ENT - paediatrics Flashcards by RC RC

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

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

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Examination of a child with hearing loss

Otoscope/auriscope

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Subjective investigations of child with hearing gloss (4)

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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Objective investigations of child with hearing loss (2)

Otoacoustic emissions

Auditory brain stem responses

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Otitis media with effusion prognosis in children

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

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Symptoms of otitis media with effusion in children (3)

Hearing loss
Speech delay
Behavioural problems

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Signs of otitis media with effusion in children (3)

Dull tympanic membrane
Fluid behind tympanic membrane
Academic decline

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

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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Causes of otitis media (3)

Eustachian tube dysfunction
Hypertrophy of adenoids
Resolving acute otitis media

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Differentials of a child with painful discharging ear (4)

Otitis externa
Acute/chronic otitis media
Cholesteatoma

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Otitis externa treatment (3)

Aural microsuction
Topical antibiotics
Keep water out

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Causative organisms of acute otitis media (3)

H. influenza
Strep. pneumoniae
Moraxella catarrhalis

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Symptoms/signs of acute otitis media (3)

Otalgia
Fever
Otorrhoea

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Complications of acute otitis media

Mastoiditis –> brain abscess possible

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

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Definitive treatment of cholesteatoma

Mastoidectomy

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

Blocked nose
Rhinorrhoea
Sneezing
Reduced smell
Facial pain

If rhinorrhoea is unilateral, could be due to what

Foreign body

Examination of blocked/runny nose

Auriscope (otoscope)

Differentials of child with blocked/runny nose (5)

Rhinitis (allergic or non-allergic)
Adenoid hypertrophy
Foreign body
Sinusitis &amp; polyps
Choanal atresia

Treatment of rhinitis (3)

Nasal douching (washing)
Antihistamines
Topical intranasal steroids

What condition can adenoid hypertrophy cause

Sleep apnoea

What is choanal atresia + how does it present

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

Causes of epistaxis (2)

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

Coagulopathy

Treatment of epistaxis (3)

Pinch tip/soft part of nose If severe: Cautery - to seal blood vessel by scarring it Nasal packing

Symptoms of a child with sore throat (7)

``` Cough (+/- mucous) Dysphagia Odynophagia Difficulty breathing Hoarse voice ``` Snoring Drooling

Examination of child with sore throat

Examine ears, nose, throat, neck

Tonsillitis mostly caused by what

Virus - EBV

Complications of tonsillitis (2)

Post streptococcal glomerulonephritis (injury of glolmeruli in kidney) Quinsy - peritonsillar abscess

Children typically have larger what compared to adults (3)

Tongue Tonsils Epiglottis

Differentials of child with airway issues (3)

Foreign body Epiglottitis Laryngomalacia

Investigations of foreign body in airway (2)

Laryngoscopy | X-ray

Symptoms/signs of epiglottis

Stridor/noisy breathing

Treatment of epiglottis (3)

Antibiotics Fluids Anti-pyretics

What is laryngomalacia

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

Treatment of laryngomalacia

Just observe - will get better as child grows up | Intervention needed if breathing severely affected

Differentials of neck lump (4)

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