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Osha 3a > Paeds ENT > Flashcards

Paeds ENT Flashcards

1
Q

What is otitis media?

A
  • infection of the middle ear
  • space between tympanic membrane and inner ear
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2
Q

What does the middle ear contain?

A
  • cochlea
  • vestibular apparatus
  • nerves
  • bacteria enters from eustachian tube
  • infection often preceded by viral URTI
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3
Q

Which bacteria cause otitis media?

A
  • MC: strep pneumoniae
  • H. influenzae
  • Moraxella catarrhalis
  • S. aureus
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4
Q

How does otitis media present?

A
  • ear pain
  • reduced hearing
  • URTI symptoms
  • balance issues
  • vertigo
  • discharge
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5
Q

What is seen on examination in otitis media?

A
  • bulging, red inflamed tympanic membrane
  • hole if perforation
  • discharge
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6
Q

What does a normal ear look like on otoscope?

A
  • pearly-grey, translucent, shiny membrane
    -cone of light reflecting
  • see malleus
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7
Q

How is otitis media managed?

A
  • most resolve w/out Abx
  • simple analgesia
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8
Q

What are some complications of otitis media?

A
  • effusion
  • (temporary) hearing loss
  • perforated ear drum
  • recurrent infection
  • mastoiditis
  • petrositis
  • meningitis
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9
Q

When should Abx be prescribed in otitis media?

A
  • significant co-morbidities
  • systemically unwell
  • immunocompromised
  • <2 years with bilateral otitis media
  • otorrhoea
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10
Q

When should a delayed prescription be used in otitis media?

A
  • after 3 days if symptoms have not improved or worsened
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11
Q

Which Abx are prescribed for otitis media?

A
  • 5-7 day course of amoxicillin
  • alternatives: erythromycin
  • clarithromycin
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12
Q

When should children with otitis media be referred for specialist assessment?

A
  • <3 mo and temp >38ºC
  • 3-6mo and temp >39ºC
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13
Q

What is mastoiditis?

A
  • infection spread from middle ear in otitis media
  • abscess formation in mastoid air spaces in temporal bone
  • leads to post auricular swelling and mastoid tenderness
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14
Q

What are grommets?

A
  • tiny tubes inserted into tympanic membrane
  • allows fluid to drain from middle ear to ear canal
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15
Q

What is glue ear?

A
  • otitis media with effusion
  • middle ear filled with fluid
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16
Q

What is the Eustachian tube?

A
  • connects middle ear to back of throat
  • helps to drain fluid
  • buildup if blocked
17
Q

What is the main symptom of glue ear?

A
  • hearing reduction or loss
  • main complication is otitis media
18
Q

How is glue ear investigated?

A
  • otoscopy
  • dull tympanic membrane
  • filled with air bubbles or fluid
19
Q

How is glue ear managed?

A
  • referral for audiometry
  • conservative management: resolves within 3 months
20
Q

What is the most common cause of tonsillitis?

A
  • Group A strep (Strep pyogenes)
  • Strep pneumoniae
21
Q

Which tonsils most commonly get infected in tonsillitis?

A
  • palatine
  • either side of back of throat
22
Q

How does tonsillitis present?

A
  • fever
  • sore throat
  • painful swallowing
  • poor oral intake
  • headache
  • vomiting
23
Q

What is seen on examination of tonsillitis?

A
  • red, inflamed, enlarged tonsils
  • with or without white patches
24
Q

Which age groups does tonsillitis affect?

A
  • 5-10 years
  • 15-20 years
25
Q

How is tonsillitis managed?

A
  • safety net
  • paracetamol/ibuprofen
  • Penicillin V 10 days
  • clarithromycin if allergic
26
Q

What frequency is indication for a tonsillectomy?

A
  • 7+ episodes in a year
  • 5+ episodes per year in 2 years
  • 3+ episodes per year in 3 years
27
Q

What is the FeverPAIN score?

A
  • Fever during past 24hrs
  • Purulence
  • Attended within 3 days of symptom onset
  • Inflamed tonsils
  • No cough
  • score of 4-5 gives 62-65% probability of bacterial tonsillitis
28
Q

What is the Centor criteria?

A
  • Fever >38
  • tonsillar exudates
  • absence of cough
  • lymphadenopathy
  • score ≥3 is 40-60% probability of bacterial tonsillitis
29
Q

What are congenital causes of hearing loss?

A
  • maternal rubella or CMV
  • genetic deafness
  • associated conditions e.g. Down’s
30
Q

What can cause deafness after birth?

A
  • jaundice
  • meningitis and encephalitis
  • otitis media/glue ear
  • chemotherapy
31
Q

How does hearing loss present in children?

A
  • ignoring calls or sounds
  • frustration or bad behaviour
  • poor speech and language development
  • poor schooling
32
Q

How is hearing screened for?

A
  • newborn hearing screening programme
  • testing in neonates
  • checks eardrums individually
33
Q

What is an audiogram?

A
  • document the volume at which they can hear different tones
  • each ear tested separately
  • tests air and bone conduction
34
Q

How is hearing loss managed?

A
  • MDT
  • SALT
  • ENT specalist
  • educational psychology
35
Q

What is audiometry?

A
  • children <3 tested for basic response to sound
  • older children tested with headphones and tones

Osha 3a (14 decks)

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