ENT Flashcards

1
Q

AAP guidelines to get ear checked?

A

newborn

4, 5, 6, 7, 8, 10yo

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2
Q

Cx for hearing loss?

A

craniofacial
external: cerumen, FB
middle: otits media
inner ear: meds (gentamycin)

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3
Q

What does peds ask re: hearing?

A
family hx of hearing loss?
meds?
anatomy of ear
FB
infxn
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4
Q

Hearing loss for external-cerumen impaction -tx?

A

DO NOT USE Q TIP

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5
Q

Otits externa - sx?

A

tugging of ear
hearing loss
discharge

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6
Q

Otitis externa - bug?

A

pseudomonas

staph

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7
Q

Otitis externa -tx?

A

quinolone abx drops

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8
Q

Ear pain DESPITE tx?

A

malignant OE

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9
Q

Acute otitis media - sx?

A

OE sx (ear pain, discharge, hearing loss)
URI sx
fevers

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10
Q

Acute otitis media - bugs?

A

VIRAL > BACTERIAL

s. pneumonia
h. influenzae
m. catarrhalis

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11
Q

Acute otitis media - tx?

A

first line: HD Amox 80mg/kg/day

severe: Augmentin 90mg/kg/day BID
failure: Ceftriaxone 50mg/kg/day x 3 days

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12
Q

Acute otitis media - criteria?

A

1) abrupt onset
2) effusion
3) inflammation: erythema, otalagia

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13
Q

Gold standard for acute otitis media?

A

insufflation to check for effusion

if it doesn’t move - EFFUSION

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14
Q

Complication of acute otitis media: Bullous myringitis - tx?

A

azithormyocin to cover mycoplasma

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15
Q

Complication of acute otitis media: cholesteatoma?

A

epithelial tissue gets stuck and will not go away unless surgically removed

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16
Q

Cholesteaetoma - cx?

A

complication of acute otitis media
progress hearing loss
destruction of the bones
erosion of the mastoid bone

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17
Q

Acute serious otitis media?

A

d/t URI

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18
Q

Acute serous otitis media -tx?

A

nothing

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19
Q

Chronic serous otitis media?

A

more than 3mo

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20
Q

Chronic serous otitis media - tx?

A

tubes

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21
Q

Purpose of tympanostomy tubes?

A

stabilizes the pressure in the eustachian tube until child grows

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22
Q

Indications for tympanostomy tubes?

A

1) chronic serous otitis media (even w/ 6-12wks)
2) recurrent AOM (3x/6mo or 4x/12mo)
3) complication of AOM
4) complication of eustachian tubes

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23
Q

Choanal atresia?

A

blockage of the nasal passage way

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24
Q

Choanal atresia - bilateral at birth?

A

respiratory probs

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25
Q

Choanal atresia - unilateral?

A

discharge unilateral

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26
Q

Choanal atresia - dx?

A

endoscopy

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27
Q

Nasal polyps >10yo?

A

allergies

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28
Q

Nasal polyps <10yo?

A

cystic fiborsis - do Cl sweat test

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29
Q

Foul smell from <5yo?

A

FB!

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30
Q

Medical emergencies w/ nose?

A

displaced fractures
septal deviations
naso septal hematomas

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31
Q

Epistaxis <2yo?

A

rare

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32
Q

Epistaxis unilateral/bilateral?

A

unilateral: minor trauma
bilateral: major trauma

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33
Q

Epistaxis prolonged bleeding?

A

bleeding disorder - vita k def?

34
Q

Epistaxis + ecchymosis?

A

bleeding disorder

35
Q

Epistaxis + HA?

A

intracranial bleeding

36
Q

Prevention of recurrent epistaxis?

A

humidifier
saline gel
control underlying cx (allergies)
no nose picking

37
Q

Sinusitis vs OM?

A

OM&raquo_space; sinusitis b/c sinuses aren not developed until 8yo

38
Q

Sinusitis bugs?

