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YEAR 5 SPECIALTIES KEY INFO > PAEDS 1: Respiratory and Childhood Infections > Flashcards

PAEDS 1: Respiratory and Childhood Infections Flashcards

1
Q

What are causes of neonatal tachypnoea?

A
  • transient tachypnoea of the new-born
  • respiratory distress syndrome
  • sepsis
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2
Q

What are key features of transient tachypnoea of the new-born?

A
  • within 4-6 hours of delivery
  • C-section, fast delivery
  • no O2 requirement
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3
Q

What are key features of respiratory distress syndrome?

A
  • prematurity
  • O2 requirement
  • persistent
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4
Q

What are key features of sepsis?

A
  • RF: maternal temp, PROM, GBS
  • other abnormal observations
  • persists > 4 hrs
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5
Q

What are risk factors for transient tachypnoea of the newborn?

A
  • <39 weeks (prematurity)
  • gestational diabetes
  • maternal asthma
  • male
  • SGA, or LGA
  • c-section
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6
Q

Sx of transient tachypnoea of the newborn?

A

tachypnoea (RR > 60), grunting, nasal flaring recessions, respiratory deterioration

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7
Q

Rx of transient tachypnoea of the newborn?

A
  • Saturations - pre and post ductal
  • examination +/- blood gas
  • initial obs and monitoring if TTN seems likely
  • persistent - septic screen, CXR
  • O2 requirement - NICU admission
  • consider - congenital anomalies, cardiac causes, inborn errors
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8
Q

What is the aetiology of respiratory distress syndrome?

A

Surfactant production starts at ~20 weeks - sufficient levels reached by 35-36wks.

Surfactant deficiency leads to increased surface tension of small alveoli - atelectasis - collapse

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9
Q

RFs of respiratory distress syndrome?

A

Prematurity, GDM, multiple gestation, birth asphyxia

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10
Q

Signs and Sx of Respiratory Distress Syndrome?

A

tachypnoea (RR > 60), cyanosis, within mins of delivery

uniformly decreased air entry, poor peripheral perfusion, work of breathing: grunting, recessions, accessory muscles

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11
Q

Rx of Respiratory Distress Syndrome?

A

Antenatally - steroids

Neonate - apply PEEP w/mask +/- O2, whilst monitoring sats

Examine HS, lung fields, assess prematurity if unknown gestation

Give surfactant via LISA or endotracheal tube

CXR + blood gas

Septic screen

Assess level of resp support required - high flow/CPAP/invasive ventilation

Consider: pneumothoraces, response to O2 therapy

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12
Q

What is a classical CXR finding of Respiratory Distress Syndrome?

A

“diffuse ground glass appearance”

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13
Q

What is bronchopulmonary dysplasia?

A

supplemental oxygen or respiratory support required >36 weeks corrected gestation

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14
Q

RFs for bronchopulmonary dysplasia?

A

Lower gestational age, lower birthweight, SGA, invasive ventilation <24hrs, clinical sepsis, CPR required

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15
Q

What are complications of bronchopulmonary dysplasia?

A

systemic HTN, pulmonary HTN, poor neurodevelopmental outcome, left ventricular hypertrophy

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16
Q

What is early intervention for bronchopulmonary dysplasia?

A

supplemental O2 (target sats >90% after first 10mins of life), NIV where able e.g. CPAP, early surfactant use, early caffeine initiation (<3 days), volume targeted ventilation, low dose dexamethasone

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17
Q

What is established management for bronchopulmonary dysplasia?

A

diuretic therapy, tracheostomy consideration, home oxygen support, RSV immunisation

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18
Q

What is the prognosis of bronchopulmonary dysplasia?

A

high rates of readmission in 1st year

reactive airway disease e.g. bronchiolitis, wheeze, asthma

may need home O2 for a period

impact on development and growth

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19
Q

What are some imaging changes you might see for bronchopulmonary dysplasia?

A

CXR - reticular markings
CT - bronchial wall thickening

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20
Q

What are some causes of tachypnoea/cough in a child?

A
  • Pneumonia
  • CF
  • TB
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21
Q

What are key features of pneumonia in a child?

A

Acute cough, fever >39C, cyanosis, raised RR, increased WOB, focal crackles, sats <95%, absent breath sounds

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22
Q

What is the diagnostic criteria of bacterial pneumonia?

A

consider where: persistent fever >38.5 with chest recessions and raised RR

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23
Q

What are complications of pneumonia?

