Paediatric

Question 1

How is nasal discharge managed?

Answer 1

Unilateral is foreign body until proven otherwise

Managed with parental kiss, wax forceps, removal under GA

Question 2

What are the symptoms of periorbital cellulitis?

Answer 2

Nasal obstruction
Discharge 
URTI
Blurred vision 
Proptosis 
Fever
Headaches 
Meningism 
Septicaemia 
Chandler's classification

Question 3

What are the complications or orbital cellulitis?

Answer 3

Menignitis
Cavernous sinus thrombosis
Intracranial abscesses
Osteomyelitis (frontal sinus- potts puffy tumour)

Question 4

What are the differentials for stridor in children?

Answer 4

Laryngomalacia
Vocal cord palsy
Subglottic stenosis
Haemangioma

Question 5

What is laryngomalacia?

Answer 5

Inspiratory stridor, worse when feeding
Omega shaped epiglottis
Self resolving for most (18-24 months)
Supraglottoplasty for failure to thrive

Question 6

What is vocal cord palsy?

Answer 6

Unilateral (iatrogenic)
Bilateral (idiopathic, chiari malformation
Respiratory distress- 50% need tracheostomy

Question 7

What is subglottic stenosis?

Answer 7

Biphasic stridor
Congenital/acquired (intubation/infection)
Endoscopic reconstruction, tracheostomy

Question 8

What is a haemangioma?

Answer 8

Benign vascular tumour
Rapid growth and then regression
70% by 70 yrs
Propanolol

Question 9

What is recurrent respiratory papillomatosis?

Answer 9

HPV 6+11
Vertical transmission
Husky voice and stridor
Treatment is repeated debulking