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Systems: Head and Neck AB > Paediatric Otorhinolaryngology > Flashcards

Paediatric Otorhinolaryngology Flashcards

1
Q

What conditions are included under the heading otology?

A
  • Hearing loss
  • Discharging ear
  • Earache
  • Tinnitus
  • Vertigo
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2
Q

How can hearing loss in children be characterised?

A
  • Congenital vs acquired
  • Unilateral vs bilateral
  • Conductive vs sensorineural
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3
Q

What ear symptoms may be present with hearing loss?

A
  • Pain
  • Discharge
  • Loss of function: hearing loss, dizziness, tinnitus
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4
Q

What may there be a history of with hearing loss?

A
  • Ear symptoms
  • Problems with speech development and school performance
  • Behavioural problems
  • Maternal perinatal infections
  • Delivery issues (prematurity, anoxia)
  • Neonatal infections, drugs, jaundice
  • Growth delays, immunisations, passive smoking, breast vs bottle feeding
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5
Q

How is a 6-18 month old subjectively assessed for hearing?

A

Distraction test

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6
Q

How is a 12 month -3 year old subjectively assessed for hearing?

A

Visual reinforced audiometry

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7
Q

How is a 3-5 year old subjectively assessed for hearing?

A

Play audiometry

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8
Q

How is a 4+ year old subjectively assessed for hearing?

A

Pure tone audiometry

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9
Q

What does objective assessment of the audiometry system include?

A
  • Otoacoustic emissions
  • Auditory brain stem response
  • Tympanometry
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10
Q

In what age group do 80% of otitis media with effusion cases occur?

A

Under 10s

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11
Q

When are the 2 peaks in age groups for otitis media with effusion?

A
  • 2 years

- 5 years

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12
Q

What are the risk factors for otitis media with effusion?

A
  • Day care
  • Smoking
  • Cleft palate
  • Down syndrome
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13
Q

How is otitis media with effusion treated?

A
  • Most improve by themselves
  • Hearing aids
  • Grommets
    • Adenoidectomy
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14
Q

What are the symptoms of otitis media with effusion?

A
  • Hearing loss
  • Speech delay
  • Behavioural problems
  • Academic decline
  • Imbalance
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15
Q

What are the signs of otitis media with effusion?

A
  • Dull Tm
  • Fluid level
  • Bubbles
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16
Q

What is the aetiology of otitis media with effusion?

A
  • Eustachian tube dysfunction either due to anatomy of the skull base of muscular immaturity
  • Adenoidal hypertrophy
  • Resolving A.O.M
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17
Q

How is otitis externa treated?

A
  • Aural microsuction
  • Topical antibiotics
  • Water precautions
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18
Q

When is acute otitis media common?

A

3-18 months

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19
Q

How does a child with acute otitis media present?

A
  • Short history
  • Pain
  • Fever
  • Discharge
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20
Q

What is acute otitis media related to/

A

OME

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21
Q

What is the microbiology of acute otitis media?

A
  • Haemophilus influenza
  • Strep pneumonia
  • Moraxella catarrhalis
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22
Q

How is acute otitis media treated?

A
  • Antibiotics ( eg Co-amoxiclav)

- Grommets and adenoidectomy if recurrent

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23
Q

When should you suspect chronic otitis media/cholesteatoma in children?

A
  • Chronic discharging ear

- Hearing loss despite grommets

24
Q

How is cholesteatoma treated?

A

Mastoidectomy

25
Q

What conditions are included under the heading rhinology?

A
  • Blocked nose

- Runny nose

26
Q

How often is normal for a child to present with a blocked/runny nose?

A

8 episodes per year lasting up to 15 days

27
Q

What should be discussed in the history of a child presenting with blocked/runny nose?

A
  • Nasal symptoms
  • History of foreign body
  • Feeding
  • Snoring, quality of sleep
28
Q

What nasal symptoms may be present in a child with blocked/runny nose?

A
  • Pain
  • Discharge
  • Loss of function: blocked nose, sense of smell
29
Q

How can rhinitis be classified?

A

Allergic vs non allergic

30
Q

How is rhinitis diagnosed?

A

Allergen tests (IgE)

31
Q

How is rhinitis treated?

A
  • Nasal douching
  • Antihistamines
  • Nasal steroids
32
Q

If a child has large adenoids, what should you check for?

A

Sleep apnoea

33
Q

How does a foreign body in the nose present?

A

Unilateral

34
Q

What does a foreign body in the nose require?

A

EUA

35
Q

How can sinusitis be characterised?

A

Acute vs chronic

36
Q

Sinusitis and polyps have overlapping symptoms with…

A

Rhinitis/large adenoids

37
Q

What condition is sinusitis and polyps associated?

A

Cystic fibrosis

38
Q

What is the incidence of choanal atresia?

A

1 in 6000-8000 births

39
Q

How does bilateral choanal atresia manifest?

A

Unable to breathe

40
Q

What is the prevalence of epistaxis?

A
  • Common

- M>F

41
Q

What should be considered with epistaxis?

A

Coagulopathy/ haematological abnormality

42
Q

How should epistaxis be managed?

A
  • Appropriate first aid
  • Antibiotic ointments
  • Cauterise
  • Nasal packing
43
Q

What antibiotic ointments can be used in the treatment of epistaxis?

A
  • Naseptin

- Bactroban

44
Q

How can cauterisation be carried out for epistaxis?

A
  • Silver nitrate under local anaesthetic

- Diathermy under general anaesthetic

45
Q

What conditions come under the heading laryngology?

A
  • Sore throat

- Airway issues

46
Q

What should be discussed in the history of a child with a sore throat?

A
  • Throat symptoms
  • Snoring
  • Drooling
47
Q

What throat symptoms may a child with a sore throat present with?

A
  • Pain (odynophagia, ear ache)
  • Discharge (cough)
  • Loss of function (dysphagia, breathing problems, hoarse voice)
48
Q

What should be examined when a child presents with a sore throat?

A
  • Throat
  • Neck
  • Ears and nose
49
Q

What are the 2 types of tonsillitis?

A
  • Bacterial caused by B haem strep B

- Viral caused by EBV

50
Q

With tonsillitis , what is there a risk of?

A

Glomerulonephritis

51
Q

What is the treatment for tonsillitis?

A
  • Supportive

- Antibiotics

52
Q

What is a complication of tonsillitis?

A

Quinsy- peritonsillar abscess

53
Q

What are the characteristics of a child’s head and neck anatomy?

A
  • Large tongue
  • Large tonsils
  • Large epiglottis
  • Short neck
  • Sub glottis narrowest
54
Q

How does a child with airway issues usually present?

A

As an emergency but it can be chronic

55
Q

What is there usually a history of with a child with an airway issue?

A
  • Foreign body
  • Recent illness
  • Feeding problems
  • Stridor particularly inspiratory
56
Q

What are causes of airway issues in children?

A
  • Foreign body
  • Epiglottitis
  • Laryngomalacia
57
Q

What are common neck lumps in children?

A
  • Thyroglossal cyst
  • Branchial cyst
  • Cystic hygroma
  • Cervical lymphadenopathy

Systems: Head and Neck AB (15 decks)

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