Pediatric EENT Flashcards
Common staphylococcal abscess on upper or lower eyelid
Hordeolum (stye)
Stye S/S
Hordeolum
-abrupt onset
-localized pain (acutely tender) and tender
*localized warm compress several times a day
Chalazion
beady nodule on eyelid, infection or retention cyst of the meibomian gland
*hard, non-tender cyst
*painless
-may cause visual distortion if the cyst is large to impress cornea, may cause astigmatism (blurry vision)
-Surgery for removal
Conjunctivitis
purulent discharge=bacterial
tx: erythromycin 0.5% ophthalmic ointment
*DO NOT USE STERIODS B/C INCREASED INTRAOCULAR PRESSURE AND ACTIVATION OF HERPES SIMPLEX
Cataracts in pediatrics
progressive opacity of the eye
-clouded, blurred, dim vision
-white fungus reflex( absent red reflex)
-refer for surgical removal
Strabismus
ocular misalignment of uncoordinated ocular muscles
-check CCN 3,4,6
-Esotropia: inward
-Exotropia: outward
-Hypertropia:upward
-Hypotropia: downward
-Hirschberg pupillary light reflex
is unequal
-refer to ophthalmology (H follows hand H)
inflammation of external auditory meatus
Swimmers ear/ Otitis externa
-tympanic membrane is normal
Tx:
Ciprofloxacxin and dexamethasone otic drops
Ofloxacin otic drops
*eye drops for ears ok! ear drops not for eyes!!
has steroids in mix not okay for eyes!!!
Acute Otitis Media (AOM)
Streptococcus Pneumoniae
Haemophilus influenza
-Tympanic membrane often bulges
Tx: watchful waiting 48-72hours
-Amoxicillin 80-90mg/kg/day, BID oral for 10 days
(no ABX in last 30 days)
-Amoxicillin-clavulante recommended for resistant strains
Presence of fluid in middle ears w/out signs and symptoms of AOM
Serious Otitis Media/ Otitis Media w/ Effusion (OME)
S/S
hearing loss
Fullness in ear
-Weber and Rhinne test suggestive of CONDUCTIVE hearing loss
Tx:
watchful monitoring 3months
types of hearing loss
conductive
sensineural
mixed
Decreased ability to conduct sound from external to inner ear
Conductive hearing loss
-Cerumen impaction/ foreign body
*sound lateralize to right ear=foreign body
-hematoma
-otitis media
-perforated TM
Sensorineural Hearing loss
impaired transmission of sound through nervous system
causes:
*syphilis
*Medication toxicity
-acoustic neuroma
-CNS disease
what test: sound should be heard equally in both ear and not lateralize (means to move towards)
Weber Test
-tuning fork on top of head
what test: air conduction (AC) > bone conduction (BC)
Rhinne Test
-tuning for at ear
during weber test sound lateralizes to affected ear? which hearing loss?
Conductive hearing loss
during Weber test sound lateralize to unaffected ear? which hearing loss?
Sensorineural hering loss
during rhinne test, abnormal sound in affected ear (AC<BC). which hearing loss
Conductive hearing loss
during Rhinne test, normal in the affected ear, which hearing loss?
Sensorineural
Viral Rhinitis
AKA common cold
-rest and hydration
-no ABX
Sinusitis (rhinosinusitis)
caused by.
S. pneumoniae
H. influenzae
M. catarrhalis
S/S
teeth hurt/ dull throbbing pain worsening when head is dependent
Dx made on clinical presentation
Tx
Amoxillin-clavulante for 10 days
(if no ABX in past 30 days)
Epitaxis
S/S
Friable (touches and bleeds), possible septal erosion caused by inhaled substances
Management:
-Sit upright
*pressure at Kiesselbach’s plexus (i.e triangle): anterior inferior aspect of the nasal septum
(end of bony ridge) for 10 min
-apply ice
Pharyngitis/ Tonsilitis
ABX only for streptocccal Infection
-penicillin VK 250mg orally 2-3times daily for 10days
Epiglotitis
Sudden severe swelling of the epiglottis from bacterial infection
*DROOLING
*THUMB SIGN - thumb-shape appearance on XR of neck
*IMMEDIATE HOSPITALIZATION
-do not perform a pharyngeal exam
Croup
Parainfluenza viral infection of the larynx
peaks 6months-3years
-bark like cough
-if stridor, red flag, severe
-*STEEPLE SHAPE appearance, narrowing of the trachea on XR of neck
Infectious Mononucleosis
-infection due to Epstein-Barr virus (EBV)
-ages 15-25
Physical exam
-Posterios cervical lymadenopathy
-splenomegaly (no contact sports 3weeks to several months)
*anterior cervical lymadenopathy = strep
