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MJ- Peds Block 1 > Peds HEENT > Flashcards

Peds HEENT Flashcards

1
Q

What are characteristics of bacterial conjunctivitis?

A

Thick, purulent, ropy discharge

Starts unilateral

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2
Q

What pathogen is MC in bacterial conjunctivitis?

A

Chlamydia trachomatis

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3
Q

What pathogen is MC in viral conjunctivitis?

A

Adenovirus (1 of the primary causes of colds/URI)

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4
Q

What are characteristics of viral conjunctivitis?

A

Watery discharge
Bilateral
Feels “gritty”

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5
Q

What are characteristics of allergic conjunctivitis?

A

Extremely pruritic

Profuse watery discharge/tearing

Bilateral

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6
Q

How do you treat symptomatic pts w/ allergic conjunctivitis?

A

Olopatadine in children ≥ 2

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7
Q

What are characteristics of periorbital cellulitis?

A

Preseptal (anterior to orbital septum)

Vision & EOMs normal

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8
Q

What are the 2 MC pathogens involved in periorbital cellulitis?

A

S. aureus & S. pyogenes

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9
Q

How do you treat periorbital cellulitis?

A

Oral/systemic abx

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10
Q

What are characteristics of orbital cellulitis?

A

Posterior to orbital septum

Pain w/ EOMs, proptosis

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11
Q

What are 2 complications of orbital cellulitis?

A

Acute ischemic optic neuropathy

Cerebral abscess

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12
Q

How do you dx & tx orbital cellulitis?

A

CT or MRI
Emergent optho consult
IV abx +/- drainage

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13
Q

What is the leading cause of acquired heart disease in US children?

A

Kawasaki disease

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14
Q

What is kawasaki disease?

A

Widespread inflammation of medium & small arteries, including coronary arteries

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15
Q

What are the diagnostic criteria for kawasaki disease?

A

Conjunctivitis: bilteral, non exudative

Mucositis: cracked lips, strawberry tongue, pharyngeal erythema

Polymorphous rash: skin peels

Lymphadenopathy

Extremity changes: edema

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16
Q

How do you treat KD?

A

IVIG + ASA (80-100mg)

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17
Q

What are complications of KD?

A

CV: coronary artery aneurysms

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18
Q

What is a corneal abrasion?

A

Loss of SF layer of corneal cells

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19
Q

What are the sx of a corneal abrasion?

A

Severe ocular pain*
Blephorospasm
Squinting, photophobia
Rubbing at eye

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20
Q

How do you dx a corneal abrasion?

A

Fluorescein stain, Wood’s lamp

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21
Q

How do you treat a corneal abrasion?

A

If FB –> optho referral

Erythromycin ointment, recheck in 24-48hrs

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22
Q

What is the MC cause of persistent tearing & eye discharge in infants/children?

A

Dacryostenosis (nasolacrimal duct obstruction)

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23
Q

How do you treat dacryostenosis?

A

Lacrimal sac massage in downward direction 2-3x/day

Refer if sx persist past 6mos

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24
Q

What is dacryocystitis?

A

Secondary infection of dacryostenosis

Infection of nasolacrimal sac –> erythema & edema

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25
Q

What pathogens cause dacrocystitis?

A

Bacteria that colonize URT

S. aureus, S. pneumo, S. pyogenes, S. viridans, M. catarrhalis, Haemophilus

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26
Q

How do you treat dacryocystitis?

A

If severe –> IV abx

If mild –> PO + topical abx

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27
Q

What causes AOM?

A

Allergies
Viral or bacterial infection
Eustachian tube dysfxn

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28
Q

What are sx of AOM in infants?

A

Fever

Poor feeding or sleeping, pulling ear, fussy

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29
Q

What are sx of AOM in older children?

A

Ear pain
Sinus tenderness
HA, dizziness
Decreased hearing

30
Q

What does AOM look like on PE?

A

Erythematous, bulging TM & MEE

If perforated: canal w/ exudate

31
Q

How do you treat AOM from birth to 2yo?

A

Immediately w/ abx

Can treat w/ observation in 6mos-2yrs if mild sx

32
Q

How do you treat AOM in children ≥ 2yo who appear toxic vs those w/ mild sx?

A

If toxic: immediately w/ abx

If mild: initial observation or treat

33
Q

What med is 1st line in AOM?

A

Amoxicillin 80-90mg/day x 10 days

34
Q

How do you treat OM in those w/ PE tubes?

