Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

A2 ME3031 HEAD & NECK > W7: ENT Paeds, Allergy, Rhinology, Radiology > Flashcards

W7: ENT Paeds, Allergy, Rhinology, Radiology Flashcards

1
Q

Common presentations of ENT in Children

A

Hearing loss

Pain

Discharge: watery = ext. / pus = middle ear

Changes in school performance

Sore throat

Tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ENT Paeds: OTITIS MEDIA

A

Conductive hearing loss, presenting w/ behavioural, social

RF: <10Y/O ~5y/o peak (adenoid); day care, cleft palate

*self-resolve

> Hearing aids
Grommets tube
Adenoidectomy
Autoinflation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ENT Paeds: ACUTE OT. MEDIA

A

Common pres. w/ pain, fever, discharge

*H. influenza, strep pneumon., moraxella cataarrhalis

> co-amoxiclav

!progress to mastoiditis when mastoid air cells become infected
!progress to intra-cranial infection = MENINGITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Investigating hearing loss in ENT paeds

A

TYMPANOMETRY: middle ear pressure + patency

OTOACOUSTIC EMISSION: children screening. cochlear emission recieved

AUDITORY B.STEM RESPONSE: nerve stimulation sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ENT Paeds: OTITIS EXT.

A

Infective nature OR inflamm = dermatitis (swimmer’s ear)

> aural microsuction

> topical abx

> water precautions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ENT Paeds: CHRONIC OT. MEDIA

A

Persistent hearing loss + chronic discharge

+?CHOLESTEATOMA
> Mastoidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rhinology

A

RHINITIS = blocked/runny nose
think allergy, IgE
recurrent URTI
large adenoid = sleep apnoea

!bilateral blocked nose = FOREIGN BODY

SINUSITIS + POLYPS: association with CF; lesss common; acute vs chronic sinusitis

CHOANAL ATRESIA = bilateral inability to breathe (congenital narrowing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Complications of Sinusitis

A

PERI-ORBITAL CELLULITIS = eye inflamm, oedema, proptosiis

+abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ENT Paeds: Epistaxis

A

common, M>F

  • digital trauma
  • mucosal irritation
  • coagulation pathology: hereditary hemorrhagic telangiectasia (arteriovenous malformations in face esp)
  • Little’s Area: most septal part w/ major anastamoses

> First Aid
Abx ointment
Cautery: silver nitrate
Nasal packing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common hereditary disorder associated with epistaxis

A

hereditary hemorrhagic telangiectasia (arteriovenous malformations in face esp)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ENT Paeds: SORE THROAT

A

TONSILLITIS

  • B haem strep
  • EBV

> Abx

QUINSY: pus-filled swelling in the throat that develops infrequently as a complication of acute tonsillitis

  • acute worsening of sore throat (unilateral), swelling
  • trismus = lockjaw
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ENT Peds: AIRWAY ISSUES

A

Think: foreign body, and STRIDOR

LARYNGOMALACIA: congenitl soft cartilage = narrowing

EPIGLOTTITIS: Haemophilus influenza type b (Hib) bacteria
> IV abx
>intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

ENT Paeds: NECK ABSCESS

A

d/t lymphadenotitis = firm swelling, cyst
?dental infection

*USS

> drainage & aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define allergy

A

Type 1 IgE mediated response upon re-exposure comprising of MAST CELL degran. producing immediate and late symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Summarize the factors that produce allergic reactions including eczema, asthma and food allergies

A

Host: hereditary, race, age

Env: exposure to. infectious disease + pollution, dietary changes, HYGIENCE HYPOTHESIS

Occupational: flour, latex, wood dust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

describe diagnostic tests including skin tests, RAST and blood tests

A
  • SKIN TEST*
  • RAST: detection of IgE presence and levels
  • Hx and PMG
  • ImmunoCAP Specific IgE blood test: finger prick blood =
17
Q

Allergic Rhinitis Classifiction

A

INTERMITTENT: <4d/w

PERSISTENT: >4d/w AND >4 consecutive weeks

MILD: normal sleep and no impairment

MODERATE: Disturbances and impairment

*seasonal and per-annual nature

18
Q

Management of Allergies

A

Pt education = avoiding any future triggers

> Anti-histamines

> Topical steroid spray

> Na Chromoglicate = masst cell destab.

