Paediatric ENT

Question 1

What are the possible otological symptoms?

Answer 1

Hearing loss
Discharging ear
Ear ache
Tinnitus
Vertigo

Question 2

What are the forms of paediatric hearing loss?

Answer 2

Congenital vs acquired
Uni vs bilateral
Conductive vs sensorineural

Question 3

What symptoms may be present in a child with hearing loss?

Answer 3

Pain
Discharge
Dizziness
Tinnitus

Question 4

What history must be taken for a child with hearing loss?

Answer 4

Symptoms
Speech development, school performance
Behavioural problems
Maternal perinatal infections, drugs, jaundice
Growth, immunisations, passive smoking, breast vs bottle feeding

Question 5

What subjective tests can be done to test for hearing loss in 6-12 months?

Answer 5

Distraction test

Question 6

What subjective tests can be done for hearing loss in 12 months- 3 years?

Answer 6

Visual reinforced audiometry

Question 7

What subjective tests can be done for hearing loss in 3-5 year olds?

Answer 7

Play audiometry

Question 8

What subjective tests can be done for hearing loss in 4+ year olds?

Answer 8

Pure tone audiometry

Question 9

What objective tests can be done for hearing loss in children?

Answer 9

Otoaucostic admissions
Audiometry brain stem response
Tympanometry

Question 10

What is the most common cause of hearing loss in children?

Answer 10

Otitis media with effusion

Question 11

What are the risk factors for otitis media with effusion?

Answer 11

Day care
Smoking
Cleft palate
Down syndrome

Question 12

How is otitis media with effusion treated?

Answer 12

Hearing aids
Grommets
Adenoidectomy
Autoinflation

Question 13

What are the signs and symptoms of otitis media with effusion?

Answer 13

Hearing loss
Speech delay
Behavioural problems
Academic decline
Imbalance
Dull tympanic membrane
Fluid level and bubbles behind tympanic memrane

Question 14

What is the cause of otitis media with effusion?

Answer 14

Eustachian tube dysfunction
Adenoidal hypertrophy
Resolving AOM

Question 15

What history should be taken in a child with a painful/discharging ear?

Answer 15

Associated symptoms
Duration
Hearing issues

Question 16

What examination and investigation should be done for a child with a painful/discharging ear?

Answer 16

Otoscope

Pure tone audiometry

Question 17

What are the common causes of a painful/discharging ear in children?

Answer 17

Otitis externa
Acute otitis media
Chronic otitis media

Question 18

What is otitis externa and what does it result in?

Answer 18

Inflammation of outer ear

Results in closing of external auditory canal, causing pain and hearing loss

Question 19

How is otitis externa treated?

Answer 19

Cleaning ear

Topical antibiotics

Question 20

What is a history of acute otitis media?

Answer 20

Short history of pain, fever and discharge

Question 21

What are the common causes of acute otitis media?

Answer 21

H influenza
Strep pneumonia
Moraxella catarrhalis

Question 22

How is acute otitis media treated?

Answer 22

Antibiotics

Grommets and adenoidectomy if recurrent

Question 23

What are the complications of acute otitis media?

Answer 23

Mastoidectomy

Brain abscess

Question 24

How is mastoiditis treated?

Answer 24

IV antibiotics and possible surgery

Question 25

What is chronic otitis media?

Answer 25

Chronic discharging ear or hearing loss despite grommets

Question 26

When do the ethmoid and maxillary sinuses develop?

Answer 26

0-4 months

Question 27

When do the sphenoid sinuses develop?

Answer 27

3-7 years

Question 28

When do the frontal sinuses develop?

Answer 28

8+ years

Question 29

What history should be taken when there is a blocked/runny nose?

Answer 29

Pain, discharge, loss of function Foreign body Feeding Snoring, quality of sleep

Question 30

What examinations should be carried out for a blocked/runny nose?

Answer 30

Otoscope | Cold spatula test

Question 31

What are the common causes of a blocked/runny nose?

Answer 31

``` Rhinitis Large adenoids Foreign body Sinusitis and polyps Choanal atresia ```

Question 32

What are the symptoms of rhinitis?

Answer 32

Runny nose Lack of sense of smell Blocked nose Sneezing

Question 33

What os the treatment for rhinitis?

Answer 33

Nasal douching Antihistamines Nasal steroids

Question 34

What are the symptoms of large adenoids?

Answer 34

``` Runny nose Lack of sense of smell Blocked nose Sneezing Sleep apnoea ```

Question 35

What are the symptoms of sinusitis and polyps?

Answer 35

Runny nose, lack of sense of smell, blocked nose, sneezing

Question 36

What are sinusitis and polyps associated with?

Answer 36

Cystic fibrosis

Question 37

What is the complication of sinusitis and polyps?

Answer 37

Periorbital cellulitis

Question 38

What should be considered in severe/recurring epistaxis?

Answer 38

Coagulopathy | Haematological abnormality

Question 39

How is epistaxis managed?

Answer 39

Appropriate first aid Antibiotic ointments Cautery Nasal packing

Question 40

What are the associated symptoms of sore throat?

Answer 40

Odynophagia, ear ache Dysphagia, treating problems, hoarse voice Snoring/drooling

Question 41

What should be examined for a sore throat?

Answer 41

Treat, neck, ears and nose

Question 42

How is tonsillitis treated?

Answer 42

Support and antibiotics

Question 43

What are the complications of tonsillitis?

Answer 43

Peritonsillar abscess

Question 44

What are the anatomicalmical causes of airway issues in children?

Answer 44

Large tongue, tonsils and epiglottis Short neck Narrow subglottis

Question 45

What history should be taken in airway issues?

Answer 45

Foreign body Recent illness Feeding problems Inspiratory stridor

Question 46

What are the common causes of airway issues?

Answer 46

Anatomical Foreign body Epiglottis Laryngomalacia

Question 47

How is a neck abscess treated?

Answer 47

Drain | IV antibiotics

Question 48

What are the common causes of neck lumps?

Answer 48

Thyroglossal cyst Branchial cyst Cystic hygroma Cervical lymphadenopathy