A

empyema, lung abscess, atypical pathogen

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24
Q

What pathogens cause pneumonia in neonates?

A

GBS, Klebsiella, E. Coli, Listeria

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25
Q

What pathogens cause pneumonia in children <2yrs?

A

Viruses - RSV, influenza

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26
Q

What pathogens cause pneumonia in children 2-5yrs?

A

S. pneumoniae, H. influenzae

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27
Q

What pathogens cause pneumonia in children >5yrs?

A

Mycoplasma pneumoniae, S. pneumoniae

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28
Q

Rx of pneumonia in children?

A
  1. Assess severity to decide if admission needed. Red flags = sats <92, not responding to Abx, absent breath sounds, increasing WOB
  2. community management = anti-pyretics, fluids, identifying deterioration
  3. hospital management = O2 to maintain sats >92%, IVF as required (monitor U&Es)
  4. Follow up radiography - only in those w/round pneumonia, complications or persistent sx
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29
Q

When are antibiotics not used in pneumonia?

A

if <2 years w/mild sx (but review if persistent)

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30
Q

When are antibiotics indicated?

A

Oral if tolerated, IV if unable to tolerate/absorb, septicaemia, complicated pneumonia, Abx given if clear clinical diagnosis of pneumonia

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31
Q

What is the 1st line antibiotic for childhood pneumonia if non-severe sx?

A

amoxicillin (clarithromycin if pen allergic)

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32
Q

What is the 1st line antibiotic for childhood pneumonia if severe sx?

A

co-amoxiclav + clarithromycin

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33
Q

What is Cystic Fibrosis?

A

an inherited disease caused by mutations in a gene called the cystic fibrosis transmembrane conductance regulator (CFTR)

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34
Q

How is CF diagnosed?

A

Infant screening - immunoreactive trypsin test

Sweat test

Genetic testing (AR)

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35
Q

How does CF present?

A

Meconium ileus, faltering growth, recurrent/chronic resp disease, chronic sinus disease, acute/chronic pancreatitis

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36
Q

What are complications of CF?

A

malnutrition (fat soluble vitamin deficiences - ADEK), infertility, CF-related diabetes, reduced bone density

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37
Q

Rx of CF?

A

Support and education
MDT - specialist nurse, physio, dietitian, pharmacists, psychologist

Antibiotics - long term, IV courses, nebs, prophylaxis vs treatment

Physio - twice daily, extensive, airway clearance
Mucoreactive agents - DNAase, hypertonic saline

Monitor colonisation - eradication where needed

Enzyme supplements
Gene therapy e.g. Kaftrio (F508del mutation)

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38
Q

What is TB?

A

Infection caused by mycobacterium tuberculosis

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39
Q

What are RFs for TB?

A

born outside UK, high prevalence areas, <5yo, close contacts w/active TB, co-morbidities, e.g. HIV, DM, ESRF, underserved groups

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40
Q

Sx of TB?

A

cough, fever, night sweats, malaise

lymphadenopathy

faltering growth, fatigue, persistent fever

meningitis

children typically present w/non-specific signs and usually can’t expectorate <5yrs

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41
Q

Ix for TB?

A

CXR, deep cough sputum, gastric washings, induced sputum, rapid testing (NAAT), additional scans/tests if extra-pulmonary sx

Exposure testing:
- Mantoux test (tuberculin skin test)
- IGRA (blood test detecting response of WBC to TB antigens)

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42
Q

How is TB managed in children?

A

Active TB should be managed by a TB specialist

Active w/o CNS involvement = RIFE (+pyridoxine) 2/12, then just RI for 4/12

Active w/CNS = RIFE (+pyridoxine) 2/12, then just RI for 10/12

Consider drug susceptibility testing, fixed dose combo, daily directly observed therapy for MDR-TB

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43
Q

Summarise rhinitis/common cold?

A

Causes = viral (rhinoviruses, RSV, coronaviruses, parainfluenzae, influenza, human meta-pneumovirus)

Complications = predisposes to bacterial sinus and ear infections

Mx = supportive care, reassurance, education, safety netting

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44
Q

Summarise key features of tonsilitis?

A

Definition = palatine tonsil inflammation (tonsil grading system 0-IV)

Cause = adenovirus, EBV, group A strep

Sx = 5-7 days painful swallowing, fever, snoring, halitosis

Signs = red inflamed tonsils, white exudate spots, cervical lymphadenopathy

Mx = antibiotics if likely bacterial (Centor 3+)

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45
Q

What is the Centor criteria for tonsilitis?

