EENT Flashcards
What is the antibiotic for streptococcal throat infections?
Penicillin VK 250 mg orally TID * 10 days
What is the steeple sign?
A narrowing of the trachea seen on an x-ray of a child with croup
What causes middle ear effusions?
Blocked eustachian tubes, allergies
What strabismus directionalities require immediate referral to ophthalmology? What other characteristic needs to be referred?
Hypertropia and hypotropia as they are more related to tumors, fixed in one direction
What is otitis externa commonly referred as?
Swimmer’s ear
What bacteria typically causes hordeolum?
Staphylococcal bacteria
What is the treatment for conjunctivitis caused by chlamydia?
Erythromycin ointment
What are some unique signs and symptoms of a strep infection?
Scarlet fever with sandpaper like rash, anterior cervical lymphadenopathy, and fever
What is the typical age range of sinusitis?
Typically greater than 9 years of age
When is croup most common?
In toddlers during the fall and winter
What is the thumb sign?
A thumb-shaped patch seen on an x-ray of the neck and children with epiglottitis
Define sensory neural hearing loss
Impaired transmission of sound through the nervous system
What are the abnormal findings on the Weber and rinne test in sensory neural hearing loss?
Deep Weber test sound will lateralize to the unaffected ear. Rinne is not an effective way of analyzing this concern
What are the classic signs of epiglottitis?
Drooling, and hyperextension of the neck or tripod position
What are expected physical exam findings of a child with acute otitis media?
A tympanic membrane that is erythematous and edematus, and slightly concave
When looking for the red reflex what exam is seen with a child with cataracts?
White fungus reflex or gauze over the iris
What is the treatment for gonococcal conjunctivitis?
IV penicillin g in the neonates and ceftriaxone IM
What are the characteristic physical exam findings of otitis externa
Erythema of the ear canal, edema of the ear canal, purulent exudate, pain upon manipulation of auricle
What does the acronym FLEA stand for in the setting of group a beta hemolytic streptococci?
F for fever, L for lack of cough, E for exudate, A for anterior cervical adenopathy
What is the typical treatment of sinusitis?
Augmentin for 10 days or levaquin if no improvement in 3 days
What are the two bacterias most commonly responsible for acute otitis media?
S. Pneumoniae and H influenzae
What is the typical treatment for a bacterial conjunctivitis?
Erythromycin ophthalmic ointment or polymyxin B ophthalmic ointment
What is epistaxis?
Nosebleed
What is the discharge associated with allergic conjunctivitis?
Clear increased tearing
What is the typical disease course of a sinusitis infection?
Typically follows the resolution of cold-like symptoms
What are some causes of sensory neural hearing loss?
Acoustic neuroma, syphilis, CNS disease, medication toxicity
What is the first line antibiotic for acute otitis media?
Amoxicillin 80 to 90 mg per kilogram per day twice daily times 10 days
What pathogen causes croup?
Para influenza
Describe the onset of a hordeolum.
Abrupt
What are causes of conductive hearing loss?
Cerumen impaction, hematoma, otitis media, perforated tympanic membrane
What are typical signs / symptoms of sinusitis?
Peanut pressure over the cheek, headache, discolored nasal discharge, halitosis
Define conductive hearing loss
Decreased ability to conduct sound from the external ear to the inner ear
What are the typical pathogens of sinusitis?
Same as otitis media such as s. Pneumoniae, h influenzae, and M catarrhalis
A chilazion is associated with pain or no pain
No pain
What age can a child begin to receive antitussives?
Older than 6 years of age
What is an abnormal, uniform, progressive opacity of the eye seen in children with comirbid syndromes?
Cataracts
In conductive hearing loss, what will the Weber and Rinne test findings be?
The Weber test will have sound lateralized to the affected ear and the Rinne test will be abnormal in the affected ear in that air conducted sound will disappear before a bone conducted sound
Describe the onset of a chalazion?
Insidious
What is the characteristic sign or symptom of croup?
Bark like a cough
What is a characteristic sign or symptom of otitis externa?
Otalgia, pruritis, discharge
What distinguishes a gonococcal conjunctivitis?
Copious yellow or green discharge
What is the peak incidence of epiglottitis?
6 to 10 years of age or school age
What is the management of middle ear effusions?
Watch for waiting with reevaluation in 3 to 6 months
What is the management of bacterial otitis externa?
Cipro drops or ofloxacin drops
What are three common physical exam findings of mono?
Posterior cervical lymphadenopathy, generalized lymphadenopathy, splenomegaly, white exudate on tonsils, macula popular or particular r
What is the observation period For healthy children with acute otitis media?
48 to 72 hours if appropriate which means unilateral, mild pain or mild fever, and a compliant family member
What is the management of a chalazion?
Surgery
A hordeolum or stye is associated with pain or no pain?
Pain
What is the management if there is concern for hearing loss?
Referral for audiogram and further evaluation
Where should pressure be held to stop epistaxis?
Kiesselbach’s triangle
Until what age is strabismus normal?
6 months of age
What are the physical exam findings of a middle ear effusion?
Air bubbles behind the tympanic membrane and a flat light instead of the curved light on the tempting membrane
What is the Weber test and it’s normal findings?
Uses the tuning fork and holds it on top of the head. Sound should be heard equally in both ears and not lateralized
When do you refer a child to the to the ophthalmologist for a hordeolum?
No resolution within 48 hours
What is the typical treatment for viral conjunctivitis?
Saline, cool compresses then maybe decongestants or mast cell stabilizers
Why can’t children return to sports immediately after a mono infection?
Concern for spleenic rupture for at least 3 weeks to several months. there can be no more enlarged lymph nodes prior to resuming a play
What are absent symptoms of the common cold? That other respiratory illness is typically half?
Fever and lymphadenopathy
What is the incubation period Of mono?
One to two months
What sign or symptom distinguishes acute otitis media?
Fever and otalgia
What is the most severe symptom of mono?
Pharyngitis
What is the Rinne test and what are its normal findings?
Tuning fork is held at the bone until the sound disappears and then in front of the ear until the sound disappears. Air conjunction should be twice as long as bone conduction so it should take twice as long for the sound to disappear through air conduction.
What is the term for an ocular misalignment as a result of uncoordinated ocular muscles?
Strabismus
What are laboratory findings of mono?
Early rise in immunoglobulin m EBV followed by a permanent rise in immunoglobulin g EBV
What are the signs and symptoms of middle ear effusions?
Hearing loss popping sensation when pressure altered, fullness in the ear
What type of conjunctivitis causes a purulent discharge?
Bacterial
What is the treatment for herpetic conjunctivitis?
Refer to ophthalmologist
What is the management for cataracts?
Referral for surgery
What bacteria causes epiglottitis?
Hib
What is serous otitis media or otitis media with effusion?
Presence of fluid in the middle ears without the signs or symptoms of AOM
What are the four directionalities of strabismus?
Esotropia, inward Exotropia, outward Hypertropia, upward Hypotropia, downward
What pathogen causes infectious mononucleosis?
Epstein-Barr virus
What type of allergic response is associated with allergic rhinitis?
IGE mediated response
What are the three categories of allergic rhinitis?
Seasonal, perennial, or episodic
What are common physical exam findings with allergic rhinitis?
Boggie nasal mucosa, nasal crease, allergic salute, Denny line, cobblestone pharynx
What is the first line of medications to treat allergic rhinitis?
Oral antihistamines and/or intranasal steroids
What can cause rhinitis medicamentosa?
Intranasal decongestants like afrin also caused rebound rhinorrhea
How long does it take for intranasal corticosteroids to take effect?
4 weeks
