Peds HEENT Flashcards
Craniosynostosis- Eti
- Premature closure of cranial sutures
- Sporatic & idiopathic
- Sagital most common
Craniosynostosis- Sx
- Scaphocephaly, elongation of head AP
- Bradycephaly, increased growth L to R
- Should not compromise brain development, intracranial volume
Craniosynostosis- Tx
Preserve normal skull shape
- excise fused suture
- Best if performed within 6 months of life
Cleft lip/ palate- Eti
- Lip common in male, palate females
- Most common among asians
Cleft lip/ palate- Sx
- Isolated anomaly or syndromic of genetic disorder
- Nonsyndromic- inherited condition, recurrance 2-3%
- Syndromic- envt, single gene disorders or chromosomal
Cleft lip/ palate- Complications
- Feeding difficulties
- Airway obstruction
- recurrent otitis media
- language/ speech
Cleft lip/ palate- Dx
- Detected on prenatal US
- Genetic counseling
Cleft lip/ palate- Tx
Cleft palate clinic- surg
Strabismus/ amblyopia- Eti
- Strabismus- ocular misalignment
- 2% children
- Amblyopia- loss of visual acuity not correctable by glasses in otherwise healthy eye
Strabismus/ amblyopia- Sx
- Refer >3 months to opthal
- Most common cause of amblyopia is strabismus
Strabismus/ amblyopia- Dx
Penlight on pupils
Strabismus/ amblyopia- Tx
- Refer to opthal for tx: surg, botox, orthoptics
Dental caries- Eti
- Most common chronic disease of childhood
- Disease of poverty
- Strep mutans, lactobacilis
- Demineralization of tooth enamel through lower pH
Dental caries- Sx
- White, chalky decalcified area on gingival margin
- Brown = rampant decay
- Sensitive to temp changes
Dental caries- Tx
Prevention! Fluoride, brushing
- Chlorhexidine
Epistaxis- Eti
- Anterior portion of nasal septum (Kiesselbach area)
- Dryness, rubbing, picking
- Less than 5% due to von Willibrand
Epistaxis- Sx
- Bloody nose
- Telangiectasias, hemangiomas & varicosities
- Erythematous, raw surface with clots and crusts
Epistaxis- Tx
- Corticosteroid spray, saline irrigation, moisture
- Compression for 5 min
- ENT referral for > 30 min, onset before 2, low hct
- Cautery if doesn’t resolve with tx failure
Otitis media- Eti
Acute infection of middle ear, S. pneumonia & H flu.
- Eustachian tube dysfunction, bacterial colonization, URI, bottle feeding
Otitis media- Sx
- Mild to severe bulging of TM
- Middle ear effusion
- Otalgia
- Intense erythema of TM
Otitis media- Dx
- Pneumatic otoscope- decreased movement
Otitis media- Tx
- Ibuprofen/ acetaminophen
- Watch & wait
- Abx < 6 months
- Amoxacillin if sx don’t improve in 48-72 hrs
Otitis externa- Eti
- Cellulitis of soft tissues of external ear canal
- “swimmer’s ear”
- Trauma, heat/ moisture, q-tips
Otitis externa- Sx
- Pain
- Aural fullness
- Decreased hearing
- Manipulation causes sig. pain
- swollen, narrow ear canal
Otitis externa- Tx
- Pain mgmt
- Fluoroquinolone ear drops
Chronic otitis media- ETi
- Persistant otorrhea
- P. aeruginosa, S. aureus,
Chronic otitis media- Sx
- Chronic mucosal edema, ulceration & granulation
Chronic otitis media- Tx
Cleaning, culture & drainage
- Approp abx tx
Foreign body- Nose- Sz
- Foul smelling rhinorrhea, halitosis, bleeding
- Watch out for batteries- cartilage destruction
Foreign body- Nose- Tx
- Vigorous blowing
- Nasal decongestant
- Aligator forceps
Foreign body- Ear- Sx
- Common, cerumen, bugs & objects
- Attempt removable if reasonable
- Refer to ENT
- Watch out for batteries
