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1. Disciplines 2 > Peds HEENT > Flashcards

Peds HEENT Flashcards

1
Q

Describe bacterial conjunctivitis

A
  • thick, purulent, ropy discharge
  • usually unilateral
  • eyelids “crusted shut in am”
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2
Q

Pathogens responsible for bacterial conjunctivitis is kids?

newborns?

A

kids= S. pneumoniae, H. influenza, M. cattarhalis

newborns= Chlamydia trachomatis

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3
Q

Primary cause of “colds” (URI) and viral conjunctivitis

A

adenovirus

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4
Q

Describe viral conjunctivitis

A
  • typically bilateral
  • injected conjunctiva
  • discharge is typically watery
  • may be a/w URI sx, feels “gritty”
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5
Q

Describe allergic conjunctivitis

tx?

A
  • extremely prutritic
  • usually bilateral
  • profuse watery discharge/tearing
  • a/w allergic rhinitis

tx= olopatadine in >2 yo

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6
Q

MC organisms a/w preseptal/periorbital cellulitis

A

s. aureus and s. pyogenes

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7
Q

Sx of preseptal/periorbital cellulitis

A
  • erythematous and edematous eyelids, pain, and mild fever

- vision and EOMs are normal

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8
Q

Sx/Tx of Orbital cellulitis

A
  • pain w/ EOMs, proptosis
  • decreased vision
  • +/- fever
  • Emergent Ophthalmology consult
  • IV abx
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9
Q

What is Kawasaki disease?

A

widespread inflammation of medium and small arteries, including coronary arteries

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10
Q

Leading cause of acquired heart disease in children in the US

A

Kawasaki disease

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11
Q

Sx of Kawasaki disease?

A
  • Fever
  • conjunctivitis
  • mucositis
  • polymorphous rash and desquamation
  • lymphadenopathy (LC sx)
  • edema, redness of palms/soles
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12
Q

If a patient presents with 5 days of fever, what disease do you need to be thinking about?

A

Kawasaki disease

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13
Q

Tx of Kawasaki disease

A

IVIG (IV immune globulin)

+ Aspirin (80-100mg/kg/d)

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14
Q

Complications of Kawasaki disease

A

Coronary artery aneurysms -> MI, infarction, sudden death

highest risk <1 yo and >9 yo

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15
Q

Sx of corneal abrasion

A
  • severe ocular pain
  • red, watery eye
  • rubbing eye
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16
Q

MC cause of persistent tearing and discharge in infants and children

A

Decryostenosis (nasolacrimal duct obstruction)

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17
Q

Secondary infection of Dacryostenosis?

A

Dacryocystisis

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18
Q

Tx for Dacryocystisis

A

IV abx if severe

if mild PO abx

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19
Q

Clinical presentation of AOM in Infants vs children

A

infants= poor feeding, pulling at ear, poor sleeping, fussiness

Children= c/o ear pain, sinus tenderness, HA, decreased hearing

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20
Q

PE findings of AOM

A
  • erythematous, bulging TM and middle ear effusion

- if perforation of TM: canal w/ exudate

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21
Q

For children <6 mo and children up to 2 yrs w/ AOM, do you treat with abx or observe?

A

treat immediately w/ abx

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22
Q

For a healthy child w/ unilateral OM w/ mild sx and no drainage, what is treatment plan?

