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HEENT Flashcards

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1
Q

Until what age do we always measure head circumference?

A

36 months

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2
Q

Esostrabismus?

A

Nasal deviation

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3
Q

Exostrabismus?

A

Temporal deviation

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4
Q

Hyper-strabismus?

A

eye more superior

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5
Q

Hypostrabismus?

A

Eye more depressed

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6
Q

What are some of the risk factors to strabismus?

A

Family history, low birth weight, prematurity, vision impairment

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7
Q

What are some complications of strabismus?

A

Amblyopia, diplopia, contractures or torticollis

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8
Q

how do you treat strabismus?

A

refer to ophthalmology

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9
Q

What is pseudostrabismus, and how do you confirm?

A

Optical illusion, seen in children with wide nasal bridge – confirm with corneal light reflex

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10
Q

If a child has unilateral purulent nasal drainage, epistaxis, with mouth breathing – what should you expect?

A

Nasal foreign body

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11
Q

What are the worst items to be swallowed or put up the nose? Thus, keep them far from children.

A

Small batteries & small magnets

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12
Q

If a child has a pseudocyst on buccal mucosa what diagnosis & how do you treat?

A

Mucoceles & refer to ENT, don’t excise

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13
Q

If a child has a pseudocyst of the sublingual gland, what diagnosis & how do you treat?

A

Ranulas & refer to ENT, don’t excise

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14
Q

What temperature is considered a fever in a child?

A

> 100.5

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15
Q

What is normal pulse ox in a child?

A

> 93%

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16
Q

When you are seeing a child in clinic for the first time, what must you always ask about?

A

Birth Hx = Gestational age at birth, complications of pregnancy/delivery, & mom’s GBS status

Interval Hx = recent office/ED/hospital visits or other injuries or illness

Chronic illnesses = Asthma

Immunization status

Second-hand smoke & child care arrangements

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17
Q

What should you always examine last in a child?

A

Ear & mouth

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18
Q

What are the 3 most common bacterial causes of infection?

A

Streptococcus Pneumoniae

Moraxella catarrhalis

Haemophilus influenza

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19
Q

If a child has a sore throat, rhinorrhea, sneezing, cough, and low grade temp – what diagnosis? How do we treat it?

A

Common cold

NO ABX!!!


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20
Q

How many colds do young children have/year?

A

7 (can last up to 14 days = 98 days of the year)

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21
Q

Does the color of snot have anything to do with bacterial cultures?

A

NO

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22
Q

What bacteria commonly causes refractory AOM? What has decreased the incidence of this?

A

S. pneumonia

Prevnar vaccine

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23
Q

What is the most common cause of bilateral AOM & conjunctivitis?

A

H. influenza

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24
Q

What bacteria most commonly causes mastoiditis?