A

S. pneumonia
H. influenzae
Moraxella
same as OM

39
Q

Sinusitis tx?

A

HD Amox 80mg/kg/daily
macrolide if allergic to amox
same as OM

40
Q

What is ankyloglossia?

A

tongue tie

41
Q

Frenulectomy if?

A

speech impairment

feeding difficulties

42
Q

Cleft palate association?

A

trisomies 13&18

43
Q

Cleft related morbidities?

A

poor feeding
choking
eustachian tube dysfxn
speech difficulties

44
Q

Adenoidal tonsiller hypertrophy- cx?

A

allergies
recurrent infxn
familial

45
Q

Adenoidal tonsiller hypertrophy - sx?

A

chronic congestion

obstructive sleep apnea

46
Q

When to remove tonsils?

A

OSA
asymmetry - malignancy
recurrent infxn

47
Q

Sore throat - bug?

A

VIRAL > BACTERIAL

48
Q

Strep throat - criteria?

A

high fever
tonsil exudates
cervical adenopathy
NO URI sx

49
Q

Group A strep throat complications?

A

scarlett fever
peritonsiller abscess
post strep glomerulonephritis

50
Q

Scarlett fever?

A

complication from group A strep

51
Q

Scarlett fever - classic?

A

sand paper rash
pharyngitis
pastias lines (found in skin creases)

52
Q

Scarlett fever - tx?

A

PCN

53
Q

Peritonsilar abcess - sx?

A

hot potato voice

deviation of uvula

54
Q

Post strep Glomerulonephritis -sx?

A

hematuria
post strep (1-2days after)
HTN

55
Q

Post strep Glomerulonephritis-dx?

A

RBC + casts

ASO titers

56
Q

Post strep Glomerulonephritis - tx?

A

control HTN

supportive

57
Q

Rheumatic fever?

A

complication of group A strep

autoimmune -attacking mitral valve

58
Q

Rheumatic fever major criteria?

A
JONES
Joint arthritis
O-carditis: valvular dz
Nodules on skin
Erythema marginatum (pink rings)
Sydenhamm chorea (jerking movements)
59
Q

Rheumatic fever minor criteria?

A

fever
arthalgias
incr ESR
prolonged PR interval

60
Q

Rheumatic fever -dx?

A

2 major
OR
1 major and 1 minor

61
Q

Rheumatic fever - tx?

A

ASA

PCN

62
Q

Rheumatic heart dz - tx?

A

ASA
longterm abx (PCN G)
valve replacement

63
Q

Peritonsilar - age?

A

older kids

64
Q

Retropharyngeal-sx?

A

along the retropharyngeal lymph nodes

complication of group A strep

65
Q

Retropharygneal - age?

A

younger

66
Q

Epiglottitis?

A

infxn of the epiglottitis d/t h influenzea

67
Q

Epiglottitis - sx?

A

Dsyphagia
Distress
Drooling

68
Q

Epiglottitis-tx?

A

ER

abx: ceftriaxone + clindamycin/vancomycin

69
Q

Epiglottitis - labs?

A

XRAY: thumbs sign

70
Q

Laryngeal abnormalities?

A

laryngomalacia
vocal chord paralysis
juvenile laryngeal papillomatosis

71
Q

Laryngomalacia?

A

common INSPIRATORY stridor

72
Q

Laryngomalacia - sx?

A

stridor worse in supine

BUT EVERYTHING IS NORMAL

73
Q

Laryngomalacia - tx?

A

reassurance

74
Q

Croup?

A

aka laryngotracheitis

75
Q

Croup - bug?

A

Parainfluenza
RSV
influenza

76
Q

Croup - sx?

A

stridor - worse in evenings
runny nose
barky cough
fever

77
Q

Croup dx?

A

clinical

78
Q

Mild croup sx?

A

only barky cough

79
Q

Croup tx?

A

mild and mod: corticosteroids (dexa)

severe: Epinephrine

80
Q

Severe croup sx?

A

stridor at rest