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08. Year 2: 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?

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
What is the aetiology of child with blocked/runny nose?
* 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
Rhinitis - aetiology
* Allergic vs non allergic
27
Rhinitis - investigations
* Allergen tests (IgE)
28
Rhinitis - treatment
Nasal douching, antihistamines, nasal steroids
29
Large adenoids - investigations
* Check for sleep apnoea
30
Epistaxis - pathology
* Bleeding nose
31
Epistaxis - epidemiology | (how commen, sex)
* Common * Males more than females
32
Epistaxis - management
* Appropriate first aid * Antibiotic ointments * Nasal packing
33
What should be considered in epistaxis?
Consider coagulopathy/haematological abnormalities
34
What is the study of the anatomy and diseases of the throat called?
Laryngology = study of the anatomy and diseases of the throat
35
What are examples of laryngological conditions?
* Sore throat * Airway issues * Hoarseness * Dysphagia
36
What is often seen in the history for a child with a sore throat?
* Throat symptoms * Pain (odynophagia, ear ache) * Discharge (cough) * Loss of function (dysphagia, breathing problems, hoarse voice) * Snoring, drooling
37
Causes of child with sore throat?
* Tonsillitis * Bacterial (b haem strep B) or viral (EBV) * Risk of glomerulonephritis * Antibiotics * Complications * Peritonsillar abscess * UVULA
38
Tonsillitis - most common organisms
* Bacterial (b haem strep B) or viral (EBV)
39
Tonsilitis - treatment
* Antibiotics
40
Tonsillitis - complications
* Peritonsillar abscess * UVULA
41
What is seen in the anatomy and physiology for children with airway issues?
* Large tongue * Large tonsils * Large/floppy epiglottis * Short neck * Sub glottis narrowest
42
What is seen in the history for child with airway issues?
* Usually as an emergency * History of foreign body * Recent illness * Feeding problems * Stridor
43
What are causes of child with airway issues?
* Epiglottitis * Laryngomalacia
44
What are neck lumps in children caused by?
* Thyroglossal duct cyst * Branchial cyst * Cystic hygroma * Cervical lymphadenopathy

08. Year 2: Head and Neck (13 decks)

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