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3a > Paediatrics ENT > Flashcards

Paediatrics ENT Flashcards

1
Q

What is tonsillitis ? usually bacteria or virus ?

A

inflam of the tonsils
- often caused by viral infection - do not respond to Abx

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2
Q

What is the most common bacterial cause of tonsillitis ? 2nd ?

A

group A strep (strep progenies)
steroptoccus pnemoiae

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3
Q

tonsillitis presentaiton ?

A

fever, sore throat, painful swallowing (5-10 yrs)

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4
Q

tonsillitis OE ? where else would you check ? (2)

A
  • red, enflamed + enlarged tonsils +/- exudate
  • also inspect ears + cervical lymph nodes
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5
Q

What criteria can be used to determine whether to give Abx for tonsillitis ? (2)

A
  • Cenotr criteria
  • Fever pain score
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6
Q

Describe centor criteria. what for ? how many needed ?

A

probability that tonsillitis is due to bacteria (>3 => indicate Abx use)
- Fever (>38)
- tonsillar exudates
- absence of cough
- lymphadenopathy

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7
Q

Describe fever pain criteria. what for ? how many needed ?

A

probability that tonsillitis is due to bacteria (4-5 => indicate Abx use)
- Fever
- Purulence
- attended within 3 days of Sx onset
- Inflamed tonsil
- No cough/coryza

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8
Q

Tonsillitis Mx ?

A

exclude meningitis, epiglottis
- Fever pain/epiglottis
- Abx: Penecillin V (GAStrep)

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9
Q

Tonsillitis complications ? (2)

A
  • peritonsilar abscess
  • post strep glomerulonephritis
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10
Q

What is quinsy ?

A

aka peritonsilar abscess (tonsillitis complication)
- bacterial infection with trapped pus => abscess in tonsil region

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11
Q

Quinsy mangment ?

A

pertonsillar abscess
incision + drainage, Abx (broad spec: co-amoxiclav)

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12
Q

What is a tonsillectomy ?

A

surgical removal of tonsils (prevent further eps of tonsillitis)

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13
Q

indications for tonsillectomy ? frequency ? (3)

A

> 7 in 1 yr
5 per yr for 2 yrs
3 per yr for 3 yrs

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14
Q

tonsillectomy main complication ?

A

post tonsillectomy bleeding
- can be life threatening due to blood aspiration

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15
Q

What is otitis Media ? where is it ?

A

infection of the middle ear (space between the tympanic memebrae + inner ear)

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16
Q

What structures are in the middle ear ? (3)

A
  • cochlear
  • vestibular apparatus
  • Nerves
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17
Q

Where might bacteria enter to cause otitis media ?

A

bacteria enter form back of throat through eustachian tube
(associated with viral URTI)

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18
Q

what is the most common cause of otitis media ?

A

strep pneumonia
(common cause of tonsillitis and rhino sinusitis too)

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19
Q

Otitis media presentation ? (3)

A
  • ear pain
  • reduced hearing
  • general symptoms of URTI (fever, cough, coryza, malaise)
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20
Q

otitis media OE ?

A

otoscope to visualise tympanic membrane
- bulging red, inflamed

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21
Q

otitis media Mx ?

A

most cases resolve without Abx
(usually viral cause)

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22
Q

otitis media complications ?

A
  • otitis media with effusion (glue ear)
    (this can also cause otitis media)
  • hearing loss
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23
Q

what is glue ear ?

A

otitis media with effusion: middle ear become full of fluid => loss of hearing in that ear

24
Q

glue ear Mx ?

A
  • audiometry
  • usually resolves within 3 months
  • grommets (inserted into tympanic membrane)
25
Q

What two categories can hearing loss be split into ? (2)

A
  • congential
  • acquired (as result of illness in childhood)
26
Q

causes of congenital hearing loss ? (4)

A
  • maternal rubella
  • maternal cytomegalovirus
  • genetic deafness
  • Downs syndrome
27
Q

perinatal causes of hearing loss ? (2)

A
  • prematurity
  • hypoxia during/after birth
28
Q

causes of hearing loss after birth ? (4)

A
  • jaundice
  • meningitis/encephalitis
  • otitis media/glue ear
  • chemotherapy
29
Q

hearing loss presentation ?

