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Special Pops- Peds > Optho, ENT > Flashcards

Optho, ENT Flashcards

1
Q

what is anisocoria?

A

unequal pupils

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2
Q

what is heterochromia?

A

different colors in the iris

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3
Q

What is ptosis?

A

a droopy eyelid

issue when it obstructs the VF

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4
Q

What is the marcus gun jaw-winking phenomenon

A

intermittent ptosis reduction during mastication/sucking and the levator muscle
will tilt their head and look under eyelid

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5
Q

What is a nasolacrimal duct obstruction caused by?

A

Incomplete canalization of the duct or membranous obstructions
**very common and usually go away in 1st year

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6
Q

What is the presentation of a child with a nasolacrimal duct obstruction?

A

always has 1 eye draining
self limiting in 1 year
if not needs an optho referral

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7
Q

How do you diagnose a child with nasolacrimal duct obstruction?

A

fluorescence in the eye

shine black light up nose and the fluroscene will be in the nose!

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8
Q

How do you treat a nasolacrimal duct obstruction?

A

push a probe down through the punctum which will either dilate it or break through the membanous portion that is blocking it

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9
Q

What is dacrocycitis?

A

infection of the nasolacrimal sac

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10
Q

How does dacrocycitis present?

A

erythema, edema over lower eyelid

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11
Q

What is dacrocycitis caused by?

A

S. aureus, strep pyogenes, strep pneumoniae,

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12
Q

How do you treat dacrocycitis?

A

Abx

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13
Q

What is a hyphema?

A

Blood in the anterior chamber

immediate referral to optho = emergency!

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14
Q

What is a hyphema caused by?

A

trauma to the globe

ruptured vessels located near root of iris or anterior chamber

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15
Q

What are som complications of a hyphema?

A

increase IOP
glaucoma
vision loss

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16
Q

How do you treat a hyphema?

A

shield over the eye
elevate head
refer to optho

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17
Q

What is a iris coloboma?

A

it is a defect due to incomplete closure of anterior embryonal fissure

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18
Q

What is the presentation of iris coloboma?

A

key hole shaped pupil

**need to refer to optho

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19
Q

What is aniridia?

A

has no iris

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20
Q

How does a patient with aniridia present?

A

usually bilateral

can be associated with Wilms tumor or autosomal dominent

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21
Q

What is glaucoma?

A

edematous and clouding of the cornea

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22
Q

What is glaucoma caused by?

A

increased IOP
causing optic nerve injury, corneal scarring, amblyopia
congenital or acquired

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23
Q

How does a patient present with glaucoma?

A

tearing, photophobia, corneal clouding

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24
Q

What is anterioruveitis/ iridocyclitis/ iritis associated with?

