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Pediatric studying torture > HEENT > Flashcards

HEENT Flashcards

1
Q

Vision acuity at 5 years

A

20/30

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2
Q

Hyperopia

A

Cannot see near things

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3
Q

Myopia

A

Cannot see far things

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4
Q

Amblyopia

A

Loss of vision in the eye due to failure of the retina to develop.

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5
Q

Amblyopia treatment

A

Patch the good eye

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6
Q

Amblyopia types

A

deprivation, strabismic, anisometropic

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7
Q

curved cornea, pain, headache and reading problems and blurry vision

A

Astigmatism

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8
Q

Amaurosis

A

blindness

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9
Q

Legal blindness criteria

A

20/200

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10
Q

First clues of blindness

A

retinopathy, nystagmus

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11
Q

Eye deviating inward

A

esotropic

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12
Q

Eye deviating outward

A

Exotropic

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13
Q

Eye deviating upward

A

hypertropia (refer immediately)

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14
Q

Eye deviating downward

A

Hypotropia (refer immediately)

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15
Q

Epicanthal fold in asians

A

pseudo strabismus

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16
Q

Test for strabismus

A

cover test, corneal light reflex/hirschberg test, EOMS

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17
Q

Referable eye issues

A

asymmetric red light reflex
asymmetric corneal light reflex
abnormal cover/uncover test
2 line difference in scoring eyes

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18
Q

Most common causes of conjunctivitis

A

Staph, strep, h influenza

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19
Q

Common cause of viral conjuncitivitis

A

adeno virus, hsv, varicella

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20
Q

purulent discharge with chemosis in newborn 2-4 days old

A

gonococcal conjuncitivitis

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21
Q

mild mucopurulent discharge with pneumonia in newborn

A

chlamydia conjunctivitis

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22
Q

signs and symptoms of conjunctivitis

A

itchy eye, foreign body sensation, tearing, purulent discharge, eyelid edema, chemosis

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23
Q

conjuncitivitis general treatment

A

Tobramycin topical

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24
Q

When to refer conjunctivitis

A

Refer if not responsive to topical antibiotics in 2-3 days, loss of vision, ciliary injection, eye pain

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25
Q

Dacryostenosis cause and treatment

A

blocked tear ducts, treat by massage. Refer if not better than 1 year

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26
Q

Obstruction and inflammation of meibomian gland in the posterior margins or upper or low lid

A

Chalazion

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27
Q

Nodular non tender cyst on palpebral surface of eye lid

A

Chalazion

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28
Q

Chalazion treatment

A

warm soaks. Does not need antibiotics

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29
Q

Acute localized inflammation of one or more sebaceous gland

A

Hordeolum (stye)

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30
Q

Sudden onset of tenderness, redness, and swelling of affected eye lid, foreign body sensation, PAIN on palpation

A

Hordeolum (stye)

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31
Q

Hordeolum (stye) treatment

A

bacitracin/ erythromycin opthalmic

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32
Q

Poor visual fixation, photophobia, decreased visual acuity, black dots in red reflex

A

Cataracts

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33
Q

Inflammation and crusting at eyelid margins

A

blepharitis

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34
Q

blepharitis common bacterial cause

A

staph

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35
Q

blepharitis treatment

A

warm compress, wash with baby shampoo

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36
Q

Photophobia, abnormal overflow of tears, blepharospasm

A

Glaucoma

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37
Q

Decreased vision in tunnel fashion

A

Glaucoma

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38
Q

developmental anomalies assc with glaucoma

A

marfans, pierre robin, congenital rubella syndrome, neurofibromatosis

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39
Q

Involuntary, horizontal, vertical, rotary or mixed eye movements

A

nystagmus

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40
Q

Nystagmus treatment for PNP

A

Refer to optho

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41
Q

Squinting, eyes turn outward more than inward, painful red eye, hyphema, creamy pink mass on fundoscopic exam

A

Retinoblastoma

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42
Q

Opthalmoplegia (paralysis of eye muscle) and proptosis (protrusion of eyeball)

