Halo-halo

Question 1

Most common childhood malignancy of the head & neck & presents as large firm mass often mobile in the anterior triangle or supraclavicular area

Answer 1

Lymphoma
Hodgkin lymphoma: nodal, supraclavicular area, often in teenagers

Nonhodgkin: extra nodal, increasing incidence with age

Question 2

Define stertor

Answer 2

Sonorous sound produced with partial upper airway obstruction at the nasopharynx or oropharynx

Question 3

Define stridor, inspiratory, expiratory & biphasic

Answer 3

Stridor: High pitched harsh monophonic sound produced by turbulent airflow on a partially obstructed airway

Inspiratory: high pitched sound produced when breathing in & signify that obstruction is above the level of true vocal cords

Expiratory: high pitched sound produced when breathing out & signify that obstruction is below the level of true vocal cords

Biphasic: high pitched sound produced when breathing in both & signify that obstruction is at the level of the true vocal cords

Question 4

Most common cause of stridor outside the neonatal period, affecting child 6mos to 3years old

Answer 4

Croup of viral LTB
Most common virus: parainfluenza & rhinovirus

Question 5

Harsh barking sound, hoarse voice, stridor thatbis worse at night & management

Answer 5

Croup or viral LTB
L-epinephrine 0.5ml/kg neb (5mg max) and dexa 0.6mg/kg PO or IM (10mg max) or neb budesonide 2mg

Question 6

Most frequent cause of wheezing in infants and children/adoloscents

Answer 6

Bronchiolitis in infants
Asthma in children & adolescents

Question 7

Most important treatment for bronchiolitis

Answer 7

Instillation of saline into the nares followed by suctioning

*maintain O2 >90%
*ventilatory support as needed (high flow NC, CPAP>BiPAP)

No benefit & not routinely given:
Bronchodilator
Neb epi 0.5ml in 3.5ml NaCl every 1-2hrs
Dexa 1mg/kg (combined with epi)
Neb hypertonic saline