ENT, URI, LRI OME

Question 1

3m-3yo kid whos sick with a URI, presents with cough, inspiratory stridor. dx? tx?

Answer 1

Croup! = bark-like cough, steeple sign on xray, give EPI to help, steroids, and O2

Question 2

CXR of croup look like?

Answer 2

clear lungs with steeple sign = subglottic narrowing

Question 3

Kid whos sick with URI, cough, inspiratory stridor who was given epi but doesnt respond. what do you do next? dx?

Answer 3

prob bacterial tracheitis = scope + culture = abx

Question 4

kid w/drooling, muffled voice, high fever + rapid onset, no vaccines. dx? tx?

Answer 4

epiglottitis = OR for intubation + abx

Question 5

kid w/drooling, muffled voice, fever + refusal to move neck, unilateral cervical lymphadenopathy + tender area of neck. dx? tx?

Answer 5

retropharyngeal abscess = CT scan, surgical for I&D + culture + abx

Question 6

adolescent with muffled voice, drooling, sore throat + on PE = displaces uvulua to one side… dx?

Answer 6

peritonsillar abscess = I&D + abx

Question 7

baby whose blue at rest and pink when crying. dx? tx?

Answer 7

choanal atresia = anatomically stenosed connection between nose and mouth = needs surgery to fix

Question 8

tx of pharyngitis?

Answer 8

amox-clav == always do rapid strep and treat bc ur worried about rheumatic fever!

Question 9

kid with nasal congestion and LOW grade fever, + copious clear rhinorrhea thats <10 days…whats the probable dx?

Answer 9

viral cold = just ride it out

Question 10

kid w/purulent nasal discharge, congestion, sinus tenderness, that >10d old, high fever. dx? tx?

Answer 10

sinusitis = amox-clav or cefdinir

Question 11

what would a radiograph of sinusitis show?

Answer 11

air-fluid levels on XR and opacification on CT

Question 12

kid w/unilateral ear pin, pain on palpation of pinna. dx? tx?

Answer 12

otitis externa, ciprofloxacin drops + steroids

Question 13

kid with unilateral ear pain for the last few days now comes in with swelling behind the ear and anteriorly rotated ear. dx? tx?

Answer 13

mastoiditis, surgical consult for decompression

Question 14

kid with unilateral ear pain that is relieved by pulling on pinna, moderatly bulging tympaic membrane. dx? tx?

Answer 14

otitis media

1. amox-clav
2. cefdinir
3. axithromycin

Question 15

where is the obstruction if you have an inspiratory stridor?

Answer 15

extrathoracic obstruction

Question 16

where is the obstruction if you have an expiratory wheezing?

Answer 16

intrathoracic obstruction

Question 17

tx of pneumonia in kids. typical vs atypical?

Answer 17

typical = amox
atypical = azith