A

Orbital cellulitis

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43
Q

lid edema, proptosis, decreased ocular mobility and decreased acuity. EOMIs not in tact

A

Orbital cellulitis

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44
Q

Accumulation of blood in the anterior chamber of the eye as a result of blunt trauma

A

hyphema

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45
Q

Hyphema treatment

A 
refer
bed rest
HOB elevated
Shield it, do not patch
no asa/reading
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46
Q

Anisometropia definition

A

> 2 line difference in the visual acuity of a child between 0-7

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47
Q

deviation of eye in all fields of gaze

A

comitant strabismus

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48
Q

limited eye movement and size of deviation is different in all fields of gaze

A

incomitant strabismus

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49
Q

crossing of the eye that becomes apparent only on alternating the cover test on the eyes.

A

Latent strabismus. (term used is phoria. e.g. exophoria)

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50
Q

Sensation of foreign body, pain, photophobia, tearing, belpharospasm, dec vision + fluoresein staining

A

corneal abrasion

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51
Q

corneal abrasion treatment

A

rest, topical antibiotics, oral analgesics, refer if severe injury

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52
Q

Flashing light sensation

A

retinal detachment

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53
Q

retinal detachment treatment

A

refer immediately to optho

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54
Q

Blurry vision that is progessively getting worse.
Dark cloud in visual field
Floaters.flashing lights
Darkening on retinal vessels on fundoscopy

A

Hematoma/contussion of orbit

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55
Q

Hematoma/contussion of orbit treatment

A

immediate referal to optho

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56
Q

trauma, pain, diplopia, numbness below orbit, facial bruising, globe displacement, swelling, hyphema, absent red light reflex, corneal abrasion

A

orbital fracture

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57
Q

orbital fracture work up

A

plain film radiography

ct

58
Q

Orbital fracture tx

A

immediate referral to optho

59
Q

Normal size tonsils in child between 6-8

A

+3/+4

60
Q

Chronic hoarse voice in child

A

consider vocal polyp

61
Q

Inflammation of the mucosa lining the structures of the throat including the tonsils, pharynx, uvula, soft palate, and nasopharynx

A

Pharyngitis

62
Q

Most common cause of nasopharyngitis

A

Adenovrius

63
Q

Acute onset of sore throat with headache, nausea, vomiting, abdominal pain in the winter and spring

A

GABHS

64
Q

ASO-what it’s used for

A

to detect past infections of strep and rises 1 week post infection. Peaks 3 to 6 weeks after infection

65
Q

GABHS treatment of choice

A 
Penicillin V potassium. 
Kids <27 kg 250 mg bid for 10 days
Kids >27 kg 500 mg bid for 10 days
May give amox
Benzathine pen g IM 
If allergic give cephalexin 20 mg/kg
Clinda
Azithromycin
66
Q

GABHS transmission

A

Fomites like bathroom cups, toothbrushes, or orthodonic devices

67
Q

When can kids return to school after GABHS

A

afebrile and have been taking antibiotics for 24 hours min

68
Q

Tx of chronic GABHS

A

Clindamycin 20-30 mg/kg/day tid for 10 days

Amox-clauv 40 mg/kg/day

69
Q

Complications of late GABHS

A

rheumatic fever, joint pain, glomerulnephritis

70
Q

PANDAS diagnostic criteria

A

Obsessive compulsive disorder
Onset of diseas emust be prepubertal
Abrupt onset with symptom course that is relapsing and remitting
Clear assc w GABHS
Neuro abnormalities like motor hyperactivity

71
Q

JONES criteria

A 
Joint pain
Myocarditis
Subcu skin nodules
Erythema marginatum
Sydenham chorea
72
Q 
Inability to open jaw
High fever
Sore throat
Prominence of tonsillar pillar on affected side
Bad breath
A

Peritonsillar abcess

73
Q

Epiglottitis patho and causitive organism

A

Inflammation of the epiglottis, the aryepiglottic folds and ventricular bands. Caused by haemophilus influenzae type b.

