Peds ENT Flashcards
Qtitis Externa definition
infection of the outer ear canal resulting in skin breakdown
Risk factors for otitis externa
swimming, excessive cleaning or scratching, devices
Common pathogens of otitis externa
P. aeruginosa, S. aureus, and fungi
Ssx of otitis externa
otalgia, pruritis, discharge, hearing loss, tragal tenderness
Mgmt of otitis externa
remove debris, topical antibiotics, ear wick if needed, pain control
what is acute otitis media
inflammation of the middle ear
what are the common pathogens in acute otitis media
strep pneumo, non-typable H. flu, M. Cat
ssx of acute otitis media
otalgia, irritablility, fever, pain, anorexia, vomiting
mgmt of acute otitis media
ear drops, Tylenol, ibuprofen
What is serous otitis media
presence of middle ear effusion without signs of acute infection
mgmt of serous otitis media
amoxicillin 10-14 days, myringotomy tube placement
what is audiometry
subjectively evaluates hearing
what are the 4 types of audiometry
behavioral observational 5
What is typanometry
measures TM compliance, rapidly identifies effusion in infants >6mos
What is the MCC for conductive hearing loss
fluid in middle ear
What other system is checked with ear abn
kidney
What is the etiology of allergic rhinitis
type 1 IgE allergic response; early - mast cell degranulation and histamine release; late - chronic nasal congestion d/t other cell involvement
What are the causes of perennial allergic rhinitis
dust mites, animal dander, mold, cockroaches
what is the allergic salute
pushing up tip of nose with hand resulting in transverse nasal crease
what is the palatal click
scratch palate with tongue resulting in click
mgmt of allergic rhinitis
nasal steroids, antihistamines, montelukast
ssx of acute viral rhinitis
sudden onset of clear or mucoid rhinorrhea, nasal congestion, +/- fever, +/- sore throat
duration of acute viral rhinitis
7-14 days
tx of acute viral rhinitis
ibuprofen/tylenol, humdified air, saline nasal drops, cough suppressants
MCC pathogens in sinusitis
strep pneumo, H. flu, M. Cat, Beta hemolytic strep
ssx of sinusitis
drainage, pressure, pain, fever, fatigue, anosmia, halitosis, cough, ear fullness
tx of sinusitis
amoxicillin/clavulanate then cephalosporin, bacrim, clinda if known to be strep
presentation of nasal foreign body
unilateral rhinorrhea foul smell, halitosis, bleeding, snoring or wheeze
Cause of epistaxis
trauma to kiesselback plexus
mgmt of epistaxis
compression, cotton under lip, vasoconstriction with 1% phenylephrine, nasal silver nitrate
MC pathogen of oral candidiasis
candida albicns
ssx of oral candidiasis
soreness of mouth, anorexia, white, curd-like patches on buccal muscosa
tx of oral candidiasis
nystatin oral suspension q6h for 1 week
Ssx of HSV 1
small ulcers on the buccal mucosa, anterior pillars, inner lips, tongue, gingiva, fever, tender cervical nodes
tx of HSV 1
oral acyclovir x 7 days
MC pathogen of herpangina
coxsackie A virus
Ssx of herpangina aka HFM
3 mm ulcers surrounded by halo, high fever, malasie, myalgias, conjunctivitis
ssx of hand-foot-mouth disease
ulcers anywhere in mouth, vesicles, pustules or papules on palms, soles, interdigital areas and buttocks
complication of hand-foot-mouth disease
encephalitis
ssx of viral pharyngitis
sore throat and fever
MC pathogens of bacterial pharyngitis
mycoplasma pneumoniae, chlamydia pneumo, C and G strep, arcanobacterium hemolyticum
ssx of bacterial pharyngitis
fever and sore throat
MCC with peritonsillar cellulitis
beta-hemolytic streptococcus
ssx of peritonsillar cellulitis/abscess
severe sore throat, tonsil bulges medially, edematous soft palate and uvula, trismus
tx for peritonsillar abscess
admit with IV PCN or clinda
MC pathogen of retropharyngeal abscess
beta-hemolytic streptococci and S. aureus
Xray presentation of retropharyngeal abscess
retropharyngeal space wider than C4
tx of retropharyngeal abscess
IV semisynthetic PCN or clinda, immediate surgical drainage
MC pathogen in epiglottitis
H flu type B
ssx of epiglottitis
sudden fever, dysphagia, drooling, muffled voice, cyanosis, soft stridor, sniffing position
tx of epiglottitis
Intubation, blood cultures, ceftriaxone
viral croup aka
laryngotracheobronchitis
etiology of viral croup
parainfluenza virus, RSV, influenza, rubeola, adenovirus, mycoplasma
ssx of viral croup
barking cough, stridor, fever absent or low-grade, stridor
Dx of viral croup
positive steeple sign on xray
what is the gold standard for strep test
throat culture - can result in false positives, takes 24-48 hours
when is rapid strep test used
when patient has anterior cervical node enlargement, palatal petechiae, beefy red uvula, tonsillar exudate
Indications for tonsillectomy
obstructive sleep apnea, recurrent infections, hypertrophy
Contraindications of tonsillectomy
bleeding d/o, acute tonsillar
what is laryngomalacia
persistent stridor in infants worse in supine position
What are laryngeal papillomas
benign warty growths
MC etiology of laryngeal papillomas
HPV 6, 11, 16
Age of onset of laryngeal papillomas
2-4 years