A
  1. Tonsillar exudate
  2. Tender cervical LNs
  3. Fever
  4. Absence of cough
46
Q

Summarise otitis media?

A

Sx = pain, malaise, fever, coryza, peak age 6-15 months, seasonal

Signs = erythematous tympanic membrane, can be a tear, purulent discharge

Mx = analgesia (most resolve in 3 days), send swab of discharge, consider abx in some

47
Q

What are indications for Abx in otitis media?

A

systemically unwell, known RFs, unwell >4 days, bilateral in <2 years, persistent illness

48
Q

What are complications of otitis media?

A

mastoiditis, meningitis, facial nerve paresis, chronic otitis media, hearing loss

49
Q

Summarise epiglottitis?

A

AIRWAY EMERGENCY

Cause = HiB

Sx = sudden fever, sore throat, drooling, tripod positioning, toxic appearance

Mx = minimise stimulation, secure airway, antibiotics

RFs = lack of HiB vaccination

50
Q

What are the phases of Whooping cough (Bordatella Pertussis)?

A

Catarrhal Phase - 7-10 days, coryzal, mild cough, low grade fever, infectious

Paroxysmal phase - rapid violent coughing fits, thick mucus in bronchi, more common at night, fever absent

Convalescent phase - 2-3 weeks, gradual improvement, subsequent resp infections may cause recurrent paroxysms

51
Q

Who is at highest risk if they have whooping cough?

A

children <6 months old (low threshold for hospital admission)

51
Q

How might whooping cough present in a child <3 months old?

A

only apnoea

52
Q

How is whooping cough diagnosed?

A

NP aspirate or swab/pernasal swab (cough < 21 days)
PCR if cough < 21 days (more sensitive)
Serology in >16yo
Oral fluid testing if <16yrs, >2/52 cough - test for anti-pertussis toxin IgG

52
Q

How is whooping cough treated?

A

Admission for breathing difficulties or complications

Appropriate isolation - school exclusion 21 days from onset of untreated OR 48hrs if appropriate abx rx

1st line = macrolide if cough < 21 days

Supportive care

Manage close contacts - prophylaxis for priority groups (unimmunised infants, HCWs etc.)

Ensure up-to-date immunisations

53
Q

How does laryngomalacia present and how is it investigated and treated?

A

Sx = first weeks of life, resolves by 2 years usually, high pitched inspiratory stridor w/normal cry

Ix = flexible endoscopy

Rx = mild - no treatment; severe - elective surgery; life-threatening - adrenaline nebs, dex, vent support

53
Q

What is laryngomalacia?

A

Congenital airway disorder (immature laryngeal cartilage, omega shaped epiglottis)

Most common cause of neonatal stridor, usually self-limiting, can be life-threatening

54
Q

What are some differentials to consider if a child presents with a rash?

A

Chicken pox
Hand, foot and mouth disease
Measles
Scarlet fever
Erythema infectiosum
Rubella
Roseola infantum
Kawasaki disease

55
Q

What is chicken pox and how does it present and spread ?

A

crops of small papules - vesicles on erythematous base, crust over (stop being infectious), rash mixed of above stages over scalp, face, trunk centred

spreads via airborne respiratory droplets, contact w/vesicular fluid

56
Q

What groups are particularly at risk of chicken pox?

A

pregnancy, neonates, immunocompromised children

57
Q

What are complications of chickenpox?

A

bacterial superinfection (GAS)
encephalitis/cerebellitis
necrotising fasciitis
stroke

58
Q

How is chickenpox managed?

A

Supportive - antihistamines, moisturisers
Aciclovir in at risk populations
Vaccination!

59
Q

Outline the symptoms, spread and treatment of hand, foot and mouth disease?

A

Cause = coxsackie virus

small macular lesions become small vesicles (1w) then resolve w/o scars

small vesicles and ulcers around mouth, lips, palate, dorsal and palmar surfaces of hands and feet

spread via respiratory droplets and fluid from blisters, stool

Mx = analgesia - anaesthetic throat spray to aid oral intake, no exclusion from school or nursery

60
Q

What is erythema infectiosum?

A

Parvovirus B19 - firm red cheeks, feel hot (2-4 days), pink rash on limbs/trunk - lace like pattern, can persist for 6 weeks

Rash presents 2-3 days AFTER initial illness (mild fever, headache)

61
Q

How is erythema infectiosum diagnosed?

A

clinical - slapped cheek/lacy rash
serology - IgG, IgM
PCR

62
Q

How is erythema infectiosum managed?

