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H and N > ENT - paediatrics > Flashcards

ENT - paediatrics Flashcards

1
Q

History of a child presenting with hearing loss/ENT related illness (7)

A 
Behavioural problems
Maternal infection
Premature
Neonatal infection
Poor growth
Lack of immunisations
Passive smoking
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2
Q

Examination of a child with hearing loss

A

Otoscope/auriscope

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3
Q

Subjective investigations of child with hearing gloss (4)

A 
Distraction test (6-18 months)
Visual reinforced audiometry (1-3 years)
Play audiometry (3-5 years) - child plays with toy then sound played in the room which makes them turn towards it
Pure tone audiometry (4+)
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4
Q

Objective investigations of child with hearing loss (2)

A

Otoacoustic emissions

Auditory brain stem responses

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5
Q

Otitis media with effusion prognosis in children

A

80% don’t need treatment, heal within 3 months

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6
Q

Symptoms of otitis media with effusion in children (3)

A

Hearing loss
Speech delay
Behavioural problems

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7
Q

Signs of otitis media with effusion in children (3)

A

Dull tympanic membrane
Fluid behind tympanic membrane
Academic decline

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8
Q

Treatment of otitis media with effusion in children (only needed if severe)

A

Hearing aids - bone anchored hearing aid (implanted device into skull bone to transmit
sound to the bone)

Otovent (forceful expiration to open up eustachian tube)

Grommets

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9
Q

Causes of otitis media (3)

A
  1. Eustachian tube dysfunction
  2. Hypertrophy of adenoids
  3. Resolving acute otitis media
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10
Q

Differentials of a child with painful discharging ear (4)

A

Otitis externa
Acute/chronic otitis media
Cholesteatoma

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11
Q

Otitis externa treatment (3)

A

Aural microsuction
Topical antibiotics
Keep water out

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12
Q

Causative organisms of acute otitis media (3)

A

H. influenza
Strep. pneumoniae
Moraxella catarrhalis

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13
Q

Symptoms/signs of acute otitis media (3)

A

Otalgia
Fever
Otorrhoea

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14
Q

Complications of acute otitis media

A

Mastoiditis –> brain abscess possible

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15
Q

Chronic otitis media is AOM that hasn’t resolved for how many months

A

3

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16
Q

Definitive treatment of cholesteatoma

A

Mastoidectomy

17
Q

Possible symptoms of a child with blocked/runny nose (5)

A 
Blocked nose
Rhinorrhoea
Sneezing
Reduced smell
Facial pain
18
Q

If rhinorrhoea is unilateral, could be due to what

A

Foreign body

19
Q

Examination of blocked/runny nose

A

Auriscope (otoscope)

20
Q

Differentials of child with blocked/runny nose (5)

A 
Rhinitis (allergic or non-allergic)
Adenoid hypertrophy
Foreign body
Sinusitis & polyps
Choanal atresia
21
Q

Treatment of rhinitis (3)

A 
Nasal douching (washing)
Antihistamines
Topical intranasal steroids
22
Q

What condition can adenoid hypertrophy cause

A

Sleep apnoea

23
Q

What is choanal atresia + how does it present

A

Congenital condition where back of nasal passage is blocked by bony or soft tissue
Presents bilaterally with breathing obstruction

24
Q

Causes of epistaxis (2)

A

Trauma, e.g. nose picking, fracture, foreign body

Coagulopathy

25
Q

Treatment of epistaxis (3)

A

Pinch tip/soft part of nose

If severe:
Cautery - to seal blood vessel by scarring it
Nasal packing

26
Q

Symptoms of a child with sore throat (7)

A 
Cough (+/- mucous)
Dysphagia
Odynophagia
Difficulty breathing
Hoarse voice

Snoring
Drooling

27
Q

Examination of child with sore throat

A

Examine ears, nose, throat, neck

28
Q

Tonsillitis mostly caused by what

A

Virus - EBV

29
Q

Complications of tonsillitis (2)

A

Post streptococcal glomerulonephritis (injury of glolmeruli in kidney)

Quinsy - peritonsillar abscess

30
Q

Children typically have larger what compared to adults (3)

A

Tongue
Tonsils
Epiglottis

31
Q

Differentials of child with airway issues (3)

A

Foreign body
Epiglottitis
Laryngomalacia

32
Q

Investigations of foreign body in airway (2)

A

Laryngoscopy

X-ray

33
Q

Symptoms/signs of epiglottis

A

Stridor/noisy breathing

34
Q

Treatment of epiglottis (3)

A

Antibiotics
Fluids
Anti-pyretics

35
Q

What is laryngomalacia

A

Congenital softening of the larynx cartilage above the vocal cords –> floppy larynx –> tissue collapse above the glottis (vocal cord) during inspiration –> upper airway obstruction

36
Q

Treatment of laryngomalacia

A

Just observe - will get better as child grows up

Intervention needed if breathing severely affected

37
Q

Differentials of neck lump (4)

A

Thyroglossal cyst
Branchial cyst
Cystic hygroma (fluid filled sac) - due to blockage in lymphatic system
Cervical lymphadenopathy

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