A

Tympanostomy tube otorrhea

FQ drops if mild

35
Q

What is serous OM?

A

MEE w/out infection

36
Q

What are sx of serous OM?

A

Pain, pressure, “popping”
Decreased hearing
Disequilibrium

37
Q

What are RFs of serous OM?

A 
Undiagnosed AOM
FH of OM
Bottle feeding
Daycare
Exposure to smoke
38
Q

What are sx & PE findings of otitis externa (swimmer’s ear)?

A

Ear pain, unilateral
Malodorous discharge
Tragal tenderness

39
Q

How do you treat OE?

A

Abx drops w/ steroids, hydrocortisone

40
Q

How do you prevent swimmer’s ear?

A

Rubbing alcohol & white vinegar after swimming

41
Q

What is the atopic triad?

A

Seen in allergic rhinitis

  • Allergies
  • Asthma
  • Eczema
42
Q

What does allergic rhinitis look like on PE?

A 
Allergic shiners
Nasal crease
Pale, blue/boggy mucosa
Clear rhinorrhea 
Cobblestone pharynx
43
Q

How do you treat allergic rhinitis?

A

Intranasal steroid sprays

Antihistamines

44
Q

What are s/s of sinusitis?

A 
> 10-14 days of sx
Purulent nasal discharge
Sinus pain
\+/- fever
HA
Halitosis, dental pain
45
Q

What is the MC pathogen in sinusitis?

46
Q

How do you treat sinusitis?

A

1st line = Augmentin BID or

Amoxicillin BID

47
Q

What are characteristics of EBV?

A

Exudative tonsillitis
Cervical lymphadenopathy
Splenomegaly
Incubation = 4-8wks

48
Q

How do you treat EBV?

A

Spleen precautions 6-8wks

No contact sports

49
Q

What are sx of GABHS?

A

Fever, ST
Nausea, abd pain
Rash

50
Q

What does GABHS look like on PE?

A 
Exudative tonsillitis 
Enlarged lymph nodes
Palatal petechiae 
Halitosis, coated tongue 
\+/- scarlatiniform rash
51
Q

How do you dx GABHS? What is the gold standard?

A

Rapid strep antigen

Gold = culture

52
Q

What is the gold standard tx for GABHS?

A

Penicillin BID x 10 days

53
Q

What is the alternative tx for GABHS?

A

Amoxicillin BID x 10 days

54
Q

How do you treat GABHS if patient allergic to PCN?

A

1st gen cephalosporin (cephalexin)

Clindamycin

Macrolides: azithro, clarithro

55
Q

What is the “major criteria” for acute rheumatic fever?

A 
Migrating polyarthritis 
Carditis & valvulitis
Chorea
Erythema marginatum 
Subcutanous nodules
56
Q

What is the “minor criteria” for ARF?

A

Arthralgia
Fever
Elevated ESR or CRP
Prolonged PR interval

57
Q

What is considered high likelihood of ARF?

A

2 major OR

1 major & 2 minor

58
Q

How do you dx ARF & PGN?

A

ASO titers

59
Q

How do you treat ARF?

A

Amoxicillin

ASA

60
Q

What are sx of PGN?

A

Edema (#1)
Hematuria, proteinuria
HTN

61
Q

What are sx of coxsackie virus (hand, foot, & mouth)?

A

Oral lesions, ST

Maculopapular or vesicular rash

Fever, refuse to eat/drink

62
Q

What is herpetic gingivostomatitis?

A

HSV1

Ulcerative lesions of the gingiva & MMs that bleed if disturbed

63
Q

How do you treat herpetic gingivostomatitis?

A

Acyclovir
NSAIDs
Hydration

64
Q

What are the prodrome sx of measles?

A

Conjunctivitis, coryza, cough

Koplik’s spots (48hrs before rash)

65
Q

What are exanthem sx of measles?

A

Maculopapular, blanching rash

Face –> neck, trunk, extremities

66
Q

How do you dx measles?

67
Q

What is a complication of the measles?

A

Encephalitis

68
Q

What are characteristics of mumps?

A

Incubation = 14-18days

Parotitis

Unilateral, but can spread to contralateral parotid gland

Orchitis

Oophoritis

69
Q

What are sx of rubella?

A

Fever w/ postauricular & occipital adenopathy

Maculopapular rash: starts on face

70
Q

How do you treat impetigo?

A

Mild –> mupirocin topical

Severe –> Mupirocin ointment + PO abx

MJ- Peds Block 1 (7 decks)

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