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EOR - Pediatrics > ENT > Flashcards

ENT Flashcards

1
Q

AOM is mc caused by

A

1. strep pneumo
2. h. flu
3. m. cat

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2
Q

classification of AOM

A

acute: < 3 weeks
chronic: > 3 mos
recurrent: 3 episodes x 6 mos OR 4 w.o clearing in between
chronic: > 3 mos of serous fluid in middle ear w.o s/sxof infxn

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3
Q

do you use abx for chronic AOM

A

no!

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4
Q

2 key findings of AOM

A

bulging of TM
limited mobility of the TM

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5
Q

1st line tx for AOM

A

amoxicillin
vs
augmentin
vs
cephalosporin

< 2 yo: 10 days
> 2 yo: 5-7 days

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6
Q

tx for AOM if pcn allergy

A

macrolide

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7
Q

2 complications of AOM

A

mastoiditis
bullous myringitis

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8
Q

mcc of acute pharyngotonsillitis

A

adenovirus

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9
Q

EBV triad

A

fever
sore throat
LAD

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10
Q

recent sexual encounter + non resolving pharyngitis

A

gonorrhea pharyngitis

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11
Q

consider _ pharyngitis in pt’s using ICS

A

fungal

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12
Q

centor criteria

A

absence of cough
exudates
fever > 100.4
cervical LAD

2-3 = rapid strep
4 = empiric tx

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13
Q

what 3 sx are NOT suggestive of strep pharyngitis

A

coryza
cough
hoarseness

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14
Q

gs dx for strep pharyngitis

A

throat culture

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15
Q

gs tx for strep pharyngitis

A

pcn

pcn allergy: azithromycin

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16
Q

2 complications of strep pharyngitis

A

rheumatic fever
psgn

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17
Q

for EBV, how long do pt’s need to avoid contact sports

A

3 weeks from symptom onset
strenuous sports: 4 weeks

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18
Q

tx for gonorrhea pharyngitis

A

IM ceftriaxone
PLUS
azithromycin

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19
Q

what is this showing

A

edematous, bluish nasal mucosa ->
allergic rihinitis

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20
Q

what are these showing

A

transverse nasal crease
allergic shiners

allergic rhinitis

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21
Q

allergic rhinitis is _ mediated mast cell _ release

A

IgE
histamine

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22
Q

what is rhinitis medicamentosa

A

rebound congestion from using intranasal decongestants > 3-5 days

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23
Q

mc cause of viral and bacterial conjunctivitis

A

viral: adenovirus
bacterial: s.aureus, strep pneumo

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24
Q

what pathogens do you think of when you see copious, purulent conjunctival discharge not responsive to conventional tx

A

m cat
gonococcal

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25
Q

-giemsa stain
-inclusion body
-scant mucopurulent conjunctival discharge

A

chlamydia (newborn) conjunctivitis

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26
Q

tx for bacterial conjunctivitis

A

in order:
1. gentamicin/tobramycin (tobrex)
2. erythromycin (e-mycin)
3. trimethoprim and polymixin b (polytrim)
4. cipro (clioxan)

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27
Q

pathogen and tx for conjunctivitis in contact lens wearer

A

pseudomonas
fluoroquinolone drops (ciloxan)

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28
Q

tx for neisseria conjunctivitis

A

referral
topical + systemic abx

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29
Q

tx for chlamydia conjunctivitis

A

-systemic tetracycline vs erythromycin x 3 weeks PLUS abx drops
-asses for STI/child abuse

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30
Q

tx for viral conjunctivitis

A

eye lavage w. NS x 7-14 days
antihistamine drops
warm/cool compress

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31
Q

tx for allergic conjunctivitis

A

systemic vs topical antihistamines or mast cell stabilizers:

azelastine (optivar)
epinastine (elestat)
emedastine difumarate (emadine)
levocabastine (livostin)

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32
Q

stridor, restless, cough, dyspnea, fever, dysphagia, drooling, tripod/sniffing dog posture, neck extended

A

epiglottitis

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33
Q

3 d’s of epiglottitis

A

dysphagia
drooling
distress - respiratory

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34
Q

mcc of epiglottitis

A

Hib

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35
Q

what is this showing

A

thumbprint sign -> epiglottitis

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36
Q

abx for epiglottitis

A

ceftriaxone

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37
Q

mc site for anterior nosebleed

A

kesselbach’s plexus (little’s area)

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38
Q

kesselbach’s plexus includes (4)

A

anterior ethmoid a
superior laial a
sphenopalatine a
greater palatine a

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39
Q

mc location for posterior nosebleeds

A

woodruff’s plexus

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40
Q

woodruff’s plexus includes _ artery

A

sphenopalatine a

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41
Q

most nosebleeds are anterior and respond to

A

1. direct pressure x 10-15 min seated/leaning forward
2. decongestants: afrin, phenylephrine, cocaine?
3. petroleum jelly or abx ointment inside the nostril bid x 4-5 days

42
Q

all pt’s who get nasal packing for epistaxis must be treated with _ to prevent _

A

cephalosporin
toxic shock syndrome

43
Q

t/f: pt w. anterior nasal packing for epistaxis must return to the clinic to have it removed

A

t!

