Mehl. bullet points 7 - ophtalmo + ENT Flashcards
Mehl. 4M + goes to daycare + red, itchy eyes; Dx?
adenovirus (most common cause of viral conjunctivitis).
Mehl. 4M + goes to daycare + red, itchy eyes; the organism most likely responsible can also cause what?
hemorrhagic cystitis (red urine) -> adenovirus.
Mehl. 6M + playing with firecracker + pain and tearing of eye + ocular movements full + visual acuity 20/20; BEST NEXT STEP?
fluorescein instillation of eye
other vignette will say kid playing in sandbox or near dad in metal shop; corneal abrasion shows up green on fluorescein staining (normal areas are blue); cornea heals super-fast + patient will normally have incessant tearing and scratchy sensation for a day and then wake up next morning just fine.
Mehl. 6M + playing with firecracker + pain and tearing of eye + ocular movements full + visual acuity 20/20; Dx?
Dx = corneal abrasion
Mehl. 6M + itchy eye + vesicles present infraorbitally + fluorescein staining of eye shows dendritic pattern; Dx?
Herpes keratitis; similar Dx is herpes zoster (VZV) ophthalmicus (immunocompromised if child).
Mehl. 6M + being treated with chemo for ALL + vesicles around ear + Bell palsy; Dx?
herpes zoster oticus, aka Ramsey-Hunt syndrome type II (VZV).
Mehl. 6M + painless bump on eyelid; Dx?
chalazion (blocked oil duct);
Mehl. 6M + painless bump on eyelid; Tx?
Chalazion (blocked oil duct); Tx with warm compresses.
Mehl. 6M + painless bump on eyelid + warm compresses not working; Dx?
dermoid cyst of eyelid; Tx is
surgical.
Mehl. 6M + painless bump on eyelid + warm compresses not working; Tx?
dermoid cyst of eyelid; Tx is
surgical.
6M + painful bump on eyelid; Dx?
hordeolum (aka stye)
6M + painful bump on eyelid; Mo?
S. aureus infection
6M + painful bump on eyelid;, Tx?
Tx with warm compresses.
6M + Q shows you image where kid looks like he got hit by a softball on his eye; Dx?
orbital cellulitis
6M + Q shows you image where kid looks like he got hit by a softball on his eye; Tx?
orbital cellulitis -> must give IV antibiotics;
in contrast, pre-septal cellulitis is less severe and can be treated with orals.
7M + otoscopy reveals squamous proliferation seen behind tympanic membrane; Dx + Tx?
cholesteatoma; will gradually grow and invade inner ear, causing irreversible hearing loss; Tx is surgical excision.
2F + fever 103 + tugging on pinna + pinna is displaced upward and outward + tenderness of mastoid process; next best step?
“CT of the temporal bone”
In mastoiditis:
Sounds incredibly wrong to do a CT on a kid in this scenario, but this is the answer on the Peds NBME; mastoiditis (malignant otitis externa) is sometimes associated with a temporal bone fluid collection that must be drained to prevent brain abscess; MRI or CT must be done; x-ray is the wrong answer; fluid collection must be drained as best answer; IV broad-spectrum antibiotics are then administered.
nu mes darbe darom CT