A

analgesia, cold cloths for cheeks
supportive unless complications
no exclusion - infective prior to rash

63
Q

What are some complications of erythema infectiosum?

A

aplastic crisis in those w/blood disorders (e.g. sickle cell)

chronic infection in immunodeficient patients

64
Q

Describe symptoms of measles and it’s cause?

A

Cause = paramyxovirus

Sx = maculopapular rash + acute resp infection, spread from ears to head to trunk to extremities, Koplik spots (white spots on buccal mucosa), rash lasts 7d

65
Q

Describe the incubation, spread and prodrome of measles?

A

Incubation = 14 days
Spread = droplets
Prodrome = cough, coryza, conjunctivitis (3 C’s)

66
Q

How is measles treated?

A

Notify health protection team

High risk = <1 year, pregnant, immunocompromised

Usually self-limiting (1 week), supportive care

Exclusion - 4 days after development of rash, avoid contact

Safety netting - SOB, uncontrolled fever, convulsions

67
Q

What are some complications of measles?

A

otitis media
bronchopneumonia
subacute sclerosing
panencephalitis (fatal degenerative disease of CNS 7-10 yrs post infection)

68
Q

Describe the cause and symptoms of rubella?

A

small pink spots spreading to neck, trunk and extremities
can be itchy, skin may flake off as resolves
less widespread than typical measles
URTI sx may occur before rash
retroauricular lymphadenopathy common
mucosal involvement e.g. petechiae on soft palate and uvula

69
Q

How is rubella managed?

A

supportive (rest, fluids, analgesia)

70
Q

What are complications of rubella?

A

arthralgia/arthritis
thrombocytopenic purpura
otitis media
encephalitis

71
Q

What is the incubation, spread and symptoms of scarlet fever?

A

incubation = 2-5 days
spread = saliva, mucous
sx = illness 24-28h before rash, resolves in 1 week
rash = sandpaper like, worse in skin folds, starts on abdomen, strawberry tongue, peri-oral pallor, cervical LNs, illness inc. fever, sore throat, fatigue, headache

72
Q

How is scarlet fever diagnosed?

A

clinical
throat swab
looking for group A strep

73
Q

How is scarlet fever managed?

A

self-resolving
abx to prevent complications and transmission
exclusion = for 2 weeks if untreated OR 24h post antibiotics

Abx = 10d phenoxymethylpenicillin (Penicillin V)

NOTE: Second-line options for people with penicillin allergy are:
Birth to 6 months — clarithromycin for 10 days.
Non-pregnant adults and children aged 6 months to 17 years — azithromycin for 5 days, or clarithromycin for 10 days.
Pregnant or postpartum (within 28 days of childbirth) — erythromycin for 10 days.

74
Q

Outline the spread, cause, sx and mx of roseola infantum?

A

Cause = HHV6B/7
spread = droplet
infectious = first few days, peak 6m - 3yo
sx = 3-5 days illness, coryza, high fever, fatigue, as sx resolve get rash which lasts 2 days
rash = fine macular red/pink rash over trunk, can have soft palate and uvula lesions, painless, non-itchy, no blisters

Mx = none required, complications rare but may inc. febrile convulsions

75
Q

What is Kawasaki disease?

A

acute febrile illness - inflammation of small and medium sized blood vessels (esp. coronary arteries)

76
Q

What are the 5 cardinal signs of Kawasaki disease?

A

RASH - morbilliform, maculopapular, erythematous, persistent, skin peeling
ORAL SIGNS - red mouth/pharynx, strawberry tongue, red/cracked lips
EYE SIGNS - non exudative conjunctivitis
LIMB SIGNS - redness of plasma and soles +/- swelling, desquamation
LYMPHADENOPATHY - typically unilateral neck, at least one > 1.5cm

77
Q

What is the diagnostic criteria for Kawasaki disease?

A

Fever > 5 days
4/5 cardinal signs
absence of alternative illness

78
Q

How is Kawasaki disease managed?

A

analgesics/anti-pyretics
IVIG (5th - 10th day)
Low dose aspirin

79
Q

What are the phases of acute viral hepatitis?

A

Prodromal phase (3-10d) = flu sx, gastro sx, low grade fever

Icteric phase (1-3w) = jaundice, pruritus, fatigue, anorexia/nausea, hepatosplenomegaly, LNs

Convalescent phase (up to 6mths) = malaise, anorexia, weakness, hepatic tenderness

80
Q

Outline hepatitis A in children?

