ENT and Respiratory Conditions in Children Flashcards

1
Q

Outline the pathophysiology of otitis media with effusion (and link this to diagnostic time cutoff)

A
  • During events such as regular OM or resp infection, eustachian tube can become swollen/obstructed
  • This creates negative-pressure chamber, causing fluid accumulation
  • When fluid is trapped for >3 months, we call this OME
  • This can cause conductive hearing loss (less ossicle movement)
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2
Q

Why is glue ear (OME) more common in children?

A
  • Smaller tube = easier blocked
  • More horizontal tube = less influence of gravity
  • Softer tube = easier to collapse
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3
Q

Complications of OME

A
  • Hearing loss (not a big deal if transient)
  • Longer term hearing loss for months on end can lead to speech and developmental delays (can’t mimic)
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4
Q

Treatment of OME

A
  • Observe for 3 months
  • If doesn’t resolve, refer to ENT for grommets
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5
Q

Aetiology of sleep disordered breathing in children

A
  • Relatively larger pharyngeal and palatine tonsils can obstruct airway
  • Even if obstruction is only partial, reduced airflow means not enough pressure to keep airways open
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6
Q

Diagnosis of OME in children

A
  • Clinical diagnosis
  • Visible on otoscopy (+ history findings)
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7
Q

Complications of sleep disordered breathing

A
  • Irritability/difficulty focusing
  • Reduced growth (energy sapped during night)
  • Diabetes
  • Pulmonary hypertension and CVD (recurrent increased sympathetic drive overnight)
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8
Q

How do we treat sleep disordered breathing in children

A
  • Nasal steroids can reduce inflammation
  • Surgery can remove/shrink tonsils
  • CPAP can help keep airways open
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9
Q

What do OME and AOM look like on otoscopy?

A
  • OME (glue ear): dull eardrum and loss of visibility of structures behind
  • AOM: erythema, opaque/outwards bulgind eardrum
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10
Q

Acute otitis media aetiology

A
  • Like OME, where eustachian tube is blocked
  • However, infectious agent travels from nasopharynx into middle ear transiently, before it’s blocked off again
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11
Q

Three most common pathogens involved in ENT infection

A
  • Haemophilus influenza
  • Strep pneumoniae
  • Moraxella catarrhalis
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12
Q

Complications of acute otitis media

A
  • Pressure can block tympanic membrane vessels -> ischaemia -> necrosis
  • Leads to popping of eardrum, escape of infectious agent, and potential transfer to surrouding brain, jugular IJV, common carotid artery, and mastoid air cells
  • Can cause meningitis, mastoiditis, brain abscess
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13
Q

Treatment of acute otitis media

A
  • Analgesia
  • Antibiotics
  • Observation
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14
Q

Viral vs bacterial tonsillitis exam finding

A

Viral typically has white, pus-like stuff on the surface of the tonsil

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15
Q

Peritonsillar asbcess aetiology. Is this a complication of tonsilits?

A
  • Salivary gland around tonsil (weber’s glands) blocked
  • Saliva stasis -> infection & purulence
  • Forms growing asbcess

(Not a complication of tonsillitis ; different)

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16
Q

Pathophysiology of atypical mycobacterial ent infection

A
  • Mycobateria despoit in neck nodes
  • T cell mediated immune response
  • Inability to clear -> granuloma in lymph node
17
Q

What are atypical mycobacterial ent infections?

A
  • Non-tuberculosis infection (often in neck lymph node)
  • Painless, isolated, otherwise asymptomatic
18
Q

Atypical mycobacterial ent infection treatment

A
  • Prolonged antibiotics (3-6 months)
  • Surgery