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PEDS FINAL > HEENT > Flashcards

HEENT Flashcards

1
Q

What condition involves unilateral eye injection with thick, purulent discharge?

A

Bacterial Conjunctivitis

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2
Q

What are the three possible etiologies of Bacterial Conjunctivitis?

A
  • Strep pneumonia
  • H. influenzae
  • M. catarrhalis
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3
Q

What are the two recommended treatments for Bacterial Conjunctivitis?

A
  • Erythromycin ophthalmic ointment

- Trimethoprim-Polymyxin B drops

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4
Q

What condition involves watery, mucopurulent/bloody discharge from the eyes?

A

Neonatal Conjunctivitis

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5
Q

What is the etiology of Neonatal Conjunctivitis?

A

Chlamydia trachomatis

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6
Q

What condition uses NAAT (Nucleic Acid Amplification Test) as the cold standard diagnostic test?

A

Neonatal Conjunctivitis

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7
Q

What is the recommended treatment for Neonatal Conjunctivitis?

A

ORAL Erythromycin

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8
Q

What condition involves rapidly progressive profuse, purulent discharge + chemosis; urethritis?

A

Hyperacute Bacterial Conjunctivitis

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9
Q

What is the etiology of Hyperacute Bacterial Conjunctivitis?

A

Neisseria gonorrhoeae

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10
Q

What is the recommended treatment for Hyperacute Bacterial Conjunctivitis?

A

Immediate ophtho referral and hospitalization (severe and life-threatening)

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11
Q

What condition are contact lens wearers at high risk of contracting?

A

Pseudomonal keratitis

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12
Q

What is the recommended treatment for possible Pseudomonal keratitis (2)?

A
  • Antibiotics (must be anti-pseudomonal)

- Urgent ophtho referral in 12-24 hours

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13
Q

What condition involves watery, burning/gritty sensation in eye?

A

Viral Conjunctivitis

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14
Q

What is the most common etiology of Viral Conjunctivitis?

A

Adenovirus

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15
Q

What is the recommended treatment for Viral Conjunctivitis?

A

SYMPTOMATIC CARE

  • Avoid touching eyes and wash hands frequently
  • Do NOT return to sports/school until discharge resolves
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16
Q

What condition involves bilateral injection, itchy (ocular pruritus), watery/stringy discharge?

A

Allergic Conjunctivitis

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17
Q

What is the recommended treatment for Allergic Conjunctivitis?

A

Antihistamines with mast-cell stabilizing

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18
Q

What should be avoided in treatment of Allergic Conjunctivitis, and why?

A

NO topical steroids

- Potentially sight-threatening

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19
Q

If a patient is diagnosed with Neonatal Conjunctivitis, what are they also at risk for contracting?

A

Chlamydial pneumonia

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20
Q

What are three signs/symptoms of Keratitis?

A
  • FB sensation
  • Blepharospasm
  • Visible corneal opacity on penlight exam
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21
Q

What condition is CRASH associated with, and what does it stand for?

A

Kawasaki disease

  • Conjunctivitis
  • Rash (mibiliform)
  • Adenopathy
  • Strawberry tongue
  • Hands red and swollen → desquamation

AND FEVER

(could also use warm CREAM)

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22
Q

What diagnosis should be considered in all children with prolonged, unexplained fever >5 days?

A

Kawasaki disease

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23
Q

What additional testing should always be ordered in addition to normal workup for Kawasaki disease, and why?

A

Echocardiogram due to high risk for CV complications

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24
Q

What is the recommended treatment for Kawasaki disease (3)?

A
  • Hospitalization with cardio and I&D consults
  • IVIG to provide antibodies and reduce prevalence of carotid artery aneurysms
  • High-dose ASA
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25
Q

What condition involves misalignment of eyes; can lead to amblyopia (lazy eye)?

A

Strabismus

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26
Q

What is the most common cause of persistent tearing/ocular discharge in children?

A

Dacryostenosis

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27
Q

What condition involves nasolacrimal duct obstruction; chronic tearing, mucoid discharge, lashes debris?

A

Dacryostenosis

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28
Q

How does Dacryostenosis typically progress, and what two treatments are recommended?

What is the definitive treatment, and when would this treatment be recommended (think time)?

