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ENT > Paediatric ENT Surgery > Flashcards

Paediatric ENT Surgery Flashcards

1
Q

Definition of otalgia

A

Ear ache

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2
Q

Definition of otorrhea

A

Ear discharge

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3
Q

What is the at risk paediatric group for otology symptoms?

A 
S.C.B.U
Family history 
Meningitis 
Perinatal sepsis
- toxoplasmosis
- rubella
- CMV
- Herpes
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4
Q

What are the paediatric hearing tests?

A

Universal neonatal screening
AOAE test
AABR test

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5
Q

What does the AOAE test stand for?

A

Automated otoacoustic emission

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6
Q

What does AABR stand for?

A

Automated auditory brainstem response

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7
Q

What age gets distraction tests?

A

6 - 18 months

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8
Q

What age gets Visual reforced audiometry (VRA)?

A

12 months - 3 years

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9
Q

What age gets play audiometry?

A

3 - 5 years

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10
Q

What age gets pure tone audiometry?

A

4+ years

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11
Q

How does tympanometry work?

A

A tympanometer creates a change in pressure in the ear canal

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12
Q

Peak ages to get otitis media with effusion

A

18/12 years and 4 years

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13
Q

What gender gets otitis media with effusion more?

A

M > F

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14
Q

At risk groups for OME

A 
Day care
Older siblings
Parental smoking
Cleft palate
Downs syndrome
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15
Q

Symptoms of OME

A 
Hearing loss
Speech delay 
Behavioural problems 
Academic decline
Imbalance
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16
Q

What does OME stand for?

A

Otitis media with effusion

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17
Q

Signs of OME

A

Dull TM
Fluid membrane
Bubbles

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18
Q

Causes/pathology of OME

A 
Eustachian tube dysfunction 
- anatomy of skull base
- muscular immaturity 
Adenoidal hypertrophy 
Resolving AOM
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19
Q

What reduces the risk of OME?

A

Breast feeding

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20
Q

Treatment of OME

A

Hearing aids
Grommet insertion
Adenoidectomy

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21
Q

Peak incidence of acute otitis media

A

3 - 18 months

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22
Q

What gender gets more acute otitis media?

A

M = F

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23
Q

Symptoms of acute otitis media

A 
Short history 
Very painful 
Fever
Systemic upset (sleep disturbance)
Ear discharge
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24
Q

Causative organisms for acute otitis media

A

Haemophilus influenzae
Strep pneumonia
Moraxella catarrhalis

25
Q

Signs of acute otitis media

A

Often vague
Unwell screaming child
Rubbing the ears
High fever

26
Q

What is the diagnostic test for acute otitis media?

A

Otoscopy

27
Q

Treatment for acute otitis media

A

Analgesia - calpol vs ibruprofen

Antibiotics - amoxycillin/coamoxiclav, erythromycin second line

28
Q

How long should antibiotics be taken for in acute otitis media?

A

5 - 7 days

29
Q

How long would a long course of antibiotics be for?

A

4 - 6 weeks

30
Q

When would you need a long course of antibiotics for in acute otitis media?

A

Recurrent AOM episodes

31
Q

Complications of acute otitis media

A 
Acute mastoiditis
Mastoid abscess
Facial nerve palsy 
Ossicular/cochlear damage 
Labyrinthitis 
Chronic perforation 
Febrile convulsion 
Brain abscess
Meningitis 
Sub/extradural empyema
32
Q

Treatment for recurrent/complicated AOM

A

Grommet insertion

+/- Adenoidectomy

33
Q

What examinations are done to investigate nasal symptoms in children?

A

Nasal speculum
Auriscope / otoscope
Spatula test
Nasal endoscopy

34
Q

What gender of children gets epistaxis more?

A

M > F

35
Q

Treatment of epistaxis

A 
First air- press nose
Antibiotic ointments
- naseptin 
- Bactroban 
Cautery (burning) 
Nasal packing
36
Q

Causes of nasal obstruction

A

Rhinitis
Adenoidal hypertrophy
Foreign body

37
Q

Types of rhinitis

A

Allergic

Non-allergic

38
Q

What would be a feature of nasal obstruction caused by a foreign body?

A

It would be unilateral

39
Q

Treatment of nasal obstruction

A 
Decongestants 
Steroids
Nasal hygiene - saline douching 
Diathermy/reduce turbinates
Adenoidectomy 
Correct choanal atresia
40
Q

What is there a risk of with periorbital cellulitis?

A

Intracranial sepsis

41
Q

Are nasal polyps rare or common in children?

A

Rare

42
Q

Causes of nasal polyps in children

A

Chronic rhinosinusitis
Cystic fibrosis
Angiofibroma

43
Q

Cause of bacterial tonsillitis

A

Beta haemolytic `streptococci

44
Q

Treatment of acute tonsillitis

A 
Penicillin +/- anaerobic cover 
Antiseptic gargle (difflam)
Analgesia 
Drain tonsillar abscess 
Tonsillectomy
45
Q

What antibiotics should be avoided in acute tonsillitis?

A

Amoxicillin

Ampicillin

46
Q

What is a complication of acute tonsillitis?

A

Quinsy

47
Q

What is a quinsy?

A

Peritonsillar abscess

48
Q

Criteria for tonsillectomy

A 
Recurrent tonsillitis 7 episodes >1 year
Quinsy >1
Obstructive sleep apnoea 
Malignancy 
- rhabdomyosarcoma
- lymphoma
49
Q

Differences in a childs airway than an adults

A 
Relative macroglossia
Tonsillar hypertrophy 
Large epiglottis
Short neck 
High larynx
50
Q

Where is the narrowest part of a childs airway?

A

Subglottis

51
Q

Where is the obstruction when a patient presents with a stertor?

A

Above larynx

52
Q

Where is the obstruction when a patient presents with a stridor?

A

At or below larynx

53
Q

What is cyanosis an extremely late sign of?

A

Upper airway obstruction

54
Q

Causes of acute stridor

A

Infective (croup / epiglottis)

Foreign body

55
Q

Causes of chronic stridor

A

Laryngomalacia
Subglottis stenosis
Vocal cord palsy

56
Q

What sign on CXR is classically seen in croup?

A

Steeple sign

57
Q

What is the commonest cause of paediatric stridor?

A

Laryngomalacia

58
Q

Pathology of laryngomalacia

A

Redundancy of the tissues above the vocal cords
The redundant tissue collapses inwards during inspiration and causes turbulence of inspired air
The turbulence causes stridor

59
Q

What sign may indicate a peritonsillar abscess?

A

Uvula deviation

ENT (17 decks)

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