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