A

inflammatory diseases and needs to be seen by optho

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25
How do patients with anterioruveitis/ iridocyclitis/ iritis present?
``` injection photophobia pain blurred vision iritis ```
26
Epidemiology of Retinoblastoma
most common primary intraocular malignancy of childhood, | child usually presents before the age of 3
27
Most common presenting sign in a child with previously undiagnosed retinoblastoma?
leukophoria= white reflex or NO red reflex
28
What is retinoblastoma caused by?
genetics multiple tumors or mass in one or both eyes optho referral!
29
What is papilledema?
optic nerve edema
30
What is papilledema caused by?
increased IOP due to tumor, infection
31
How does papilledema present?
blurred optic disc hemorrhage on fundascopic exam enlarged blind spot with normal VA
32
What are some complications of papilledema?
vision loss | optic atrophy
33
What is orbital cellulitis?
infection posterior to orbital septum | can cause acute ischemic optic neuropathy
34
Where is Periorbital cellulitis found
arising anterior to the orbital septum
35
MC cause of orbital cellulitis
H. influenza
36
What is nystagmus?
rhythmic oscillation or eyes uni/bilateral gaze dependent
37
What causes nystagmus?
ocular lesion amblyopia sensory/motor nystagmus **refer to optho
38
2 types of strabismus?
esotropia | extropia
39
What is esotropia?
deviation of the eyes towards the nose "cross eyed" treat with glasses or surgery
40
Extropia
wall eyes, divergent
41
How to diagnose stabismus?
cover uncover test | hirschberg method/ corneal light reflection test
42
What is amblyopia?
unilateral or bilateral reduction in vision due to strabismus, refractive errors, and/or visual deprivation
43
3 types of amblyopia?
Strabismus amblyopia Refractive amblyopia Deprivation amblyopia
44
Strabismic amblyopia can occur in what?
can occur in the nondominant eye of a strabismic child
45
refractive amblyopia
Both eyes if significant refractive errors are untreated (ametropic or refractive amblyopia) Refractive imbalance is present between the eyes (anisometropic amblyopia)
46
deprivation amblyopia occurs when?
occurs when dense cataracts or complete ptosis prevents formation of a formed retinal image
47
What is otitis externa?
inflammation of the external ear due to trauma, ear plugs, contact dermatitis
48
What are the common bugs of otitis externa?
S. aureus, paeruginosa
49
What is a complication of otitis externa?
facial cellulitis
50
How do you treat otits externa?
otic drops (fluoroquinilone) neosporin abx if indicated
51
What is otitis media caused by?
bacterial/ viral URI eustacian tube dysfunction, impaired immunity viral= MC
52
What are complications of otitis media?
TM perf mastoiditis facial nerve palsy cholesteatoma
53
How do you treat otitis media?
analgesia | abx- amoxicillin
54
Mastoiditis (cause, presentation, treatment)
OM down/outward displaced pinna ENT referral, myringotomy
55
What are 5 congenital ear malformations?
``` atresia lop ears--> folded down low set ears microtia preauricular tags ```
56
Sinus development
@ birth maxillary atrium & anterior & posterior ethmoid cells present sphenoid is present but not clinically significant until 5-8 years 2-4 years the frontal sinus develops 6-10 years is when site of infection
57
URI presentation?
rhinorrhea, nasal congestion, sneezing, purulent nasal discharge
58
What is the cause/ duration/ treatment of URI
viral 1 week tyleonol, motrin
59
What is sinusitis?
URI lasting more than 10 days | worsening sx after initial period of improvement
60
How does sinusitis present?
sinus tenderness allergies similar to URI
61
What is a definitive way to diagnose sinusitis?
sinus aspiration
62
What are some complications and treatments of sinusitis?
``` complications = orbital cellulitis, cheek cellulitis treatment= amoxicillin ```
63
Choanal atresia is what?
back of the nose is not open at birth
64
What is the presentation of choanal atresia
respiratory distress if bilateral unilateral appears later ENT surgery needs to be consulted
65
presentation of allergic rhinoconjunctivitis
``` o itchy nose, eyes (allergic rhinoconjunctivitis), palate, pharynx o sneezing, epistaxis o allergic salute (nasal creases) o nasal obstruction o nasal turbinates pale/blue/swollen o clear/thin nasal D/C o sore throat (worse in AM) ```
66
Classification of allergic rhinoconjunctivitis
o Intermittent→ Sx less than 4 days/weel or less than 4 weeks o Persistent→ sx greater than 4 days/week or for longer than 4 wks
67
Treatment of allergic rhinoconjunctivitis
``` o Antihistamines, mast cell stabilizers (cromolyn-prophylactic), decongestant/vasoconstrictor (but watch out for rhinitis medicamentosa) o Montelukast (singulair) o Nasal corticosteroids→ prophylactically ```
68
What is anklyoglossia?
o Tongue tied, frenulum ties tip of tongue to floor of mouth
69
What is lymphadenitis?
• Cause: hemolytic strep (70%), staphylococci (20%), bartonella, MRSA o Bartonella→ cat scratch • Causes huge lymphnodes in axilla and neck
70
5 causes of acute pharyngitis?
``` EBV enterovirus coxaki adenovirus bacterial ```
71
Strep pharyngitis does not present with? | What are the complications?
don’t have runny nose or congestion • Complications: rheumatic fever, glomerulonephritis, scarlet fever (erythematous, popular rash) •
72
Dx and Tx of strep pharyngitis?
Dx: rapid antigen: specific not as sensitive • Wait for results to come back, if (+) tx based on bacteria • Tx: PCN, Amoxicillin, azithromycin, cephalexin
73
Presentation of Strep Pharyngitis
Presentation: sudden onset sore throat, odynophagia (painful swallowing), fever, abd pain, HA, large red uvula, tonsilar exudate, strawberry tongue, conjunctivitis, viral rash
74
5 Cervical Lymphadenitis Look Alikes
* Thyroglossal Duct cyst: between hyoid & suprasternal. Move up w/swallowing * Brachial Cleft Cyst: if infected→ becomes tender 3-5cm mass along anterior border of SCM * Parotitis: often mistaken for cervical adenitis→ tender behind ear, amylase level elevated * Ranula: cyst, floor of mouth, d/t obstruction of sublingual gland (below mylohyoid muscle, presents as neck mass) * Sternocleidomastoid Muscle Hematoma: cervical mass seen at 2-4 wks old→ part of muscle, associated w/ torticollis
75
Early Childhood Caries
* 1 or more decayed/missing/filled tooth surfaces in primary tooth * Cause: nursing bottle when going to bed
76
periodontal caries
* Gram neg, anaerobic * Actinobacillus, porphyromonas gingivalis, bacteroides forsythus, prevotella intermedia * Inflammatory host response- produces proteases & cytotoxins
77
Prevention of dental caries
• Brushing 2x a day, flossing nightly, fluoride toothpaste/mouthwash • Bottle feeding no later than 1 y/o • Pacific or thumb sucking needs to stop at 2 • Fluoride→ inhibits loss of minerals o Systemic and topically taken in

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