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Peds Rotation > EENT part 2 > Flashcards

EENT part 2 Flashcards

1
Q

MC bacterial pathogens of otitis externa

A

P. aeruginosa

S. aureus

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2
Q

Bacterial pathogens of otitis externa with tympanostomy tubes

A 
S. aureus
S. pneumoniae and with chewing
M. catarrhalis
Proteus
Klebsiella
Occasionally anaerobes
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3
Q

Clinical findings of otitis externa

A 
Pain
Tenderness
Aural d/c
Fever absent
Hearing unaffected
Tenderness with movement of the pinna
Lining of the auditory canal is inflamed with mild to severe erythema and edema
Scant to copious d/c from the auditory canal
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4
Q

Tx of otitis externa

A

Ofloxacin
Ciprofloxacin with hydrocortisone or dexamethasone
Polymyxin B-neosporin-hydrocortisone

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5
Q

Seasonal allergic rhinitis

A

Caused by airborne pollens, which have seasonal patterns
Trees in spring
Grasses in late spring to summer
Weeds in summer and fall

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6
Q

Perennial allergic rhinitis

A

Primarily caused by indoor allergens, such as house dust mites, animal dander, mold, and cockroaches

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7
Q

Episodic rhinitis

A

Occurs with intermittent exposure to allergens

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8
Q

Sx of allergic rhinitis

A

Thin rhinorrhea
Nasal congestion
Paroxysms of sneezing
Pruritis of the eyes, nose, ears, and palate

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9
Q

PE of allergic rhinitis

A

Pale pink or bluish gray, swollen, boggy nasal turbinates with clear, watery secretions
Frequent nasal itching and rubbing of the nose with the palm of the hand (allergic salute)
Allergic shiners- dark periorbital swollen areas
Swollen eyelids or conjunctival injection

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10
Q

Labs for allergic rhinitis

A

Allergy testing

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11
Q

Tx of allergic rhinitis

A 
Allergen avoidance
Intranasal corticosteroids
2nd generation antihistamines
Decongestants
Immunotherapy
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12
Q

What is the most common cause of mild to moderate hearing loss in children?

A

Conduction abnormality

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13
Q

What is more common in severe hearing loss?

A

Sensorineural hearing loss

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14
Q

Causes of sensorineual deafness

A

Congenital infections
Tumors and their treatments
Genetic deafness

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15
Q

Dx of hearing impairment

A 
Auditory brainstem response
Otoacoustic emissions
Audiologic assessment for young, neurologically immature, or behaviorally difficult children
Pneumatic otoscopy
Tympanometry
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16
Q

Tx of sensorineural hearing loss

A 
Speech-language therapy
Hearing aids
ASL
Special ed
Cochlear implants
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17
Q

Indication for cochlear implants

A

Children >12 mos with profound sensorineual hearing loss who have limited benefit from hearing aids, have failed to progress in auditory skill development, and have no radiologic or medical contraindications

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18
Q

S/sx of mastoiditis

A

Posterior auricular tenderness, swelling, and erythema

Pinna is displaced downward and outward

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19
Q

Dx of mastoiditis

A

Radiographs or CT of the mastoid reveals clouding of the air cells, demineralization, or bone destruction

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20
Q

Tx of mastoiditis

A

Systemic abx and drainage

21
Q

Causes of epistaxis

A 
Trauma
Mucosal irritation
Septal abnormality
Inflammatory diseases
Tumors
Blood dyscrasias
Arteriosclerosis
Hereditary hemorrhagic telangiectasia
Idiopathic
22
Q

Labs for epistaxis

A

Persistent heavy bleeding: hematocrit and type and cross-match
Hx of recurrent epistaxis, platelet d/o, or neoplasia: CBC with differential
Suspicion of a bleeding d/o: bleeding time
Taking warfarin or if liver dz is suspected: INR/PT

23
Q

Tx for epistaxis

A 
Manual hemostasis
Humidification and moisturization
Cauterization
Nasal packing
Arterial ligation
Embolization
24
Q