44
Q

management of pt who needs posterior balloon packing for epistaxis

A

consult
admit

45
Q

you must rule out what 2 conditions in a pt w. recurrent epistaxis

A

htn
hypercoagulable d.o

46
Q

classifications of hearing loss

A

conductive
sensorineural
mixed

47
Q

for the weber test, sound lateralizes to the affected ear in _ hearing loss
and to the unaffected ear in _ hearing loss

A

affected: conductive
unaffected: sensorineural

48
Q

for the rinne test:
BC > AC =
AC > BC =

A

BC > AC: conductive
AC > BC: sensorineural

49
Q

mcc of conductive hearling loss

A

otitis media

50
Q

trick to remember weber and rinne results

A

weber: hear in bad ear
rinne: BC > AC (think rhino = bone)

51
Q

mcc of sensorineural hearing loss

A

presbycusis

52
Q

gradual, symmetric hearing loss associated w. aging

A

prebycusis

53
Q

moi for presbycusis

A

degeneration of sensory cells and nerve fibers at the base of the cochlea

54
Q

8 causes of sensorineural hearing loss

A

presbycusis
noise
infxn
drugs
congenital
meniere
CNS lesions

55
Q

8 causes of conductive hearing loss

A

cerumen impaction
otitis media
otitis externa
exotoses
TM perforation
otosclcerosis
neoplasms

56
Q

what are exotoses

A

bony outgrowths of external auditory canal caused by exposure to cold water - “surfers ear”

57
Q

what is this showing

A

anterior/inferior displacement of the auricle -> mastoiditis

58
Q

mastoiditis is a complication of

A

acute otitis media

59
Q

5 pathogens associated w. mastoiditis

A

strep pneumo
h.flu
m.cat
s. aureus
s.pyogenes

60
Q

dx for mastoiditis

A

CT w. contrast

61
Q

tx for mastoiditis

A

ceftriaxone

62
Q

10 month old boy w. friable white plaques on the tongue that bleed when scraped

A

oral thrush

63
Q

what is this showing

A

oral thrush

64
Q

oral thrush is caused by what fungus

A

candida albicans

65
Q

white plaques that bleed when scraped

A

oral thrush

66
Q

dx and tx for oral thrush

A

dx: KOH smear -> budding yeast and pseudohyphae

tx: nystatin vs oral fluconazole

67
Q

what is this showing

A

orbital cellulitis

68
Q

proptosis, pain w. eye movements, inability to adduct or abduct the eye

A

orbital cellulitis

69
Q

periorbital cellulitis is infxn of the _
orbital cellulitis is infxn of the _

A

periorbital: skin
orbital: muscles and fat behind the eye

70
Q

orbital cellulitis can be a complication of

A

sinusitis

71
Q

_ is a rare symptom of orbital cellulitis

A

decreased vision

72
Q

PE exam of suspected orbital cellulitis should focus on

A

assessment of extraocular movements

73
Q

tx for orbital cellulitis

A

admit
vancomycin

74
Q

what is this showing

A

otitis externa - swimmers ear

75
Q

what 2 actions increase pain w. otitis externa

A

movement of the tragus
eating

76
Q

what discharge is associataed w. otitis externa

A

cheesy white

77
Q

rinne testing suggestive of otitis externa

A

BC > AC

78
Q

pathogens associated w. otitis externa: simmer’s ear vs digital trauma

A

swimmers: pseudomonas
digital trauma: s.aureus

79
Q

what pt pop does malignant otitis externa make you think of

A

diabetics

80
Q

tx for otitis externa

A

abx drops: aminoglycosides vs fluoroquinolones

+/- steroids

81
Q

tx for otitis externa if perforated TM

A

cipro drops
PLUS
dexamethasone drops

82
Q

tx for malignant otitis externa

A

admit
IV abx

83
Q

what pathogen is associated w. malignant otitis externa

A

aspergillus

84
Q

pruritis, weeping pain, hearing loss, swollen, moist appearance

A

fungal otitis externa: aspergillus vs candida

85
Q

tx for fungal otitis externa

A

2% acetic drops
clotrimazole drops
oral itraconazole

86
Q

fever
hot potato voice
trismus

A

peritonsillar abscess

87
Q

what is this showing

A

peritonsillar abscess

88
Q

peritonsillar abscess is mc caused by

A

strep pyogenes

89
Q

tx for peritonsillar abscess (3)

A

aspiration
I&D
IV abx
+/- tonsillectomy

90
Q

abx for peritonsillar abscess (3)

A

amoxicillin
augmentin
clindamycin

91
Q

strabismus is defined as

A

any form of ocular misalignment

92
Q

what is this showing

A

out-turning of eye -> exotropia

93
Q

what is this showing

A

in-turning of eye -> esotropia

94
Q

PT test for strabismus

A

cover/uncover

95
Q

indications for referral for strabismus

A

constant
intermittent > 6 mo

96
Q

what exercise is used in strabismus management

A

patch exercises

97
Q

complication of strabismus if treated after age 2

A

amblyopia

98
Q

2 causes of TM perf

A

AOM
barotrauma/direct impact/explosion

99
Q

management of TM perf

A

usually self resolve
keep dry
surgery if persists > 2 mo
+/- abx drops

100
Q

only abx ear drop that is not ototoxic

A

floxin

EOR - Pediatrics (15 decks)

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