74
Q

Abrupt fever, severe sore throat, dyspnea, inspiratory distress without stridor, and drooling
Kid looks acutely ill and toxic

A

Epiglottitis

75
Q

Epiglottitis diagnostic studies

A

Blood culture

Lateral neck radiograph

76
Q

Thumb sign on radiograph

A

Epiglottitis.

77
Q

Epiglottitis treatment

A

Get patient to hospital asap
Have pt be examined by otolaryngologist
Admin broad spectrum IV antibiotics
Admin oxygen and respiratory support

78
Q

Epiglottitis prophylaxis

A

Rifampin 20 mg/kg should be given to all household contacts if in the home there is a kid younger than 4 w no vaccines, immunocompromised person, kids less than 1 w no HIB vaccine

79
Q

Acute Otitis media 2nd common organism

A

Strep pneumoniae

80
Q

Acute Otitis media #1 most common organism

A

H influenza

81
Q

Acute Otitis in a child <1 month old tx

A

Refer to ED

Check for bacteremia

82
Q

Acute Otitis in a child <2 years old

A

treat most cases for 10 days with high dose amoxil

83
Q

Acute Otitis in a kid > 2 years old with no frequent AOM

A

Consider watchful waiting for 2-3 days. If need to treat give high dose amoxil for max 5 days

84
Q

Acute Otitis in a kid >2 years who received antibiotics a month prior

A

Watchful waiting for 2-3 days. If tx give high dose amoxil/clav for max of 5 days

85
Q

Acute Otitis in a kid of any age with frequent AOM

A

verify AOM vs OME if AOM tx with high dose amoxil/clav for 10 days. Consider prevnar if <5

86
Q

Treatment of choice for pain relief in AOM

A

acetaminophen is #1 but can give ibuprofen

87
Q

When to refer AOM

A

greater than 3 episodes in 6 months or 4 episodes in 1 year

kids w middle ear fluid lasting longer than 3 months

88
Q

When to order tympanotomy tubes

A

Chronic OME that lasts longer than 3 months with hearing loss. Recurrent AOM >3 episodes in 6 months or >4 episodes a year

89
Q

When to watch and wait for AOM

A 
>2 years old
Mild or unilateral AOM
No toxicity or sever pain
Late presentation > 36 hours 
No otorrhea
No hx of chronic OM
Available for f/u
90
Q

Inflammation of the nasal passages that can last up to 4 weeks

A

Rhinosinusitis

91
Q

URI with persistent nasal discharge or daytime cough lasting 10 days without improvement

A

Rhinosinusitis

92
Q

URI who develops woresening or new onset of fever, nasal discharge, or daytime cough after initial improvement

A

Rhinosinusitis

93
Q

fever > 102.2 or 39 with purulent nasal discharge for at least 3 days who also has sinusitits

A

Rhinosinusitis

94
Q

Chronic Rhinosinusitis

A

> 12 weeks

95
Q

High fever w purulent nasal discharge in which child experiences worsening of symptoms after initial symptoms of recovering from URI “double sickening”

A

sinusitis

96
Q

Facial pain or nasal congestion or fullness, nasal discharge, purulence, or discolored post nasal drip, fever, or anosmia (loss of smell)

A

sinusitis

97
Q

HA, halitosis (bad breath) faitgue, dental pain, cough, ear pain, pressure, or fullness

A

sinusitis

98
Q

What not to do for sinusitits

A

Transillumination and percussion.

99
Q

Diagnostic for sinusitis

A

Imaging not needed–clinical diagnosis

100
Q

Treatment of sinusitits

A

Severe onset=anitibiotics
Complication w rhinosinusitits=antibiotics or watchful waiting for 3 days
Pain relief w acetaminophen or ibuprofen

101
Q

Antibiotic for sinusitis

A

Amox w or w.o clav for 10-14 days. Reassess if you tx with antibiotics or not in 3 days.

102
Q

What not to give for sinusitits

A

Decongestants and antihistamines, topical corticosteroids

May give saline but no guidelines supporing

103
Q

What activity not to do with sinusitis

A

Diving

104
Q

Common complication with sinusitits in kid under 5y

A

Orbital inflammation and infection

105
Q

Pott’s puffy tumor–what is it?