A

Often resolves on its own…

  • Lacrimal sac massage
  • Warm compress

Definitive: surgical probe (>12 months)

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29
Q

What condition involves inflammation/infection of lacrimal sac; erythema, swelling, warmth, lacrimal sac tender?

What condition is this a possible complication of?

A

Dacryocystitis

- Rare complication of Dacryostenosis

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30
Q

What are the two recommended treatments for Dacryocystitis?

What should also be done diagnostically?

A
  • Treat with empirical abx x7-10 days
  • Ophthalmology referral
  • Diagnostic: obtain cultures
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31
Q

What are the three possible etiologies of Acute Otitis Media (AOM)?

Bonus: what other HEENT condition has the same etiologies?

A
  • Strep pneumonia
  • H. influenzae
  • M. catarrhalis

Also seen with bacterial conjunctivitis

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32
Q

What condition involves otalgia; fever, irritability?

A

Acute Otitis Media (AOM)

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33
Q

What condition shows bulging TM or acute inflammation AND middle ear effusion on PE?

A

Acute Otitis Media (AOM)

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34
Q

What is the diagnostic criteria for Acute Otitis Media (AOM) - ___ or ___ AND ___?

A

Bulging TM OR acute inflammation

AND middle ear effusion

35
Q

What is considered recurrent Acute Otitis Media (AOM)?

What is the recommended treatment if prophylactic antibiotics (Amoxicillin, Sulfa) are not effective?

A
  • 3+ episodes in 6 months
  • 4+ episodes in 12 months

If abx are ineffective, consider T-Tubes

36
Q

What is the recommended treatment for Acute Otitis Media (AOM) - with dose? When should a patient follow up?

A

High-dose Amoxicillin (90 mg/kg/day BID) or Augmentin

- Follow up in 48-72 hours

37
Q

What condition involves middle ear effusion with no signs of acute infection?

A

Otitis Media with Effusion (OME)

38
Q

What condition involves amber/gray/blue, cloudy, opaque TM; retracted TM on PE?

A

Otitis Media with Effusion (OME)

39
Q

What condition involves inflammation of EAC causing otalgia?

A

Otitis Externa

40
Q

What is the most common etiology of Otitis Externa?

A

P. aeruginosa

41
Q

What condition involves tender tragus/pinna OR diffuse erythema/edema of EAC on PE?

A

Otitis Externa

42
Q

What is the recommended treatment for Otitis Externa (2)?

A
  • Floxin otic solution (Ofloxacin)

- Avoid promoting factors

43
Q

What is the most important risk factor associated with Allergic Rhinitis?

A

FH of atopy

44
Q

What condition involves allergic shiners, Dennie-Morgan lines, “allergic salute”, pale/bluish/boggy/edematous turbinates; cobblestoning?

A

Allergic Rhinitis

45
Q

What condition involves allergic shiners?

A

Allergic Rhinitis

46
Q

What condition involves “allergic salute”; cobblestoning?

A

Allergic Rhinitis

47
Q

What condition involves pale/bluish/boggy/edematous turbinates?

A

Allergic Rhinitis

48
Q

What condition involves Dennie-Morgan lines?

A

Allergic Rhinitis

49
Q

What is the recommended pharmacologic treatment for Allergic Rhinitis? What other two treatments are recommended in conjunction?

A

INTRANASAL STEROIDS

  • Allergen avoidance
  • Allergen immunotherapy
50
Q

What condition is very common in children; non-toxic appearing; low-grade fever, rhinorrhea?

51
Q

What is the most common etiology of Viral URI?

A

Rhinoviruses

52
Q

What are the two most common symptoms seen with Viral URI in INFANTS?

A
  • Nasal discharge

- Fever

53
Q

What are the three most common symptoms seen with Viral URI in CHILDREN?

A
  • Nasal discharge
  • Nasal congestion
  • Cough
54
Q

For what condition should OTC decongestants be avoided, and for what specific age range should they be not used/avoidance recommended?

A

Viral URI

  • Avoid if <6 years
  • Recommended avoidance if 6-12 years
55
Q

What condition has a timeline of NOT improving; >10 days but <30 days?

