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Pediatrics Module > Peds HEENT > Flashcards

Peds HEENT Flashcards

1
Q

Most likely organism to cause otitis externa

A

Pseudomonas

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2
Q

Tx of otitis externa

A

quinolone abx drops

+/- steroid

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3
Q

PE of serous otitis media

A

TM is dull with bubbles

No signs of infection; non-erythemous

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4
Q

serous otitis media treatment

A

self-limiting; 4-6 wks

if no improvement in 3 months, then chronic and needs ET tubes

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5
Q

Ear infection common in pilots and scuba divers

A

barotitis media (barotrauma)

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6
Q

barotrauma treatment

A

Valsalva

decongestant

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7
Q

Common etiologies of acute otitis media

A

viral: 80%
bacteria: strep pneumo, H-flu, Moraxella

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8
Q

Risk factors for otitis media infection

A

smoke exposure, nighttime bottle, pacifier use, asthma, allergies, ET tube dysfunction

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9
Q

Signs of otitis media

A

otalgia, hearing loss, fever, URI, ear tugging

PE: TM erythema, bulging, bubbles

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10
Q

When to use abx to treat otitis media?

A

< 6 mon: ALWAYS
6 mon - 2 yrs: if severe
over 2 yo: watch and see

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11
Q

ABX of choice for otitis media

A

Amoxicillin 80-90 mg/kg/day or Augmentin

Cefriaxone x 3 days if 1st line fails

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12
Q

What is a cholesteatoma?

A

collection of trapped epithelial tissue that grow on surface of TM and may cause erosion of mastoid bone

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13
Q

Possible complications of otitis media

A

cholesteatoma, acute mastoiditis

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14
Q

How to treat acute mastoiditis?

A

Hospitalize

IV abx to cover strep and staph

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15
Q

Criteria for ET tube placement

A
  • persistent serous OM x 6-12 wks

- recurrent OM 3x/6 mon or 4x/12 mon

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16
Q

“plugged ear” + recent URI + NO fever + retracted TM =

A

ET dysfunction

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17
Q

Common etiology of acute viral conjunctivitis

A

Adenovirus

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18
Q

How are viral, bacterial, and allergic conjunctivitis differentiated?

A

viral is watery discharge and lid edema

bacterial purulent discharge with more redness

allergic has watery discharge and periorbital puffiness; h/o allergies

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19
Q

Common etiology of acute bacterial conjunctivitis

A

staph aureus, staph epidermidis, strep pneumo, H flu

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20
Q

How to treat bacterial conjunctivitis?

A

Cipro

*need 24 hrs of abx to return to school

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21
Q

tx of allergic conjunctivitis

A

PO anti-histamines

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22
Q

diagnostic sign of oral candidiasis

A

white plaques in mouth that do not scrape off

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23
Q

tx of oral candidiasis

A

fluconazole (Nystatin)

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24
Q

bug causing strep throat

A

Group A beta-hemolytic strep (strep pyogenes)

25
Q

Centor Criteria for strep throat

A
  1. tonsilar exudates
  2. tender anterior cervical adenopathy
  3. fever
  4. No cough
26
Q

Labs to differentiate different causes of pharyngitis

A

rapid strep antigen test

Mono spot

27
Q

strep throat tx

A

penicillins

28
Q

sandpaper rash + pharyngitis + pastias lines

A

Scarlet fever

29
Q

Scarlet fever treatment

A

penicillin

30
Q

Jones criteria

A

criteria to dx Rheumatic Fever; must have 2 major or 1 major with 2 minor + prior hx of strep infection

Major: Joints, carditis, Nodules, Erythema marginatum, Sydenham’s chorea

Minor (inflamm markers): fever, arthralgia, increased ESR/CRP, leukocytosis, prolonged PR interval

31
Q

Viral causes of pharyngitis

A

Coxsackie, Adenovirus, Influenza, EBV, HIV

32
Q

Rheumatic fever tx

A

PCN, aspirin

cardiac eval

33
Q

Complications post strep infection

A

Scarlet fever
Rheumatic fever
Post-strep glomerulonephritis

34
Q

UA: cola-colored, RBC casts, hematuria, proteinuria. Dx?

A

glomerulonephritis

35
Q

What lab should be ordered to see if patient had recent strep infection?

A

ASO titer

36
Q

How is Mono differentiated from strep?

A

fatigue, tender POSTERIOR cervical adenopathy, caused by EBV virus

37
Q

hot potato voice and drooling indicates ________.

A

peritonsillar abscess

38
Q

What is tonsiladenitis?

A

extreme obstruction of nasopharygeal or oropharyngeal airways

39
Q

When are tonsils and adenoids removed surgically in children?

A

recurrent infections:
3 in each of past 3 yrs
5 in each of past 2 yrs
7 in past year

40
Q

Child who is irritable, drooling, and has neck in hyper-extended position.

A

epiglottitis

41
Q

Bug causing epiglottitis

A

H-flu type B

42
Q

XR shows ______ with epiglottis.

A

thumb sign

43
Q

Child with inspiratory stridor that worsens in supine position. otherwise normal exam.

A

laryngomalacia - congenital flaccidity of laryngeal

44
Q

XR with steeple sign pathognomonic for _______.

A

croup

45
Q

Croup tx

A

corticosteroids, racemic epinepherine

46
Q

Common causes of URI

A

Rhinovirus, coronavirus, RSV, parainfluenza

47
Q

If nasal polyps seen in patient younger than 10 yo, consider _____ and order ____ lab.

A

Cystic fibrosis

chloride sweat test

48
Q

Child with barky cough and stridor that is worse at night.

A

Croup

49
Q

Common cause of croup

A

parainfluenza, influenza, RSV

50
Q

choanal atresia

A

bony or membranous occlusion of 1 or both nasopharynx openings

51
Q

Most common causes of bacterial sinusitis

A

strep pneumo, H-flu, Moraxella

52
Q

1st line therapy for bacterial sinus infection

A

amoxicillin x 10-14 d

macrolide if allergic

53
Q

cleft palate associated with what chromosomal abnormalities?

A

trisomy 13 (Patau) and 18 (Edwards)

54
Q

Maternal phenobarbital use increases risk of __________ in newborn.

A

cleft lip/palate, neural tube defects, microcephaly

55
Q

Male child with hematuria, sensorineural hearing loss, and visual changes. What is next best step in dx?

A

renal bx to evaluate child for Alport syndrome

56
Q

Child with hearing loss and white forelock.

A

Warrdenburg syndrome

57
Q

sore throat + grey pseudomembrane

A

diphtheria

58
Q

How to differentiate acute OM and OM with effusion?

A

TM in AOM is bulging; discharge

TM in OME is neutral or retracted; bubbles

Pediatrics Module (15 decks)

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