PEDS HEENT Flashcards
H. Flu, M. Cat and Strep pneumo are causes of what disorder?
Bacterial conjunctivitis
pt. presents with unilateral injection, thick purulent discharge.
bacterial conjunctivitis
How do you treat bacterial conjunctivitis
erythromycin drops, TMP-Polymyxin B drop
neonatal conjunctivitis commonly caused by what?
chlamydia trachomatis
gold standard for diagnosis of neonatal conjunctivitis?
NAAT
Tx for neonatal conjunctivitis
erythromycin 50mg/kg PO QID for 14 days
rapidly progressive
profuse purulent discharge
severe and sight threatening
chemosis…
hyperacute bacterial conjunctivitis
what causes hyperacute bacterial conjunctivitis
n. gonorrhoeae
Tx for n. gonorrhoeae bacterial conjunctivitis
ophthalmo referral + hospitalization
foreign body sensation
opacity w/ penlight
Hx of contact wearing
pseudomonal Keratitis
Tx for keratitis?
anti-pseudomonal abx, urgent referral
burning, gritty sensation
watery, stringy discharge
LAD
viral conjunctivitis
cause of viral conjunctivitis?
adenovirus
Tx for viral conjunctivitis?
sx relief, self limiting
watery, stringy discharge
ocular pruritis
bilateral injection
Hx atopy
Allergic conjunctivitis
Tx for allergic conjunctivitis?
> 3 yo antihistamine w/ mast-cell stabilizing properties
> 4yo cromolyn drops
Fever > 5 days
bilateral conjunctivitis
morbilliform rash
adenopathy
strawberry tongue
hand desquamination
kawasaki
screen for cardiovascular sxs in kawasaki?
echocardiogram
Tx for kawasaki?
IV Ig, high dose aspirin
strabismus dx
corneal light reflection
cover uncover
nasolacrimal obstruction
dacrostenosis
tx for dacrostenosis
massage lacrimal sac
tx for dacrocystitis
clinda for mild
vanco for severe
common causes of AOM
strep pneumo, h. flu, m. cat
otalgia, bulging TM
AOM
tx for AOM
amoxicillin 90 mg/kg q 12 hrs
when consider augmentin for AOM?
recent b-lactam, purulent conjunctivitis, recurrent AOM
AOM tx for PCN allergy/
cefdinir
When do you want to f/u w/ AOM?
48-72 hours
Unilateral AOM under 2… do you give abx?
yes
severe otalgia under 6 mo… do you treat w/ abx?
yes
recurrent AOM within 15 days of failed tx
augmentin
recurrent AOM after 15 days of failed tx
ceftriaxone
retracted TM, amber otorrhea
OME
Tx for OME
self-limited
cause of OE?
p. aeruginosa
otalgia, tragus tenderness, erythema/edema of EAC
OE
Tx for OE?
floxin otic, cortisporin, ciprodex
allergic shiners
dennie morgan lines
blue, boggy mucosa
cobblestoning
allergic rhinitis
DOC for allergic rhinitis?
intranasal steroids
when to consider immunotherapy for allergic rhinitis?
max environmental control and on optimal medical regimen
pedunculated tumor
peeled grape appearance
associated with CF, chronic sinusitis, allergic rhinitis
nasal polyps
SAMTERs triad:
nasal polyps, ASA sensitivity, Asthma
Tx for nasal polyps?
decongestants
nontoxic appearing
low grade fever
cough
erythema of nasal mucosa
rhinorrhea
viral URI
complications of viral URI
AOM, asthma, acute bacterial sinusitis
What tx for viral URI should you avoid in children under 6
OTC decongestants
cold sxs not improving after 10 days
fever
purulent discharge for 3 days
“double sickening”
ABRS
Sinusitis dx studies?
x-ray, CT
Tx of ABRS
augmentin 45 mg/kg/day
sore throat
fever
what agent caused this
pharyngitis
adenovirus, coxackie a
fatigue
cervical LAD
splenomegaly
GAS sxs
EBV
Dx of EBV
heterophile antibody test/monospot
tx for EBV
activity restriction for 4 weeks
abrupt onset of sxs
sore throat + exudate
palatal petechiae
cervical LAD
sandpaper rash
GAS
Dx for GAS
rapid antigen detection
if negative, throat culture
tx for GAS
within 48 hours
Oral PCN/Amoxicillin, 1st gen cephalosporin
tx of GAS with PCN allergy
azithro
complications of strep
acute rheumatic fever
post strep glomerulonephritis
tonsil removal indicated for…
7 episodes in a year
5 episodes in 2 years
3 episodes in 3 years
Tx of oral candidiasis?
nystatin oral suspension
fever
myalgia
parotitis
mumps
tx for mumps
supportive care