A

Osteomyelitis of the frontal bone and neurosurgical consult should be obtained. A potential complication of sinusitis

106
Q

What do you need to do if there’s a complication with sinusitis

A

referral to otolaryngologist and infectious disease

107
Q

What to order if you suspect a coagulopathy in a nosebleed?

A

CBC, PT, PTT, platelet count, If labs are normal consider von willebrand disease workup

108
Q

Persistent or recurrent unilateral purulent nasal discharge that is foul. Possible epistaxis, nasal obstruction, and mouth breathing

A

Nasal foreign body

109
Q

What you must consider if there are nasal polyps

A

CF

110
Q

When are polyps usually seen?

A

In kids with allergies

111
Q

Treatment for nasal polyps

A
  1. Nasal steroid first line
  2. Anihistamine
  3. Astelin (topical anihistamine)
  4. Cromolyn
112
Q

Midline neck mass that moves when tongue protrudes

A

Thyroglossal duct cyst

113
Q

A solitary, painless mass in the neck. Smooth, nontender, fluctuant masses, which occur along the lower one third of the anteromedial border of the sternocleidomastoid muscle between the muscle and the overlying skin.

A

Brancial cleft cyst

114
Q

Cervical adenitis

A

infection of lymph nodes

115
Q

When to refer a kid with a chalazion for excision?

A

when there is lid lag

116
Q

Age that you need to treat strabismus by to prevent ambylopia

A

7, but can go up to 12

117
Q

Causitive agents of sinusitis

A

Strep pneumo, m cat or h flu

118
Q

Chronic sinusitis

A

> 30 days

119
Q

Acute sinusitis

A

> 10 days

120
Q

Symptoms of bacterial pharyngitis

A 
High fever
Malaise
Sore throat
n/v, ha, petechiae
tonsillar exudate, swollen lymph
121
Q

Bacterial pharyngitis treatment

A

Penicillin or amoxicillin

122
Q

High fever, drooling, tripod sitting, muffled voice, toxic,

A

epiglottitis

123
Q

fever, drooling, muffled voice, halitosis, unilateral tonsillar swelling, uvula displacement from affected side

A

peritonsillar abscess

124
Q

Peritonsillar abscess treatment

A

Immediate referall to ED. Need I&D and antibiotics

125
Q

High fever, severe sore throat, drooling, hyperextension of head, toxic appearing, stridor, prominent swelling of post pharynx wall

A

Retropharyngeal abscess

126
Q

Retropharyngeal abscess treatment

A

Immediate referral to ED

127
Q

Allergic rhinitis patho

A

IgE mediated response to allergens, causing nasal mucosa inflammation

128
Q

Sensorineural hearing–loss what is it

A

damage to the cochlea/auditory nerve

129
Q

Cause of sensorineural hearing loss

A

noise, menigitis, hyperbili, kernicterus, gentamycin, lbw, measels, mumps, rubella, intracranial hemorrhage

130
Q

High frequency hearing loss

A

sensorineural

131
Q

Low frequency hearing loss

A

conductive hearing loss

132
Q

Cause of conductive hearing loss

A

OME, AOM, cerumen, FB, perf TM, cholesteatoma

133
Q

An abnormal white reflection from the retina of the eye

A

Leukokoria

134
Q

Glaucoma treatment

A

surgery, beta blockers

135
Q

Cataracts treatment

A

surgical removal of the lens with use of corrective lens, possible watch and wait

136
Q

Management of strabismus

A

occlude/path the good eye

137
Q

Acute infection /inflammation of the external auditory canal

A

swimmer’s ear aka otitis externa

138
Q

Otitis externa bacterial agents

A

pseudomonas and staph,

139
Q

Otitis externa s+s

A

itching outter ear, pain when moving tragus, swollen EAC. Fullness in the ear + black spots on tm if fungal

140
Q

Otitis externa tx

A

analgesics, otic antibiotic drops (cipro/mycotic drops)

141
Q

External cyst of middle ear that is congenital or acquired

A

Cholesteatoma

Pediatric studying torture (23 decks)

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