Medications for epistaxis

A

Oxymetazoline
Lidocaine
Mupirocin ointment
Silver nitrate

25
Q

MC organisms in tonsillitis

A 
HSV
EBV
CMV
Adenovirus
Measles virus
26
Q

Organisms noted in chronic tonsillitis

A

Alpha and beta-hemolytic strep
S. aureus
H. influenzae
Bacteroides

27
Q

S/sx of acute tonsillitis

A 
Fever
Sore throat
Foul breath
Dysphagia
Odynophagia
Tender cervical lymph nodes
Resolve in 3-4 days but may last up to 2 wks despite adequate therapy
28
Q

How to diagnose recurrent tonsillitis

A

7 culture-proven episodes in 1 yr
5 infections in 2 consecutive years
3 infections each year for 3 years consecutively

29
Q

PE of acute tonsillitis

A

Fever
Enlarged inflamed tonsils that may have exudates
Open-mouth breathing and voice change
Tender cervical lymph nodes and neck stiffness

30
Q

Labs for tonsillitis

A

Throat cultures
Monospot
CBC
Serum electrolyte

31
Q

Tx of tonsillitis

A

Corticosteroids for EBV
PO PCN for GABHS infection
Tonsillectomy for recurrent tonsillitis

32
Q

What was historically the cause of epiglottitis in children in the US?

A

Hemophilus influenzae type B

33
Q

S/sx of epiglottitis

A 
Rapid onset and progression of sx
Sore throat
Odynophagia/dysphagia
Fever
Muffled or hoarse voice
Drooling, dysphagia, distress
34
Q

PE of epiglottitis

A 
Stridor
Voice muffling
Tripod position or sniffing position
Drooling/inability to handle secretions
Cervical adenopathy
Toxic appearance
35
Q

Workup of epiglottitis

A

Nasopharyngoscopy/laryngoscopy
Lateral neck soft-tissue radiography
Blood cultures

36
Q

Tx of epiglottitis

A

Have intubation equipment ready
Airway management
Third-generation cephalosporin

37
Q

MCC of oral candidiasis

A

Candida albicans

38
Q

Causes of oral candidiasis

A

Inhaled corticosteroid use
Immunocompromised pts
Antibiotic use

39
Q

S/sx of oral candidiasis

A

Infants: pain, poor feeding, fussiness
Others: Itching, burning, soreness

40
Q

PE of oral candidiasis

A

White plaques that may affect the lips, tongue, gums, and palate
Scraping may reveal erythema and bleeding at the base

41
Q

Labs of oral candidiasis

A

KOH slide preparation

42
Q

Tx of oral candidiasis

A

Nystatin oral suspension

43
Q

S/sx of peritonsillar abscess

A

Sore throat/dysphagia and neck swelling and pain: usually for 5-7 days, not improving on abx
Trismus
Fever
Pooling of saliva and drooling
Tiredness, irritability, and reduced oral intake
Muffled voice
Referred ear pain

44
Q

PE of peritonsillar abscess

A

Potential respiratory distress
Moderately uncomfortable appearing
Asymmetric swelling of the soft tissues with displacement of the affected tonsil medially and anteriorly
Tonsil may have erythema and exudates
Uvula is displaced to the contralateral side
Halitosis
Cervical and submandibular LAD

45
Q

Causes of peritonsillar abscess

A 
GABHS
S. aureus
Alpha-hemolytic streptococci
Coagulase-neg staphylococci
S. pneumoniae
46
Q

Labs for peritonsillar abscess

A

CBC with diff
Serum electrolytes if oral intake has declined
Throat culture

47
Q

Imaging for peritonsillar abscess

A

CT with IV contrast when dx is unclear, pt is uncooperative with the exam, and when infectious process is thought to involve deeper structures

48
Q

Tx of peritonsillar abscess

A 
Hydration
Analgesia
Drainage
Outpatient: Augmentin
IV ceftriaxone

Peds Rotation (12 decks)

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