A

most children asx

RFs = travel, clotting factor disorders, IVDU, occupational risk

transmission = faecal-oral, contaminated water

Ix = HAV-IgM and IgG
Rx = supportive, HPT notification, treat nausea and itch, education, follow up w/repeat LFTs 1-2 weekly

Prognosis - majority fully recover in 6mths

Complications - 15% relapsing course, <1% liver failure

81
Q

Outline hepatitis B in children?

A

RFs = exposure, needlesticks, HIV +ve

Often no signs if chronic infection

Transmission = BBV

Ix = HBsAg (infectious), HBeAg (high replication), IgM (recent), HBV DNA (viral load)

Mx = supportive for acute, specialist referral for anti-viral consideration, HPT notification, baseline Ix

Infants = HBV screening for those born to +ve mothers, vaccination programme (+ HBIG)

82
Q

Outline hepatitis C in children?

A

RFs = high prevalence countries, IVDU, close contacts

Transmision - BBV

Ix = antibody and HCV RNA test

Mx = specialist referral (antiviral consideration), HPT notification, STI screening, baseline liver ix (NOTE: NO VACCINE)

83
Q

Outline hepatitis D symptoms and spread?

A

contact w/infected blood
prevent w/hep B vaccine, avoiding sharing needles, toothbrushes, razors or nail scissors

Sx = fever, fatigue, loss of appetite, N&V, abdominal pain, dark urine, pale stool/clay-coloured

84
Q

Outline hepatitis E symptoms and spread?

A

eating contaminated food or drinking contaminated water, prevent w/practicing good hygiene, avoid drinking water that has come from a potentially unsafe source

sx = nausea, fatigue, jaundice

85
Q

Outline Sx, spread, Ix and Mx of EBV?

A

Sx = fever, cervical lymphadenopathy, sore throat, non-specific rash/prodromal sx, hepatosplenomegaly

Spread = contact w/saliva, usually asx in children <3yrs

Ix = FBC, LFTs, EBV serology (IgG, IgM), monospot - heterophile antibodies

Mx = supportive care, sx last 2-4 wks, avoid contact sports for 1 month, avoid penicillins (rash)

86
Q

Outline symptoms and treatment of mumps?

A

painful swelling of parotid glands, fever, joint pain, headaches

spread via saliva droplets

lasts 1-2 weeks

supportive care

87
Q

What are complications of mumps?

A
  • viral meningitis
  • testicular swelling
88
Q

Outline the Sx, Ix, spread and Mx of headlice (pediculosis capitus)?

A

Sx = itchy scalp, brown eggs and white shells in hair, feeling of movement in hair

Spread = hair to hair contact, common

Ix = combing hair

Mx = wet combing, comb out eggs and shells after washing and conditioning hair, medicated lotions and sprays

89
Q

Outline the symptoms and management of rheumatic fever?

A

Complication of Group A strep infection

Sx of GAS = fever, pharyngitis, headaches

Sx of acute rheumatic fever = can be asx until cardiac presentation, consitutional sx may include arthralgia
- carditis (tachycarida, new murmur)
- derm (SC nodules, erythema marginatum)
- neuro (Syndenham’s chorea)

Mx = GAS eradication, symptomatic therapy (analgesia for arthritis), derm and neuro sx usually self-limiting, carditis can lead to HF and require valve replacement

90
Q

What is the diagnostic criteria for rheumatic fever?

A

Duckett-Jones diagnostic criteria (MAJOR and MINOR criteria)

MAJOR = CASES
C - carditis
A - arthritis
S - SC nodules
E - erythema marginatum
S - sydenhams chorea

MINOR = FRAPP
F - fever
R - raised ESR/CRP
A - arthralgia
P - prolonged PR interval
P - prev. RF

must be evidence of streptococcal infection + 2 major or 1 major + 2 minor

91
Q

What are the SCORTCH neonatal infections?

A

S = syphilis
C = CMV
O = other (parvovirus B19, enterovirus, Zika virus, chagas, malaria)
R = rubella
T = toxoplasmosis
C = chickenpox
H = HSV, HIV, HBV, HCV, HTLV-1

92
Q

What is important in a maternal history when suspecting a SCORTCH infection?

A

untreated or treated, lesions, exposure and risks, scans and serology, placental specimens

93
Q

What is important in examination when suspecting a SCORTCH infection?

A

HC and weight - plot, fully body exposure, hearing screen, ophthalmology, symmetry

94
Q

What are red flags for SCORTCH infection?

