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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

Otitis externa - presentation

A
  • Short history, pain, fever, discharge
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15
Q

Otitis externa - investigations

A
  • Microbiology important, haemophilus influenze, strep pneumonia, Moraxella catarrhalis
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16
Q

What microorganisms most commonly cause otitis externa in children?

A
  • Microbiology important, haemophilus influenze, strep pneumonia, Moraxella catarrhalis
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17
Q

Acute otitis externa - treatment

A
  • Treat with antibiotics (such as co-amoxiclav), also with grommets and adenoidectomy if recurrent
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18
Q

When should chronic otitis externa be suspected in children?

A
  • Suspect in children with chronic discharging ear, hearing loss despite grommets
19
Q

Chronic otitis externa - investigations

A
  • Investigation is CT scan
20
Q

Chronic otitis externa - treatment

A
  • Requires mastoidectomy
21
Q

What is the study of the ear and diseases called?

A

Otology

22
Q

What is the study of the nose and diseases called?

A

Rhinology = studying the anatomy and diseases of the nose

23
Q

What are examples of rhinology conditions?

A
  • Blocked nose
  • Runny nose
  • Sneezing
  • Reduced sense of smell
  • Facial pain
24
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
25
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
26
Q

Rhinitis - aetiology

A
  • Allergic vs non allergic
27
Q

Rhinitis - investigations

A
  • Allergen tests (IgE)
28
Q

Rhinitis - treatment

A

Nasal douching, antihistamines, nasal steroids

29
Q

Large adenoids - investigations

A
  • Check for sleep apnoea
30
Q

Epistaxis - pathology

A
  • Bleeding nose
31
Q

Epistaxis - epidemiology

(how commen, sex)

A
  • Common
  • Males more than females
32
Q

Epistaxis - management

A
  • Appropriate first aid
  • Antibiotic ointments
  • Nasal packing
33
Q

What should be considered in epistaxis?

A

Consider coagulopathy/haematological abnormalities

34
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

35
Q

What are examples of laryngological conditions?

A
  • Sore throat
  • Airway issues
  • Hoarseness
  • Dysphagia
36
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
37
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
38
Q

Tonsillitis - most common organisms

A
  • Bacterial (b haem strep B) or viral (EBV)
39
Q

Tonsilitis - treatment

A
  • Antibiotics
40
Q

Tonsillitis - complications

A
  • Peritonsillar abscess
  • UVULA
41
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
42
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
43
Q

What are causes of child with airway issues?

A
  • Epiglottitis
  • Laryngomalacia
44
Q

What are neck lumps in children caused by?

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

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