Peds - EENT

Question 1

tropia

Answer 1

always present

Question 2

phoria

Answer 2

intermittent

Question 3

cause of psuedostrabismus

Answer 3

prominent epicantheal fold

Question 4

cover-uncover test:

uncovered eye moves to focus on object

Answer 4

TROPIA

Question 5

cover-uncover test:

covered eye moves to refocus once it is uncovered

Answer 5

PHORA

Question 6

esotropia NL in

Answer 6

infants <4mo

Question 7

chemical conjunctivitis in 1st 24h life

Answer 7

2nd to bacteriocidal gel

self-resolves over days

Question 8

copious purulent discharge from eyes in 1st 2-5d life

Answer 8

N. gonorhoroeae

Tx: ceftraizone + optho referral

Question 9

swelling of lid, scant discharge from eyes 1st 4-19d life

Answer 9

Chlomidia Traachomatis

Tx: Erythromycin (+ gonorrohea tx)

Question 10

unilateral conjunctivitis in neonate

Answer 10

Herpes

SYSTEMIC acyclovir

Question 11

MCC tearing in kids

Answer 11

nasolacrimal duct obstruction (dacryostenosis)

tears w/o conjuctiva erythema

Question 12

dacrostenosis when to refer

Answer 12

erythema, swelling, warmth, increased purulent discharge (systemic abx + optho ref)

Question 13

ET more horizontal or vertical in infants/young kids?

Answer 13

horizontal

Question 14

most specific finding OM ?

Answer 14

TM bulging

Question 15

OM patho

Answer 15

starts viral, inflammation of Eust tubs, bacterial invasion

Question 16

MC organism for OM

Answer 16

S pneumoniae, followed by H. flu

Question 17

When to def use amox for OM

Answer 17

<6mo
6mo-2y b/l w/ otorrhea
any age sev sx (toxic, >48h, >39c, ?f/u)

Question 18

When ok to watch OM

Answer 18

unilateral w/o otorrhea 6mo-2y

w/o otorrhea 2+

Question 19

Pain relief options for OM

Answer 19

topical analgesic >5yo

ibu/acetaminophen

Question 20

Critical info for parent for kid w/ OM

Answer 20

F/u 48-72h

Question 21

Blactamase R H flu-caused infection - treat w/?

Answer 21

Augmentin

Question 22

Indication for Tymp Tubes

Answer 22

• 3+ OM in 6mo

- 4+ in 12 mo w/ 1 in last 6mo

Question 23

Tx: otorrhea w/ tubes

Answer 23

ofloxacin, ciprofloxacin

Question 24

OME - tx

Answer 24

supportive, tubes if 3+ mo

not infectious!

Question 25

Viral rhinoviriu course

Answer 25

7-9 (up to 15d) begin w/ sore throat fever gone by 3rd day sx worst 3rd day

Question 26

When could it be sinusitis

Answer 26

Sx 10d + w/o improvement Sx worsen (+fever, +cough) 39C > 3d

Question 27

Allergens (non-seasonal) appear what age at earliest

Answer 27

10-12mo

Question 28

Seasonal allergies earliest

Answer 28

4yo

Question 29

Allergies - relief of congestion + itching/sneezing

Answer 29

congestion- steroid spray | itch/sneeze - antihistamine

Question 30

Important info regarding immunotherapy

Answer 30

6-12mo before improvement

Question 31

Definitive dx test for mono

Answer 31

EBV serology w/ +IGM

Question 32

Ulceration in post pharynx w/ rash on hands+feet

Answer 32

Coxsackie (HFM dz)

Question 33

HFM dz tx

Answer 33

symptomatic, slurry of Benedryl+Maylox

Question 34

epiglottitis tx

Answer 34

airway + IV ceftriaxone

Question 35

Croup organism

Answer 35

Parainfluenza

Question 36

Croup - what ages

Answer 36

6-36 mo, rare >6yo

Question 37

Croup - tx

Answer 37

Supportive if mild Dexamethasone IM once Nebulized racemic epi (ED) O2 (if desat)

Question 38

Centor 4 pt scale - what are the 4 pts

Answer 38

``` Fever Tonsillar exudates No cough Anterior cervical adenopathy (^^^ GAS likelihood) ```

Question 39

GAS - why treat

Answer 39

- px tonsillar abscess - reduce spread - px rhuematic fever, PANDAS

Question 40

Rhuematic fever

Answer 40

Any of the following | arthritis, carditis, chorea, erythema marginatum, SQ nodules

Question 41

Paradise freq of strep infection to get tonsils out

Answer 41

7 / y 5+ for 2y 3+ for 3y

Question 42

Croup contagious

Answer 42

1 week before-3week after sx