Pediatric ENT Flashcards
Bacterial conjunctivitis
- purulent
- EEC, tetracycline, polymyxin B
Gonococcal conjunctivitis
- must culture conjunctivitis
Allergic conjunctivitis
- stringy, tearing
- oral antihistamines
- refer to allergist/ophth
Viral conjunctivitis
- watery
- moderate: saline drops, antihistamines
- sulfacetamide 10 percent ophth solution for bacterial prophylaxis (Bleph 10)
Herpetic conjunctivitis
- bright red and irritated
- refer to ophthalmologist
When to refer strabismus?
fixed
≥ 6 months old
hypertropia and hypotropia
Otitis externa (Swimmer’s ear)
- fungal: black specks, odor, treat with antifungal
- bacterial: acetic acid, cortisporin (neomycin, polymyxin B)
Acute otitis media
- S. pneumoniae, H. influenzae
- Signs/symptoms: impaired TM mobility
- pain management (tylenol, benzocaine otic drops)
- watchful waiting 48 to 72 hours, then amoxicillin 80-90 mg/kg/day, BID for 10 days
- prevent with vaccines, avoid secondhand smoke
Otitis media with effusion (OME)
- hearing loss, popping, pressure, air bubbles behind TM, decreased membrane mobility
- Tx: Watchful monitoring x3 months
Which middle ear bone touches the umbro of the TM?
Stapes
Anvil
+++Malleus+++
Assessment of conductive hearing loss
Weber: lateralizes to AFFECTED ear
Rinne: abnormal in affected ear (AC less than BC)
Causative organisms of Pharyngitis/Tonsillitis
Viral: RSV, influenza, EBV
Bacterial: Group A beta hemolytic strep, gonorrhea
Centor criteria
Fever (greater than 100.4F)
Lack of cough
Exudate
ANTERIOR cervical adenopathy
Treatment of positive strep test
Pen VK 250mg PO TID x10 days
or if allergic, EEC 250mg PO QID x10 days
Epiglottitis
- bacterial: S. pneumoniae, H. flu
- high fever, drooling, respiratory distress, “thumb sign” on x-ray
- Immediate hospitalization
Croup
- viral infection of the larynx
- URI, barking cough, stridor, low grade fever, lungs clear
- “steeple sign” on x-ray
- treat mild cases as outpatient, supportive
- hospitalize severe cases, steroids and racemic epinephrine
Mononucleosis (Epstein Barr Virus)
- fever, severe pharyngitis, malaise, POSTERIOR cervical adenopathy, tonsillar exudate, splenomegaly, may have rash
- diagnose with Monospot
- supportive treatment, avoid contact sports 3 weeks to several months to avoid splenic rupture
Sinusitis (Rhinosinusitis)
- S. pneumoniae, H. influenzae, M. catarrhalis
- CT scan is preferred, culture
- augmentin x10 days, change to Levaquin if no improvement in 3 days (no quinolones in ≤ 9 years old)
- refer recurrent, chronic, or refractory sinusitis to ENT
Assessment of sensorineural hearing loss
Weber: lateralizes to UNAFFECTED ear
Rinne: normal in affected ear (not a good test for this)
