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Pediatrics Board Exam > ENT > Flashcards

ENT Flashcards

1
Q

Pendular nystagmus, intermittent head tilt, head bobbing or nodding. Tx?

A

Spasmus nutans, a self-limited condition does not require tx

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2
Q

How do you rule out pseudostrabismus (phoria)?

A

Cover test (Eye with strabismus deviates instead of fixating); Or corneal light reflex should be symmetric

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3
Q

How to manage child that does not use their eyes together

A

Esotropia. Early surgery

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4
Q

Why is detection of strabismus critical at an early age?

A

Results in amblyopia (loss of binocular vision) if not detected by age 6

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5
Q

Painless nodule on eyelid x 4 months. Pathophysiology? Tx?

A

Dx is chalazion. Pathophysiology: chronic inflammation of moebian glands. Referral to ophthalmology for surgical excision if >2 weeks sx or if secondarily infected

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6
Q

Loss of visual acuity, optic discs appear normal

A

Retrobulbar optic neuropathy

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7
Q

Hearing loss and retinitis pigmentosa. What syndrome?

A

Usher syndrome

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8
Q

Indications for ROP screening

A

BW < 1500g or GA <32 weeks; or BW 1500-2000g with unstable clinical course

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9
Q

When do you screen for ROP

A

31-34 weeks post-conception or 4-6 weeks after birth, whichever is LATER

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10
Q

Diagnosis?

A

Retinopathy of prematurity. There is a broad thick ridge separating the avascular retina from the vascular retina

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11
Q

Diagnosis?

A

Retinal detachment

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12
Q

Management of infant with ocular enlargement

A

Congenital glaucoma. Urgent referral to ophthalmology.

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13
Q

Most common infectious cause of congenital cataracts

A

Rubella

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14
Q

Fever, pharyngitis, and follicular conjunctivitis is most likely what virus?

A

Adenovirus

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15
Q

Unilateral granulomatous conjunctivitis with ipsilateral swollen preauricular or submandibular lymphadenopathy. Etiology?

A

Parinaud oculoglandular syndrome. Caused by Bartonella henselae.

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16
Q

Treatment of infected stye, insect bite, or impetigo

A

Cephalexin, or if MRSA suspected Clindamycin or bactrim

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17
Q

Retinoblastoma gene is on what chromosome

A

Chromosome 13

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18
Q

Slit lamp exam with increased WBCs circulating in the vitreous and increased protein content 2/2 to inflammation

A

Uveitis

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19
Q

Oral aphthous ulcers, genital ulcers, uveitis

A

Bechet Syndrome

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20
Q

Peaked or teardrop pupil. What does this indicate?

A

Corneal laceration

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21
Q

360 degree subconjunctival hemorrhage indicates what

A

Posterior rupture of the globe

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22
Q

9 yo boy with foul smelling purulent discharge from right ear over several months despite several courses of antibiotics. Retraction of the TM and squamous debris. Tx?

A

Cholesteatoma. Referral to ENT

23
Q

Sudden onset of bilateral sensorineural deafness. What is the dx? Tx?

A

Viral labyrinthitis. Tx is watchful waiting

24
Q

Most common cause of neonatal hearing loss

A

Bacterial meningitis

25
Q

What does this tympanogram indicate?

A

Normal volume, normal compliance

26
Q

What does this tympanogram indicate?

A

Low volume and poorly compliant TM. Indicates impacted cerumen or probe against ear canal

27
Q

What does this tympanogram indicate?

A

Peak compliance at negative pressure, normal volume. Indicates retracted TM (URI, eustachian tube dysfunction)

28
Q

What does this tympanogram indicate?

A

Poor compliance, high volume of TM. Indicates TM perforation or tympanostomy tubes

29
Q

Audiogram with abnormal air conduction, normal bone conduction. What is the most common cause of this type of hearing loss?

A

Conductive hearing loss; MCC is otitis media with effusion

30
Q

What is the normal range for air and bone conduction on an audiogram?

A

-10 to 20 dB

31
Q

Abnormal bone AND air conduction, within 10 dB of eachother on audiogram. What is the most common cause of this type of hearing loss?

A

Sensorineural hearing loss. MCC is genetic non-syndromic Connexin 26 defect (autosomal recessive)

32
Q

Abnormal bone AND air conduction, >10 dB apart

A

Mixed hearing loss

33
Q

Most common type of hearing loss

A

Conductive hearing loss

34
Q

Most common acquired infection leading to sensorineural hearing loss

A

Meningitis

35
Q

What age can behavioral observation audiometry be used in? What can it test?

A

<6 mos old, infant watched for behavioral changes in response to clicks in ear, only can exclude profound hearing loss

36
Q

What ages can visual reinforcement audiometry be used in?

A

6 months to 3 yrs old - observe child to look for sound

37
Q

What ages can conditional play audiometry be used in?

A

3-4 years old. Headphones instruct child to play tasks.

38
Q

What age can conventional audiometry begin testing for hearing loss?

A

>4 years old

39
Q

What health maintenance to think about in children with cochlear implants?

A

PPSV-23 vaccine should be given, as they are at increased risk for meningitis

40
Q

4 yo child with chronic drainage through a perforated TM. Most likely cause? Best treatment?

A

Chronic suppuritive otitis media. MCC is pseudomonas- tx with topical ofloxacin.

41
Q

5 yo with tympanostomy tubes with 3 days of bloody otorrhea, nasal congestion. Large erythematous mass in ear canal. Dx?

A

Tympanostomy tube granuloma

42
Q

Patient with choanal atresia and coloboma. What syndrome and what should you screen for?

A

CHARGE (Coloboma, Heart defects, Atresia of choanae, Retardation of growth, Genitourinary problems, Ear abnormalities)

Screen with ECHO, Renal US

43
Q

What is a major complication of ethmoid sinusitis? Frontal sinusitis?

A

Orbital cellulitis (Ethmoid) and brain abscess (Frontal)

44
Q

Study of choice for chronic recurrent sinusitis

A

CT sinuses

45
Q

13 yo boy with recurrent progressively worsening epistaxis. Next step?

A

CT scan to r/o nasopharyngeal angiofibroma or other mass

46
Q

At what times do the ethmoid/maxillary, frontal, and sphenoid sinuses develop?

A

Ethmoid and maxillary at birth, sphenoid 5 years, and frontal in adolescence

47
Q

When does a monospot become positive and how long can it remain positive?

A

Becomes positive within 2-3 weeks of illness, can stay positive for up to 9 months

48
Q

Child with TE fistula repair presenting with expiratory stridor

A

Tracheomalacia (Laryngomalacia presents with relief on expiration)

49
Q

Rapid deterioration in a patient several days after diagnosed with croup. Etiology?

A

Bacterial tracheitis, caused by staph aureus

50
Q

Hearing loss, syncope, prolonged QT. What syndrome?

A

Jervelle Lange Nielsen

51
Q

Treatment of mastoiditis

A

Ceftazidime + Vancomycin

52
Q

What diagnosis to consider in patient with 3 yr history of allergic rhinitis coupled with unilateral sinusitis and hyperattenuated mucin on CT scan

A

Allergic fungal sinusitis

53
Q

Drug of choice for dental infection

A

Penicillin VK

Pediatrics Board Exam (23 decks)

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