Paediatric otorhinolaryngology

Question 1

Give an example cause of conductive and sensironeural hearing loss

Answer 1

conductive - blockage eg tumour

sensironeural - problem with cochlear nerve

Question 2

Give three potential differing types of hearing loss

Answer 2

congenital vs acquired
bilateral vs unilateral
conductive vs sensironeural

Question 3

Give some examples of what may be found in the history of a child with ear problems/hearing loss

Answer 3

ear - pain, discharge, loss of function eg tinnitus/vertigo

speech development, maternal infection, behaviour problems, delivery and neonatal issues

Question 4

What is often used to both look up a childs nose and their ears?

Answer 4

otoscope

Question 5

The 4 subjective hearing tests

Answer 5

distraction test
visual reinforcement audiometry
play audiometry
pure tone audiometry

Question 6

The 3 objective hearing tests

Answer 6

autoacoustic emission
auditory brain stem response
tympanometry

Question 7

Risk factors of glue ear

Answer 7

day care, smoking, cleft palate, downs syndrome

Question 8

5 possible treatments of glue ear

Answer 8

grommet, hearing aid, adenoidectomy, auto balloon inflation, BAHA

Question 9

Symptoms of glue ear

Answer 9

academic decline, hearing loss, speech delay, behavioural problems

Question 10

Signs of glue ear

Answer 10

dull tympanic membrane

fluid level and bubbles

Question 11

3 causes of glue ear

Answer 11

large adenoids
acute otitis media resolving
Eustachian tube dysfunction

Question 12

otitis externa treatment

Answer 12

aural suction, topical antibiotics

Question 13

acute otitis media causative organisms

Answer 13

Moraxella catarrhalis, H influenza, strep pneumonia

Question 14

Treatment of acute otitis media

Answer 14

grommet, adenoidectomy, antibiotics

Question 15

What is a complication of acute otitis media?

Answer 15

can erode into the mastoid bone which requires a mastoidectomy and antibiotics

Question 16

If there is chronic discharge and no resolving with grommet what is required?

Answer 16

mastoidectomy

Question 17

ages of sinus development

Answer 17

0-4M: ethmoid, maxillary
3-7Y: sphenoid
8+= frontal

Question 18

history of nose problems

Answer 18

discharge, loss of function, pain

snoring, problem feeding, foreign body

Question 19

3 examinations of the nose/breathing

Answer 19

rigid nasal endoscopy
cold spatula test
otoscope

Question 20

2 types of rhinitis and treatment

Answer 20

allergic and non allergic

nasal douching, antihistamines, nasal steroids

Question 21

If you suspect large adenoids what should you ask about?

Answer 21

sleep apnoea/problems

Question 22

Is a foreign body usually bilateral or unilateral?

Answer 22

unilateral

Question 23

What condition are sinusitis with nasal polyps associated?

Answer 23

CF

Question 24

Complication of sinusitis+polyps

Answer 24

periorbital cellulitis

Question 25

choanal atresia

Answer 25

posterior end of nose unopen leading to recurrent infection and sinus problems, If bilateral cannot breathe

Question 26

What should you consider in epistaxis apart from digital trauma?

Answer 26

coagulopathy/ haematological abnormality

Question 27

Management of epistaxis

Answer 27

first aid, antibiotic ointments, packing, cauterisation

Question 28

History of throat problems

Answer 28

pain, discharge, loss of function, snoring, drooling, aspiration

Question 29

Tonsilitis causative agents

Answer 29

Bacterial - strep B and viral (EBV)

Question 30

What is a risk to the kidneys of tonsillitis?

Answer 30

glomerulonephritis

Question 31

Difference with acute and severe tonsillitis

Answer 31

supportive and antibiotics

steroids and IV antibiotics

Question 32

Complication of tonsillitis

Answer 32

Quinsy - peritonsillar abscess

Question 33

Differences in the anatomy of a child’s neck

Answer 33

large adenoids 
large epiglottis 
large tongue 
short neck 
sub glottis narrowest

Question 34

Laryngomalacia

Answer 34

cartilage not well formed and soft

Question 35

History of airway issues

Answer 35

foreign body, recent illness, feeding problems, stridor, epiglottis

Question 36

Neck abscess treatment

Answer 36

drainage and IV antibiotic

Question 37

4 types of neck abscesses

Answer 37

thyroglossal duct cyst
brachial cyst
cystic hygroma
cervical lymphadenopathy

Question 38

Cystic hygroma

Answer 38

lymphatic problem