Exam 2 - Nose, Mouth, Throat & Neck Flashcards

1
Q

Nasal airway DOUBLES in size by ______

A

6mo.

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2
Q

Never do a nasal exam in isolation - always accompany with full HEENT exam.

A
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3
Q

____ pairs of paranasal sinuses. They are not aerated at birth but slowly progress. What is the progression of sinus aeration?

A

4
Born with aerated ethmoids.
Maxillary between birth and 3-4mo
Sphenoid between 1-5 years
Frontal sinuses 7-adolescents.

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4
Q

What does CHARGE stand for and associated with?

A

Coloboma
Heart disease
Atresia/choanae
Retarded growth/development
Genital anomalies
Ear anomalies or deafness.

Syndrome for those who have mutation in CHD7 gene

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5
Q

What are some associated conditions with allergic rhinitis?

A

Conjunctivitis, sinusitis, OME, hypertrophic tonsils and adenoids and eczema.
3 fold increased risk of asthma.

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6
Q

Patients with allergic rhinitis have a 3-fold increase in risk for _____

A

Asthma

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7
Q

Allergic rhinitis is considered a

A

Major chronic respiratory disease of children because of high prevalence, effects on QOL, school performance and comorbidities.

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8
Q

Allergic rhinitis is usually a ________ diagnosis.

A

Clinical.

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9
Q

Allergic rhinitis is NOT common in kids ______

A

Under 2

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10
Q

Allergic rhinitis (AR) treatment

A

Avoid/limit exposure to allergens
Intra nasal corticosteroids (fluticasone, mometasone)
Oral antihistamines (Zyrtec, Claritin, Allegra)
Non responsive? Refer to immunotherapy.

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11
Q

You can start Flonase at what age?

A

2-4years old, however oral may be easier to administer if child is not able to sniff during Flonase administration.

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12
Q

With the common cold, fever usually resolves w/in______, sore throat in _____ and cough/nasal congestion w/in______

A

3-5days
7-9days
2 weeks

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13
Q

No cough or cold medicines in kids under ______

A

6yo.

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14
Q

Risk factors for Acute Bacterial Rinosinusitis (ABRS)

A

Recent URI, allergic rhinitis, cystic fibrosis, nasal polyps, immunodeficiency.

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15
Q

Acute vs chronic sinusitis

A

Acute <30days
Chronic >30 days.

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16
Q

What sinuses are most commonly affected by ABRS in younger pediatric patients?

A

Maxillary and ethmoid.

17
Q

Common ABRS pathogens

A

Strep pneumonia, HIB, M cat.

18
Q

Clinicians should make a presumptive diagnosis of ABRS when a child with a URI presents with one of the following:

A

Persistent symptoms >10 days without improvement (nasal discharge, cough)
Severe Symptoms
Fever (102.2 or >) and purulent nasal discharge > 3 days
Ill appearing
Worsening symptoms after initial improvement or “double sickening”

19
Q

1st line tx for ABRS

A

Amoxicillin
However with high resistance, Augmentin is probably a better choice for 10 days.

(Start after 10 days)

20
Q

Nosebleeds are rare in _______ and after ______

A

Infancy
Adolescents.

21
Q

Watch closely for nasal infections such as furunkles, pimples, abscesses etc, because drains to

A

Cavernous sinus

22
Q

Tx for Impetigo (microbe?)

A

Mupirocin (bactroban) ointment
Strep pyrogenes > staph.

23
Q

Steroids are ________ in Herpes simplex gingivostomatitis

A

Contraindicated.

24
Q

Tx for oral thrush

A

Nystatin oral suspension daily x7days.

25
Q

Most common pathogen to cause pharyngitis?

A

Virus - rhinovirus.

26
Q

What is most common bacterial cause of pharyngitis? Tx?

A

GA Strep.
penicillin 250-500mg/dose BID-TID x10 days
IM penicillin G x 1 dose
Oral amoxicillin
Allergic to beta lactate? Azithromycin

27
Q

Strep pharyngitis is relatively uncommon in children _______

A

Under 3

28
Q

Group A beta hemolytic strep is primarily seen in kids age __________

A

5-15

29
Q

Treating early and for 10 days, we can prevent rheumatic fever, PTA, retropharyngeal abcess and cervical lymphadenitis but NOT ________1

A

Glomerular nephritis

30
Q

Why might teens have an increased incidence of mumps?

A

They didn’t get their second MMR.