A

Group A streptococcus

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25
What are some of the symptoms AOM can cause?
Otalgia, fever, irritability, vomiting, and diarrhea
26
What if the child has a really high fever and you see red, swollen, irritated looking ear drum?
Keep looking… AOM will NOT cause a high-fever
27
Who needs to be treated with AOM?
Children under 2 with bilateral sxs | Children over 2 observe if minimal sxs and unilateral disease
28
So, how do you treat AOM?
NSAIDs, APAP, Auralgan drops if OLDER than 2, Amoxicillin HIGH DOSE
29
When do we use Amoxicillin/clavulanate?
If treated with Abx in the past months & if they also have conjunctivitis
30
What is sinusitis, and what is its normal course?
Viral infection – associated with the common cold Usually resolves in 7-10 days – AKA NO ABX!!!
31
What is it called when sinusitis continues for longer than 10 days?
Acute bacterial rhinosinusitis – bacterial infection (give ABx)
32
How does a child present with sinusitis?
Cough, nasal sxs, HA, and possibly a fever
33
If a mother calls back and it’s been 10 days and the child is not getting better with their sinusitis sxs, what do we treat it with? What are we preventing?
Tx = Amoxicillin/clavulanate AKA Augmentin (high dose for more severe) Prevent = preseptal cellulitis, orbital cellulitis, septic cavernous sinus thrombuosis, and meningitis.
34
If a child has a very high fever (>104) with no other sxs, what diagnosis do we need to keep in the back of our minds?
Roseola
35
How do you diagnose and treat?
Dx = clinical (often a rash presents on the 4th or 5th day), but often a diagnosis of exclusion Tx = Supportive
36
What disease causes a low grade fever, HA, and rhinorrhea, along with a slapped cheek rash?
Fifth’s disease
37
What bacteria causes 5th’s disease?
Parvovirus B-19
38
If a child has 5th’s disease, who do they need to stay away from?
Immunosuppressed adults & preggo ladies
39
What are the 2 common pathogens of impetigo? | How do you treat it?
S. aureus & GAS | Tx = Topical mupirocin (must remove the crust first!) or Dicloxicillin
40
If a mother says that she thinks the child had a spider bite, what do you need to think of and r/o?
MRSA
41
What disorder causes a high fever in a child, with stridor, drooling and a sore throat?
Epiglottitis
42
What causes epiglottitis?
Haemophilus influenza type B
43
Is epiglottitis preventable?
YEP! Hib vaccine
44
If a child presents with a sore throat, myalgia, abdominal pain and no URI sxs – what diagnosis?
Strep pharyngitis
45
What causes strep pharyngitis?
Group A Streptococcus
46
How do you treat strep and what are you preventing?
Amoxicillin | Prevent peritonsillar abscess, mastoiditis, and rheumatic fever (does not prevent glomerulonephropathies)
47
If a patient has a hot potato voice with drooling and trismus (spasm of the neck muscles), what diagnosis?
pertonsillar abscess
48
What is the first virus to be associated with cancers in humans?
Epstein-Barr virus
49
What are some of the acute infectious sxs of EBV?
Malaise, HA, fever, exudative tonsillitis, with posterior cervical adenopathy
50
how do you diagnose EBV?
CBC with diff (shows atypical lymphocytes), Heterophile antibodies (mono spot), EBV specific serology
51
If we diagnose a kid with EBV, what must we do?
Take them out of contact sports = splenic rupture
52
What else can EBV cause (common in Africa)?
Burkitt lymphoma
53
What 3 diagnosis’s should you always have on your differential list when evaluating a febrile child??
Bacterial meningitis, Kawasaki’s disease, and UTI
54
How does Kawasaki’s disease present?
Fever x 5 days, conjunctivitis, mucositis (“strawberry tongue”), rash, and extremity changes (edema, erythema, desquamation)
55
What disease is highly contagious, spread via droplets which can remain airborne for hours, with a maculopapular rash, and koplik spots on buccal mucosa?
Measles
56
What disease is highly infectious and spreads rapidly in closed spaces via droplets and results in swelling of the parotid gland?
Mumps
57
What disease can be transmitted to the developing fetus and results in damaged blood vessels and ischemia in affected organs?
Rubella
58
How do we treat otitis externa?
Floroquinolone – Ofloxacin Can add topical glucocorticoids to decrease inflammation
59
How do you treat mastoiditis?
Hospital admission with IV Abx
60
If a mother brings in a child due to their hoarse voice, what must you rule out?
Croup or parainfluenza virus Otherwise rule out: tumors, trauma, endocrine, GERD, or congenital abnormalities
61
If a child has itchy, watery eyes, that are injected – what diagnosis? How do you treat it?
Allergic conjunctivitis Treat with anti-histamine & cool compresses Could also be viral (common in mid-summer to early fall)
62
If a child has red eyes that are stuck together with mucopurulent discharge – what diagnosis? How do you treat?
Bacterial conjunctivitis Treat with floroquinolones

Pediatrics (12 decks)

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