A

observe x48 hrs

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23
Q

abx for AOM

A

1st= Amoxicillin 80-90mg/kg per day x 10 d
2nd= Augmentin
3rd=Cefdinir

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24
Q

Tx of OM in a child w/ PE tubes

A

otic fluoroquinolone abx drops

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25
What is serous otitis media?
middle-ear effusion (fluid) w/o infection
26
Tx for serous otitis media
Usually self-limited No abx/steroids/antihistamines/decongestants
27
Tx for otitis externa w/o TM perforation and w/ TM perforation
``` w/o= polymyxin B drops perforation= fluoroquinolone (Ciprodex) ```
28
Atopic triad
allergies asthma eczema
29
PE findings of allergic rhinitis
- allergic shiners - Dennies lines (under eyes) - nasal crease - pale, blueish/boggy nasal mucosa - clear rhinorrhea - "cobblestone" appearance of posterior pharynx
30
Tx options for allergic rhinitis
-Intranasal steroid spray: >2yo (Nasacort), >4 yo (Flonase) Antihistamines - Oral (diphenhydramine) - Intranasal (Azelastine)
31
What makes kids less likely to have sinusitis?
Frontal sinus does not develop till age 5-7 Sphenoid sinus at age 9
32
Sx of sinusitis
>10-14 d of sx w/o improvement** - purulent nasal d/c - sinus pain - +/- fever - halitosis - HA - dental pain
33
#1 bacterial cause of sinusitis?
S. pneumoniae | & H flu
34
1st line tx for bacterial sinusitis
Amoxicillin-clavulanate (Augmentin) or Amoxicillin
35
If child has recurrent sinus infections, what dz do you need to consider?
Cystic fibrosis
36
Is pharyngitis most commonly caused by bacteria or virus?
viral! aka no abx
37
Sx of Epstein Barr Virus (infectious mononucleosis)?
- exudative tonsilitis - cervical lymphadenopathy - fever, malaise - HA - spenomegally
38
What is the incubation period for Epstein Barr virus
4-8 weeks
39
Tx for Epstein Barr Virus
- spleen precautions x6-8 weeks (no contact sports, rough-housing) - monitor fluids and airway - no abx - analgesics
40
If a child is dx and treated for strep pharyngitis and they develop a diffuse morbilliform rash, what dx do they have?
Epstein Barr virus
41
Sx of GABHS in >3yo, <3 yo
>3= abrupt onset, HA, nausea, abdominal pain, rash, fever, sore throat < 3= atypical sx, nasal congestion, low grade fever
42
PE findings of GABHS
- exudative tonsilitis - enlarged tender anterior cervical lymph nodes - palatal petechiae - +/- scarlastiniform rash - halitosis - coated tongue
43
What needs to be done in children/adolescents w/ negative rapid strep?
throat culture
44
Abx tx for GABHS pharyngitis
Gold standard= Penicillin x 10 days (but not palatable) Alternative= Amoxicillin x10 d
45
Major criteria for Jones criteria
-migrating polyarthritis (large joints) - carditis and valvulitis - Chorea (involuntary movements, muscular weakness, and emotional disturbances) - erythema marginatum (erythematous rash, nonpruritic, spares face) - subcutaneous nodules
46
minor criteria for Jones criteria
- arthralgia - fever - elevated ESR or CRP - prolonged PR interval
47
High likelihood for acute rheumatic fever =?
2 major or 1 major & 2 minor
48
#1 cause of acquired valve dz worldwide
Rheumatic heart disease
49
How do you dx and treat acute rheumatic fever?
dx= antistreptolysin-O titers (ASO) Tx= amoxicillin, aspirin, eval for carditis
50
What are sx of post-streptococcal glomerulonephritis?
- #1= edema! - hematuria (tea-colored urine) - proteinuria - HTN (Na+ H2O retention)
51
How do you dx post-streptococcal glomerulonephritis?
Antistreptolysin O titers (ASO titers)
52
MC cause of peritonsillar abscess?
S. pyogenes
53
Sx of Coxsackie virus (Hand, foot, and mouth dz)
- oral lesions (herpangina), esp. on tongue and tonsillar pillars - maculopapular or vesicular rash on hands and feet - usually < 5 yo, daycare outbreaks - low grade fever (101F) - refusal to eat/drink
54
Tx for Coxsackie virus
supportive
55
What are sx of herpetic ginivostomatitis
- 3-4 day prodrome - fever, sleeplessness, HA - ulcerated lesions that bleed if disturbed***
56
Sx of measles
Prodrome - fever, malaise, anorexia - conjunctivitis, coryza, cough - Koplik's Spots= whitish elevations on an erythematous base opposite the molars Exanthem - maculopapular, blanching rash - beginning on face and spreading to neck, trunk, and extremities
57
Incubation period for Mumps
14-18 d
58
Sx of Mumps
- parotitis (tenderness, swelling, "earache") | - begins unilaterally, may spread to the contralateral parotid gland
59
What are possible complications of Mumps?
- Orchitis (fever, severe testicular pain and swelling) | - Oophoritis
60
Rubella sx in children
mild illness in children - fever w/ postauricular and occipital adenopathy - acute onset of maculopapular rash- starts on face
61
Consequences of congenital Rubella syndrome
- hearing loss, mental retardation, cardiovascular defects - retarded growth - pururic "blueberry muffin" rash at birth - jaundice, thrombocytopenia, deafness
62
How do you describe diaper candidiasis?
- "beefy rad" erythema w/ satellite lesions - secondary infection w/ C. albicans - involves skin folds
63
Tx for diaper candidiasis
- Clotrimazole cream - Nystatin ointment NO STEROIDS
64
What is cradle cap?
seborrheic dermatitis - greasy, yellowish scales on scalp - usu 3-12 weeks old
65
Tx for cradle cap?
- apply emollient (petroleum jello, baby oil) | - use soft baby-brush
66
Cause of Impetigo
Staph aureus (poss Strep)
67
Is bullous or non-bullous impetigo MC? What are sx?
Non-bullous thick, honey-colored crust w/ surrounding erythema
68
Tx for Impetigo
Mupirocin (Bactroban) topical abx 3x a day x5 days

1. Disciplines 2 (11 decks)

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