A

Acute Rhinosinusitis (bacterial)

56
Q

What condition has a timeline of NOT improving; >12 weeks AND 2+ of drainage, nasal obstruction, facial pain/pressure/fullness or decreased sense of smell

A

Chronic Rhinosinusitis

57
Q

What condition involves a “pealed grape” appearance on PE?

A

Nasal polyps

58
Q

What condition is associated with SAMTERs triad, and what are the three components?

A

Nasal polyps

  • Nasal polyps
  • ASA sensitivity
  • Asthma
59
Q

What are three potential complications of Viral URI?

A
  • AOM
  • Asthma exacerbation
  • Acute bacterial sinusitis
60
Q

What condition involves “double worsening”?

A

Acute Rhinosinusitis (bacterial)

61
Q

What is the recommended treatment for Acute Rhinosinusitis (bacterial)? What if this is ineffective - with dose?

A

Supportive care

- Ineffective? Try Augmentin 45/kg/day

62
Q

What is the most common cause of pharyngitis - provide two examples?

A

VIRAL

  • Adenovirus
  • Coxsackie A
63
Q

What are the two most common symptoms associated with Pharyngitis?

A
  • Sore throat

- Fever

64
Q

What condition involves fatigue; tender cervical LAD, splenomegaly?

A

Infectious Mononucleosis

65
Q

What is the etiology of Infectious Mononucleosis?

66
Q

What is the recommended diagnostic test for Infectious Mononucleosis?

A

Heterophile antibody test (Monospot)

67
Q

With what condition is activity restriction for 4 weeks recommended, and why?

A

Infectious Mononucleosis

- Prevent splenic rupture

68
Q

During what time of year is peak incidence of Bacterial Pharyngitis?

A

Winter/early spring

69
Q

What is the etiology of Bacterial Pharyngitis?

A

Group A Streptococci (GAS)

70
Q

What condition involves abrupt onset, fever; absence of usual URI symptoms?

A

Bacterial Pharyngitis

71
Q

What condition involves exudate, palatal petechiae, tender cervical LAD, possible “sandpaper” rash on PE?

A

Bacterial Pharyngitis

72
Q

What treatment (and timeline) is recommended for Bacterial Pharyngitis?

What are the two potential complications associated with Bacterial Pharyngitis?

A

Antibiotics in first 48 hours to prevent complications…

  • Acute Rheumatic Fever (ARF)
  • Post-Streptococcal Glomerulonephritis (PSGN)
73
Q

What condition is common in 5-12 years; presents with generalized edema, gross hematuria, HTN; treatment is symptomatic care?

What is this a complication of?

A

Post-Streptococcal Glomerulonephritis (PSGN)

- Complication of Bacterial Pharyngitis

74
Q

What condition is common in 5-15 years; manifests into migratory arthritis, carditis, CNS involvement, subQ nodules and erythema marginatum?

What is this a complication of?

A

Acute Rheumatic Fever (ARF)

- Complication of Bacterial Pharyngitis

75
Q

What is the Centor Criteria, and for what condition is it used?

A

Centor Criteria helps diagnose Bacterial Pharyngitis… If 3+ present, order culture:

  • Tonsillar exudate
  • Tender cervical LAD
  • Fever
  • NO cough
76
Q

What is the Paradise Criteria, and for what condition is it used to determine treatment?

A

Paradise Criteria is used to determine if tonsillectomy is necessary in treatment of Bacterial Pharyngitis…

Tonsillectomy recommended if:

  • 7+ episodes per 1 year
  • 5+ episodes/year in last 2 years
  • 3+ episodes/year in last 3 years
77
Q

What condition is more common after abx therapy?

A

Oral Candidiasis (Thrush)

78
Q

What is the etiology of Oral Candidiasis (Thrush)?

A

Candida albicans

79
Q

What is the recommended treatment for Oral Candidiasis (Thrush)?

80
Q

In what two age populations is Mumps most common?

A
  • School-age children

- College-aged adults

81
Q

What condition involves initial fever, HA, myalgias, fatigue; parotitis within 48 hours?

82
Q

What is the most common cause of parotitis?

83
Q

What is the recommended treatment for Mumps?

A

Supportive care

- Self-limiting

84
Q

What is the test used to diagnose Bacterial Pharyngitis?

A

RADT (rapid antigen detection testing)

PEDS FINAL (3 decks)

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