> Anti IgE
______
ImmTherapy = promote immune tolerance and graaadual increase (IgG blocking IgE mediation)
Sx

19
Q

Non-Aallergic Rhinitis

A

Granulomatous

Vasomotor = irritants

Infectious

Hormonally-induced (preg.)

Drug-induced (contraception, NSAIDs, decongestants, phosphodiesterase inhibitors)

20
Q

Describe standard nasal examination techniques.

A

NASAL ENDOSCOPY

Bloods: fbc, ANCA, ESR, ACE, RAST

CT Scan: turbinates

MRI

Skin test

Rhinomanometry

  • NASAL ALLERGEN CHALLENGE * gold standard but rarely used
21
Q

Describe Acute and Chronic Rhinosinusitis and treatment modalities for these.

A

acute = onset of <4w
* S. pneumonia, H influenz.

> symptomatic relief - self limit
topical steroids
abx + topical (rare): penicillins, cephalosporin, clarithromycin

chronic = at least 12 consecutive weeks
*CT

> Sinus sx via endoscope
daily saline irrigation with topical cortical steroid therapy
systemic steroids

22
Q

Describe how to assess and manage a patient with a nasal fracture.

A
  • nasal haematoma following trauma = swelling
  • can progress to a septal abscess

> drain

23
Q

Describe diagnosis and management of Nasal Polyps

A

1º = chronic inflamm, NS dysf., genetic predisposition
asthma, recurring infection, allergies, drug sensitivity or certain immune disorders

2º = CF, AFS (alleg. fungal sinusitis), Churg-Strauss Syndrome (vasc. inflamm)

  • sweat
  • nasal smear = micro., eosinophils, neutrophils
  • endoscopy

> oral and nasal steroids
aspirin desens.
tx of co-existing allergic rhinitis/asthma
dietary changes

> Sx: polypectomy

24
Q

Be aware of the criteria used to assess of patient with Epistaxis.

A

assessment of vital signs, mental status, and airway patency.

25
Q

Pott Puffy Tumour

A

Presents as a frontal sinusitis

Pott puffy tumor is a forehead swelling due to frontal bone osteomyelitis with associated subperiosteal abscess. PPT is a rare complication of sinusitis, but can also occur due to trauma

> long-term antibiotics, with surgical drainage, debridement and reconstruction
if resistant to abx = frontal sinus surgery

26
Q

Ethmoidal Mucocele

A

Presents as: diplopia, Oculomotor Nerve Paralysis

> FESS (functional endoscopic sinus surgery)

27
Q

Commonest causes of epistaxis in adults

A
  1. INFECTION: rhinitis, nasopharyngitis, sinusitis
  2. TRAUMA
  3. Allergy
  4. HT and atherosclerotic vasc. disease
  5. Hereditary hemorrhagic telangiectasia
28
Q

Nasal Packs indications and CI

A

For resistant epistaxis.

CI:
Significant facial/nasal bone fractures. Basilar skull fracture. Hemodynamic instability or airway compromise requiring emergency blood transfusion or intubation

29
Q

Sx Tx of Epistaxis

A

> endoscopic sphenopalatine artery ligation

> ethmoidal ligation

HHT:
laser coag.

> embolisation

30
Q

Benign and Non-benign causes of epistaxis

A

Angiofibroma
> embolisation and sx

malignant sinonasal melanoma: presents with hearing loss
>RT
> Sx
> Combined Rx

A2 ME3031 HEAD & NECK (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions