Paediatric ENT Flashcards
Airway problems in children?
inhaled foreign body
subglottic stenosis
RRP- recurrent respiratory papillomatous disease
ENT investigation?
nasoendoscopy in stable patients
What does obligate nasal breathing mean?
0-6 months mechanism for breathing
Name a condition which would impact obligate nasal breathing?
choanal atresia
Cause of stertor?
Micronathia- small jaw- pio raban sequence??
enlarged tonsils and adenoids
Name a paediatric airway condition that can cause apnoea?
enlarged tonsils + adenoids
What is the most common cause of stridor in children?
laryngomalacia
Differentials for stridor?
webs
cysts
clefts
vocal cord paralysis
subglottic stenosis
tracheal stenosis
foreign bodies
What is tracheomalacia?
?
What is the grading for airway stenosis?
Cotton-Myer grading
Stertor?
Above larynx- upper airway
Stridor?
just below larynx
Stertor common cause?
adenotonsillar hypertrophy
Midline neck lump most common cause?
Thyroglossal duct cyst
Investigation for midline lump?
ultrasound
Management of thyroglossal cyst?
infection
Are thyroid lumps in children common?
rare
Most common malignancy teenagers? neck lumps
Lymphoma
Paediatric ENT emergencies?
foreign bodies in ears
button battery
How to get rid of insect in ear?
drown the bug- syringe with water, oil??
What is the most obvious sign of nasal foreign body?
unilateral nasal discharge
How to get foreign body out of nose?
Mother’s kiss
crocadile forceps
Is aural or nasal RB more of en emergency?
nasal is an emergency due to risk of airway obstruction. Any batter related obstruction is always an emergency
Why are button batteries dangerous?
strictures and perforations
What is the collection of arterial vessels in the nose?
Little’s area/kesselbach area
Treatment for epistaxis?
naseptin
silver nitrate cutery
Causes of epistaxis?
coagulopathies
juvenile nasal angiofibroma
idiopathic
What is a fluid bolus in children?
10-20ml/kg!!!!!!!
Infectious emergencies of the airway?
croup
epiglottitis
What is the treatment for croup?
steroids
adrenaline nebs
Why is epiglottitis rare?
vaccination of H.influenzae?
Airway obstruction management?
adrenaline nebs
dexamethasone
oxygen- waft oxygen
secure airway
Red swelling in neck of lymph node?
infection of lymph node (overreactive lymph node) - abscess or atypical
What is trismus?
When your jaw muscles become so tight that you can’t open your mouth, you may have a condition known as trismus. Trismus refers to muscle spasms in your temporomandibular joint. Head and neck cancer treatment is the most common reason why people develop trismus.
Is quinsy unilateral or bilateral?
quinsy= unilateral
tonsillitis= bilateral
Signs of deep neck infections?
torticolis
trismus
drooling
pyrexial
Source of peri-orbital infections?
sinusitis
conjunctivitis
Evidence of abscess with eye infection?
double vision
chemosis
restriction of eye movement
First line treatment of acute otitis media antibiotic?
amoxicillin
second line augmentin
Management of mastoiditis secondary to otitis media?
IV antibiotics
surgical drainage
What is a sign of mastoiditis?
Drooping of ears
Erythema around mastoid process
What is the hearing screening test in neonates?
universal hearing screening programme
Why is it important to test for hearing problems?
important for speech
First word milestone?
1 year
How many words ay 2 years?
150-300 words, 2-3 word sentences
Another term for glue ear?
otitis media with effusion= OME
Risk factors for OME?
parental smoking
siblings with OME
bottle feeding
low socioeconomic groups
acute otitis media
nursery attendance
Name two conditions associated with OME
cleft palate
down’s syndrome
primary ciliary dyskinesia
craniofacial abnormalities
Complications of AOM?
facial nerve palsy
mastoiditis
external ear abnormalities? /prominent ears
microsia
atresia
Name a hearing test in children?
visual response audiometry
play audiometry
tympanometer
distraction testing 6-9 months
subjective vs objective (e.g. tympanometry), others above are subjective
Neonatal hearing screening test in Scotland?
Aoutomated brainstem responses ABR
Name of pinna abnormality?
microtia?
What is Chandler Classification used for?
orbital cellulitis
Which scan do you request for orbital cellulitis?
CT head, orbits, sinuses
Signs of mastoiditis on examination?
post auricular erythematous swelling with pain
Which organisms cause acute otitis media?
resp epithelial organisms- s pneumoniae and pyogenes, h.influenzae
Name one complication of mastoiditis
facial nerve palsy
abscess
meningitis
Name one initial management for foreign body in nose
mother’s kiss
- ask parent to occlude patent nasal passage and breathe into mouth
Where do foreign bodies in the throat typically get stuck in children?
cricopharyngeus= upper oesphageal sphincter
Why do you worry about cervical lymphadenitis?
can progress to abscess
WHat are the signs of abscess cervical lymphadenitis
fluctuant
puss
erythematous
hot
Why do children get retropharyngeal abscesses and not adults?
associated with inflammation of node of rouviere which disappear after the age of 4
Child with retropharyngeal abscess now develops chest pain. What are you worried about?
mediastinitis
Name one sign on CT of retropharyngeal abscess
loss of cervical lordosis
collection of gas
narrowing of airway and deviation
Which vaccine has reduced the occurence of epiglottitis?
H/ influenzae B
HIB
How to manage epiglottitis child?
do not touch!!!
manage airway
nebulised adrenaline
What is the thumb sign on XR?
sign of epiglottitis
