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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
Q

What is serous otitis media?

A

middle-ear effusion (fluid) w/o infection

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26
Q

Tx for serous otitis media

A

Usually self-limited

No abx/steroids/antihistamines/decongestants

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27
Q

Tx for otitis externa w/o TM perforation and w/ TM perforation

A 
w/o= polymyxin B drops
perforation= fluoroquinolone (Ciprodex)
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28
Q

Atopic triad

A

allergies
asthma
eczema

29
Q

PE findings of allergic rhinitis

A
  • allergic shiners
  • Dennies lines (under eyes)
  • nasal crease
  • pale, blueish/boggy nasal mucosa
  • clear rhinorrhea
  • “cobblestone” appearance of posterior pharynx
30
Q

Tx options for allergic rhinitis

A

-Intranasal steroid spray: >2yo (Nasacort), >4 yo (Flonase)

Antihistamines

  • Oral (diphenhydramine)
  • Intranasal (Azelastine)
31
Q

What makes kids less likely to have sinusitis?

A

Frontal sinus does not develop till age 5-7

Sphenoid sinus at age 9

32
Q

Sx of sinusitis

A

> 10-14 d of sx w/o improvement**

  • purulent nasal d/c
  • sinus pain
  • +/- fever
  • halitosis
  • HA
  • dental pain
33
Q

1 bacterial cause of sinusitis?

A

S. pneumoniae

& H flu

34
Q

1st line tx for bacterial sinusitis

A

Amoxicillin-clavulanate (Augmentin)
or
Amoxicillin

35
Q

If child has recurrent sinus infections, what dz do you need to consider?

A

Cystic fibrosis

36
Q

Is pharyngitis most commonly caused by bacteria or virus?

A

viral!

aka no abx

37
Q

Sx of Epstein Barr Virus (infectious mononucleosis)?

A
  • exudative tonsilitis
  • cervical lymphadenopathy
  • fever, malaise
  • HA
  • spenomegally
38
Q

What is the incubation period for Epstein Barr virus

A

4-8 weeks

39
Q

Tx for Epstein Barr Virus

A
  • spleen precautions x6-8 weeks (no contact sports, rough-housing)
  • monitor fluids and airway
  • no abx
  • analgesics
40
Q

If a child is dx and treated for strep pharyngitis and they develop a diffuse morbilliform rash, what dx do they have?

A

Epstein Barr virus

41
Q

Sx of GABHS in >3yo, <3 yo

A

> 3= abrupt onset, HA, nausea, abdominal pain, rash, fever, sore throat

< 3= atypical sx, nasal congestion, low grade fever

42
Q

PE findings of GABHS

A
  • exudative tonsilitis
  • enlarged tender anterior cervical lymph nodes
  • palatal petechiae
  • +/- scarlastiniform rash
  • halitosis
  • coated tongue
43
Q

What needs to be done in children/adolescents w/ negative rapid strep?

A

throat culture

44
Q

Abx tx for GABHS pharyngitis

A

Gold standard= Penicillin x 10 days (but not palatable)

Alternative= Amoxicillin x10 d

45
Q

Major criteria for Jones criteria

A

-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
Q

minor criteria for Jones criteria

A
  • arthralgia
  • fever
  • elevated ESR or CRP
  • prolonged PR interval
47
Q

High likelihood for acute rheumatic fever =?

A

2 major
or
1 major & 2 minor

48
Q

1 cause of acquired valve dz worldwide

A

Rheumatic heart disease

49
Q

How do you dx and treat acute rheumatic fever?

A

dx= antistreptolysin-O titers (ASO)

Tx= amoxicillin, aspirin, eval for carditis

50
Q

What are sx of post-streptococcal glomerulonephritis?

A
  • # 1= edema!
  • hematuria (tea-colored urine)
  • proteinuria
  • HTN (Na+ H2O retention)
51
Q

How do you dx post-streptococcal glomerulonephritis?

A

Antistreptolysin O titers (ASO titers)

52
Q

MC cause of peritonsillar abscess?

A

S. pyogenes

53
Q

Sx of Coxsackie virus (Hand, foot, and mouth dz)

A
  • 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
Q

Tx for Coxsackie virus

A

supportive

55
Q

What are sx of herpetic ginivostomatitis

A
  • 3-4 day prodrome
  • fever, sleeplessness, HA
  • ulcerated lesions that bleed if disturbed***
56
Q

Sx of measles

A

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
Q

Incubation period for Mumps

A

14-18 d

58
Q

Sx of Mumps

A
  • parotitis (tenderness, swelling, “earache”)

- begins unilaterally, may spread to the contralateral parotid gland

59
Q

What are possible complications of Mumps?

A
  • Orchitis (fever, severe testicular pain and swelling)

- Oophoritis

60
Q

Rubella sx in children

A

mild illness in children

  • fever w/ postauricular and occipital adenopathy
  • acute onset of maculopapular rash- starts on face
61
Q

Consequences of congenital Rubella syndrome

A
  • hearing loss, mental retardation, cardiovascular defects
  • retarded growth
  • pururic “blueberry muffin” rash at birth
  • jaundice, thrombocytopenia, deafness
62
Q

How do you describe diaper candidiasis?

A
  • “beefy rad” erythema w/ satellite lesions
  • secondary infection w/ C. albicans
  • involves skin folds
63
Q

Tx for diaper candidiasis

A
  • Clotrimazole cream
  • Nystatin ointment

NO STEROIDS

64
Q

What is cradle cap?

A

seborrheic dermatitis

  • greasy, yellowish scales on scalp
  • usu 3-12 weeks old
65
Q

Tx for cradle cap?

A
  • apply emollient (petroleum jello, baby oil)

- use soft baby-brush

66
Q

Cause of Impetigo

A

Staph aureus (poss Strep)

67
Q

Is bullous or non-bullous impetigo MC? What are sx?

A

Non-bullous

thick, honey-colored crust w/ surrounding erythema

68
Q

Tx for Impetigo

A

Mupirocin (Bactroban) topical abx 3x a day x5 days

1. Disciplines 2 (11 decks)

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