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Head and Neck > Paediatrics - ENT > Flashcards

Paediatrics - ENT Flashcards

1
Q

What are examples of otological conditions?

A

Hearing loss
Otorrhea
Otalgia
Tinnitus
Vertigo

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2
Q

What are important considerations for diagnosing child with hearing loss cause?

A

Congenital vs acquired
Unilateral vs bilateral
Conductive vs sensorineural

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3
Q

What is commonly seen in the history of child with hearing loss?

A

Ear symptoms
Pain
Discharge
Loss of function (hearing loss, dizziness, tinnitus)
Speech development, school performance
Behaviour problems
Maternal perinatal infections
Delivery issues
Neonatal infections, drugs, jaundice

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4
Q

What are common ear symptoms in hearing loss in children?

A

Ear symptoms
Pain
Discharge
Loss of function (hearing loss, dizziness, tinnitus)

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5
Q

How do you assess the hearing of children of different age groups:

6 to 18 months
12 months to 3 years
3 to 5 years
4 years onwards

A

6 to 18 months
Distraction test
12 months to 3 years
Visual reinforced audiometry
3 to 5 years
Play audiometry
4 years onwards
Pure tone audiometry

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6
Q

What can an objective assessment of the auditory system be done by?

A

Otoacoustic emissions
Auditory brain stem responses
Tympanometry

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7
Q

What are examples of conditions that can cause hearing loss?

A

Otitis media with effusion/glue ear
Autoinflation
Grommet

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8
Q

What is ottitis media with effusion also called?

A

Glue ear

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9
Q

Ottitis media with effusion - risk factors

A

Day care, smoking, cleft palate, down syndrome

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10
Q

Ottitis media with effusion - treatment

A

Most improve by themselves within 3 months time
Treat with hearing aids or grommets

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11
Q

Ottitis media with effusion - aetiology

A

Eustachian tube dysfunction
Adenoidal hypertrophy
Resolving AOM

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12
Q

Ottitis media with effusion - signs and symptoms

A

Symptoms
Hearing loss
Speech delay
Behaviour problems
Academic decline
Imbalance

Signs
Dull TM
Fluid levels
Bubbles

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13
Q

What is the most common cause of a child with painful/discharging ear?

A

Otitis externa
Acute is common for 3-18 months olds
Short history, pain, fever, discharge
Microbiology important, haemophilus influenze, strep pneumonia, Moraxella catarrhalis
Treat with antibiotics (such as co-amoxiclav), also with grommets and adenoidectomy if recurrent

Complication of acute is it becoming chronic
Suspect in children with chronic discharging ear, hearing loss despite grommets
Investigation is CT scan
Requires mastoidectomy

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14
Q

what is Otitis externa treated with?

A

Treat with antibiotics (such as co-amoxiclav), also with grommets and adenoidectomy if recurrent

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15
Q

Otitis externa - presentation

A

Short history, pain, fever, discharge

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16
Q

Otitis externa - investigations

A

Microbiology important, haemophilus influenze, strep pneumonia, Moraxella catarrhalis

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17
Q

What microorganisms most commonly cause otitis externa in children?

A

Microbiology important, haemophilus influenze, strep pneumonia, Moraxella catarrhalis

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18
Q

Acute otitis externa - treatment

A

Treat with antibiotics (such as co-amoxiclav), also with grommets and adenoidectomy if recurrent

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19
Q

When should chronic otitis externa be suspected in children?

A

Suspect in children with chronic discharging ear, hearing loss despite grommets

20
Q

Chronic otitis externa - investigations

A

Investigation is CT scan

21
Q

Chronic otitis externa - treatment

A

Requires mastoidectomy

22
Q

What is the study of the ear and diseases called?

A

Otology

23
Q

What is the study of the nose and diseases called?

A

Rhinology = studying the anatomy and diseases of the nose

24
Q

What are examples of rhinology conditions?

A

Blocked nose
Runny nose
Sneezing
Reduced sense of smell
Facial pain

25
Q

What is often seen in the history for child with blocked/runny nose?

A

Nasal symptoms
Pain
Discharge
Loss of function (blocked nose, sense of smell)
History of foreign body
Feeding
Snoring, quality of sleep

26
Q

What is the aetiology of child with blocked/runny nose?

A

Rhinitis
Allergic vs non allergic
Allergen tests (IgE)
Nasal douching, antihistamines, nasal steroids
Large adenoids
Check for sleep apnoea
Foreign body
Unilateral
Needs EUA
Sinusitis and polyps
Overlapping symptoms with rhinitis/large adenoids
Acute vs chronic sinusitis
Associated with cystic fibrosis
Choanal atresia
Uncommon (1 in 6000-8000 births)
Bilateral manifests as unable to breathe

27
Q

Rhinitis - aetiology

A

Allergic vs non allergic

28
Q

Rhinitis - investigations

A

Allergen tests (IgE)

29
Q

Rhinitis - treatment

A

Nasal douching, antihistamines, nasal steroids

30
Q

Large adenoids - investigations

A

Check for sleep apnoea

31
Q

Epistaxis - pathology

A

Bleeding nose

32
Q

Epistaxis - epidemiology

(how commen, sex)

A

Common
Males more than females

33
Q

Epistaxis - management

A

Appropriate first aid
Antibiotic ointments
Nasal packing

34
Q

What should be considered in epistaxis?

A

Consider coagulopathy/haematological abnormalities

35
Q

What is the study of the anatomy and diseases of the throat called?

A

Laryngology = study of the anatomy and diseases of the throat

36
Q

What are examples of laryngological conditions?

A

Sore throat
Airway issues
Hoarseness
Dysphagia

37
Q

What is often seen in the history for a child with a sore throat?

A

Throat symptoms
Pain (odynophagia, ear ache)
Discharge (cough)
Loss of function (dysphagia, breathing problems, hoarse voice)
Snoring, drooling

38
Q

Causes of child with sore throat?

A

Tonsillitis
Bacterial (b haem strep B) or viral (EBV)
Risk of glomerulonephritis
Antibiotics
Complications
Peritonsillar abscess
UVULA

39
Q

Tonsillitis - most common organisms

A

Bacterial (b haem strep B) or viral (EBV)

40
Q

Tonsilitis - treatment

A

Antibiotics

41
Q

Tonsillitis - complications

A

Peritonsillar abscess
UVULA

42
Q

What is seen in the anatomy and physiology for children with airway issues?

A

Large tongue
Large tonsils
Large/floppy epiglottis
Short neck
Sub glottis narrowest

43
Q

What is seen in the history for child with airway issues?

A

Usually as an emergency
History of foreign body
Recent illness
Feeding problems
Stridor

44
Q

What are causes of child with airway issues?

A

Epiglottitis
Laryngomalacia

45
Q

What are neck lumps in children caused by?

A

Thyroglossal duct cyst
Branchial cyst
Cystic hygroma
Cervical lymphadenopathy

46
Q

what is the complication of sinusitis and polyps?

A

Infection of the tissue around the brain and spinal cord (meningitis)
Infection around the tissue around the eye (orbital cellulitis)
Infection of the sinus bones (osteitis)

47
Q

what is choanal atresia and who does it affect?

A

UNCOMMON (1 IN 6000-8000 BIRTHS)

BILATERAL MANIFESTS AS UNABLE TO BREATHE - unilateral may present later in life

Head and Neck (15 decks)

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