A

Symmetrical IUGR
Hx of miscarriage

95
Q

Outline the RFs, Sx, Ix and Mx of cellulitis?

A

Definition = deep bacterial infection of the skin

RFs = trauma, bites, burns, comorbidities e.g. DM, pathogen exposure

Sx = red, hot, tender, swollen, rapid spread, systemic sx, look for entry point

Ix (if required) = skin swab, inflammatory markers, cultures, US, skin biopsy

Mx = assess if admission required - systemic illness, oral or IV abx, mark area to monitor spread, monitor response to abx

96
Q

Outline the definition, Sx, Ix and Mx of dermatitis?

A

Definition = itchy inflammatory condition w/epidermal changes, classified by cause, location or clinical appearance

Acute Sx = redness, swelling, vesicles, blisters
Chronic Sx = skin thickening, hyperkeratosis, scaling, excoriation

Ix = skin scrapings, skin swab, patch testing, biopsy, bloods e.g. IgG, TFTs

Mx = allergen/irritant identification and avoidance, skin protection, topical therapies e.g. emollients, soaks, paste bandages, steroids, anti-inflammatories, UVB light therapy + systemic treatments if needed

97
Q

What is eczema and how does it usually present?

A

Chronic inflammatory skin condition causing dry, pruritic skin, episodic disease with flares and remission, typically atopic (assoc. w/eczema, asthma, hayfever)

Hx: onset - typically infancy, pattern - episode, trigger factors, itching - almost always present, atopic history (family Hx)

98
Q

Describe the difference between the acute and chronic manifestations of eczema and between children and infants

A

Acute = poorly demarcated erythema, vesicles, scaling, crusting

Chronic = thickened skin, hyperkeratosis

Children = often localised to flexures

Infant = face, scalp, extensor surfaces

Generally signs of excoriation

99
Q

Outline the management for eczema

A

Education on use of creams is crucial!

MILD = generous emollients, 1% hydrocortisone

MODERATE = increase steroid potency, consider dressings, continue to assess for infection, if frequent flares consider maintenance therapy

SEVERE = increase steroids, derm referral

100
Q

What is eczema herpeticum?

A

Medical emergency in <2 year olds

HSV infection - grouped vesicles and punched out lesions coalesce into widespread bleeding areas across body

Sx = fever, malaise, lymphadenopathy

Mx = admit + IV acyclovir

101
Q

What is a dermoid cyst and symptoms, investigations and management?

A

Definition = benign tumour, germ cell layers foreign to that body site

On skin - appear in early childhood (before 5yrs)

Other areas - can appear any time in life, mostly on face, can be associated to pit or sinus tract

Dx = clinical appearance, typical pathology on biopsy

Rx = surgical excision

102
Q

What is a key difference between orbital and peri-orbital cellulitis?

A

Orbital involves the eye
In peri-orbital the eye is unaffected

103
Q

What pathogens commonly cause orbital and periorbital cellulitis?

A

S. aureus
S. pneumoniae
H. influenzae

104
Q

What are the Sx, Ix and Mx of periorbital cellulitis?

A

Sx = gradual onset eyelid swelling, can extend to cheek and face, low grade fever, often spread from entry point e.g. scratch, bite, eczema

Ix = routine bloods, cultures, CT/MRI orbits and sinuses

Mx = IV antibiotics, monitor carefully

105
Q

What are the Sx, Ix and Mx of orbital cellulitis?

A

Sx = pt usually has more toxic appearance, high grade fever, proptosed eye & pain on eye movements, sight-threatening

Ix = routine bloods, cultures, CT/MRI orbits and sinuses

Mx = incision and drainage, high dose IV abx

106
Q

What is amblyopia and how is it managed?

A

AKA lazy eye

One eye cannot focus as clearly as the other leading to decreased vision

Common in <5yrs

Mx = glasses, eye patch or eye drops (blur vision in stronger eye), rx should start before 7 years of age

107
Q

What is Strabismus?

A

Definition = misalignment of the visual axis (eyes not aligned)

May be found on routine eye checks: birth, 8 weeks, school entry

‘Turning eye’ - taken seriously even if intermittent

108
Q

How do you examine squint?

A

General inspection - asymmetry, eye movements, nystagmus

Corneal light reflex - fixate on light and notice any asymmetry in reflection

Cover test - cover each eye in turn as focusing on object, manifest squint

Cover/uncover test - to look for latent squint

YEAR 5 SPECIALTIES KEY INFO (16 decks)

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