A

Newborn hearing screening programme (NHSP)
- parental concern

30
Q

hearing loss Mx

A

audiometry
- MDT approach

31
Q

What is the blood source of most nose bleeds ?

A

littles area (after by little fingers)
(kiesselbach’s plexus)

32
Q

what can epistaxis be triggered by ? (5)

A
  • nose picking
  • colds
  • vigorous nose blowing
  • trauma
  • change in weather
33
Q

epistaxis Mx ?

A

usually resolve without medical assitance
- sit up + tilt forwards
- Squeeze soft part of nostrils
- spit out excess blood

34
Q

What is cleft lip

A

congenital condition here there is split or opening of upper lip

35
Q

what is cleft palate ?

A

defect exits in hard of soft palate => opening between mouth + nasal cavity
(cleft lip or palate can present together or separately)

36
Q

cleft lip and palate cause ?

A

most cases are just random

37
Q

cleft lip and palate complication ?

A
  • feedin, swallowing, speech, psychosocial
38
Q

cleft lip + palate Mx ?

A

MDT
- definitive: surgical correction (leaves subtle scar)

39
Q

What is tongue tie ? aka ?

A

ankaloglossia: baby born with short + tight inguinal frenulum => difficult to latch to breast

40
Q

tongue tie Mx ?

A

if affecting feeding : frenotomy

41
Q

What is squint ? aka ?

A

malalignment of the eyes
- strabismus

42
Q

what happens when eyes maligned ? how eyes develop from this ?

A

when eyes no aligned => images on retina don’t match => double vision
- during childhood (dev): brain copes with misalignment by reducing signal from less dominant eye => dominant + lazy eye (with gets progressively worse)

43
Q

causes of a squint ? most common ?

A

usually idiopathic
- hydopcephalus
- CP
- space occupying lesion
- trauma

44
Q

squint Ix ?

A

Hirschbergs test

45
Q

squint Mx ? by when ?

A

treatment needs to be started before 8 yrs (visual fields still developing)
- occlusive patch to cover good eye + force weak eye to develop

46
Q

What is hydrocephalus ? due to ? (2)

A

CSF building up abnormally (excessively) within brain + spinal cord
- due to CSF over production or issue with draining + absorbing CSF

47
Q

congenital causes of hydrocephalus ? (3) most common

A
  • aqueduct stenosis (most common)
  • arachnoid cysts
  • chromosomal abnormailites
48
Q

hydrocephalus presentation ? in babes

A

enlarged head circumference (cranial bone in babies don’t fuse till 2 yrs so increase pressure => head expand)
- bulging anterior fontanelle
- poor feeding
- Vomiting
- Poort tone
- Sleepiness

49
Q

hydrocephalus Mx ?

A

VP shunt

50
Q

Was is peri orbital cellulitis ? where affected ?

A

eyelid + skin infection in front of orbital septum (in front of eye)

51
Q

peri orbital cellulitis presentaiton ?

A

swollen, red, hot skin around eye lid + eye

52
Q

periorbital cellulitis Ix ?

A

must be differentiated from orbital cellulitis
- urent opthal assessment
- CT scan to distinguish

53
Q

periorbital cellulitis Mx ?

A
  • abx
  • can dev to orbital cellulitis so soldier admission
54
Q

what is orbital cellulitis ? sx ?

A

sign and life threatening emergency
- infection around eyeball involving tissue behind orbital septum
- pain with eye movement, reduce eye movement , vision changes, proptosis

55
Q

orbital cellulitis Mx ? (3)

A

emergency admission + IV Abx + surgical draining (if abscess)

3a (43 decks)

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