

• aka stye if it is external
• staph aureus
• meiobian glands is internal
• warm compresses +/- topic abx

Question 8

What is a chalazion? tx

Answer 8

• granulomatous inflammation of meiobian gland
• firm, nontender nodule in upper or lower led
• surgery

Question 9

Presentation and Tx neonatal gonorrhea conj

Answer 9

• birth or first 5 days
• send gram stain / culture, PCR
• IM Ceftriaxone x 1

Question 10

Presentation and tx neonatal chlamydia conj

Answer 10

• presents after 5 days and can be within first month of life
• erythermoycin PO x 2 weeks
• sparing of bulbar conjunctiva

Question 11

Findings Orbital Fracture

Answer 11

• limitation of upward gaze
• lower lid ecchymoses
• epistaxia
• decreased sensation of ipsi check and upper lip (disruption of infraorbital nerve)

Question 12

What torch infection most assd with cataracts

Answer 12

rubella

Question 13

Vascular Disease assd with child glaucoma

Answer 13

sturge weber

Question 14

Most common cause glaucoma

Answer 14

congenital; less than 3 years old

Question 15

Best test anterior uveitis

Answer 15

slit lamp

Question 16

Anterior Uveitis Presentation

Answer 16

pain, lacrimation, photophia, decreased vision, conjunctival injection, floathers / flashes

Question 17

Most common cause anterior uveitis

Answer 17

-JRA, ulcerative colitis, post infectious arthritis, lyme, rheum

Question 18

Initial management papilledema

Answer 18

-head CT followed by LP

Question 19

What is the most common malignant intraocular tumor in childhood?

Answer 19

retinoblastoma (usually less than 2 years)

Question 20

Most common presentation retinoblastoma

Answer 20

-leukocoria (white pupillary reflex)

0strabismus

Question 21

first Step Dx retinoblastoma

Answer 21

CT or US

Question 22

Who do we screen for ROP?

Answer 22

begin screen 4 to 6 weeks in any infant born less than 32 weeks o less than 1500g

Question 23

What do you have to screen for with newborn with ear malofrmation

Answer 23

• renal defect with US if other abnormalities

- hearing loss

Question 24

Tx otitis externa

Answer 24

-polymixin or ofloxacin or cipro otic

Question 25

Most common cause AOM

Answer 25

BACTERIAL 3/4 of time | -strep pneumo, non typebal Hflu, moraxella

Question 26

AOM tx if child is refusing PO

Answer 26

IM CTX with possible repeat 1 or two times in 2 to 3 day intervals

Question 27

When to consider tympanostomy tubes

Answer 27

3 to 4 AOM in 6 months or 5 to 6 in a year

Question 28

How to treat AOM with tympanostomy tubes in place

Answer 28

-with otorrhea clean canal and give ofloxacin or otic cipro; add oral antibiotics if does not imporve

Question 29

How to follow and tx OME

Answer 29

- follow monthly and if present for at least 3 months then refer to audiology - tubes if bilateral effusion for more than 3 months or any hearing loss

Question 30

What syndrome is choanal atresia most assd with

Answer 30

CHARGE

Question 31

Key words choanal atresi

Answer 31

-cyanosis that resolves with crying

Question 32

Sinus development

Answer 32

- ethmoids at birth - maxillaries 4 to 5 years old - frontal age 7 to 8 years old

Question 33

Most common cause delayed tooth development

Answer 33

- hypothyroid - hypopit - familial - ectoderm dysplasia - chromo disorders and syndromes (treacher, pierre)

Question 34

Tx Tooth Avulsion

Answer 34

replace in first 20 seconds | 00find tooth, rinse in tap water, insert into socket (if cant cold milk), go to tentist

Question 35

When to correct cleft lip and palate

Answer 35

- lip: 3 months with reision at 4 to 5 | - palate at less than 1 year to avoid speech issues

Question 36

Scarlet Fever

Answer 36

-symptoms strep plus the rash -diffuse erythema with fine papules (sandpaper!); heavier brither in skin creases --pastia lines: neck, inguinal area, antecubtal fossa 0rashes fades after 3 to 4 days then desquamates

Question 37

Subacute Cervical Adenitis Differential

Answer 37

- 1 week - place PPD - if negative think cat scratch

Question 38

Causes cervical adenitis

Answer 38

acute usually GAS, mumps, EBV, entero, adeno, herpes - malignancy if painless enlargement etc etc - no malignant thinks mycobacteria, EBV, CMV, HIV, syphilis

Question 39

Scans for thyroglossal duct

Answer 39

- US | - thyroid scan for ectopic tissue