Brainscape's Knowledge GenomeTM

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


See full index

NR602 - Primary Care of the Childbearing > Week 3 - Ears, Eyes, Skin > Flashcards

Week 3 - Ears, Eyes, Skin Flashcards

1
Q

Fever for infant under 2

A

100.4

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

Fever for children over 2

A

101

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

Fever can be…..

A

infectious or non-infectious

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

How to assess fever?

A
  • Duration and degree of fever
  • Associated symptoms (n/v, diarrhea, lethargy…)
  • Recent known exposure to illness
  • PMH
  • Prior abx, surgeries,
  • Current medications
  • Immunization history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

At what temperature does a fever cause damage to body?

A

107.6F

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

Strategies for fever management

A
  • Adequate hydration
  • Not all fevers need to be treated
  • Appropriate clothing, do not bundle
  • Room temp 72
  • Tepid water baths for temp over 104, stop if shivering occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Contact Dermatitis

A
  • Acute or chronic inflammation resulting from hypersensitive reaction to an irritant or allergen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Types of Contact dermatitis

A
  • Dry skin
  • nickel
  • Phytophotodermatitis
  • plant oleoresins
  • juvenile plantar dermatosis
  • latex dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dry skin dermatitis

A

very low humidity, excess soap use, inadequate rinsing of soap

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

Nickel dermatitis

A

– buttons, belts, jewelery, eyeglasses

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

Phyto photodermatitis

A

sun exposure following contact with limes, lemons, celery, carrots, parsnips or dill (blistered lesion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Plant oleoresin dermatitis

A

poison ivy, oak or sumac – can be direct or indirect, oil may be inhaled and damage lungs

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

Juvenile plantar dermatitis

A

dryness, cracking, and erythema of weight-bearing surfaces of the feet, initially the big toes; it mimics tinea pedis, often found in children with atopic dermatitis

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

Common substances that cause dermatitis

A
  • saliva
  • urine, and feces
  • baby wipes
  • bubble bath
  • agents that dry the skin
  • adhesives
  • diapers
  • allergens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Physical exam findings
for dermatitis

A
  • Localized rash with sharp borders,
  • Severity depends on length of exposure
  • Irritant reactions are immediate and allergic reactions are delayed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management of contact dermatitis

A
  • Burrow solution soaks or oatmeal baths and cool compresses with salt water applied for 20 minutes every 4-6 hours to soothe vesicular rashes
  • Petrolatum or lanolin based emollients
  • Topical corticosteroids used 2-3xday for 2-2 days
  • Oral antihistamines for pruritis
  • Resolution may take 2-3 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Scabies

A
  • Parasite that burrows into the skin and causes intense itching
  • Highly contagious through close contact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Physical findings for scabies

A
  • Characteristic lesions include curving S-shaped burrows, especially on webs of fingers and sides of hands, folds of wrists and armpits, forearms, elbows, belt line, buttocks, genitalia, or proximal half of foot and heel.
  • Dozens of lesions on small children, older children have fewer lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment for scabies

A
  • Apply thin layer of scabicide to entire body excluding eyes
  • Especially fingernails, the scalp, behind the ears, all folds and creases, and the feet and hands
  • Repeat treatment after 7 days
  • Permethrin cream – apply to whole body and rinse after 8-14 hours
  • Family and friends should be treated
  • Wash clothing in hot water, vacuum
  • Seal non washable clothing in a bag for 1 week
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Education for scabies

A
  • Rash and itching can continue for 3 weeks after treatment
  • Can return to school 24 hours after treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Chiggers

A
  • The larvae of harvest mites secrete an irritating substance that cases the skin eruption characteristic of chigger bites. Chigger mites live on grain stems, shrubs, grass, and vines and attach to human or animals that pass by.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Symptoms of chiggers

A

Complaints of itching followed by dermatitis; history of playing or walking in grassy areas, parks, or other mite habitat near woods and water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Physical findings for chiggers

A
  • Discrete, bright-red papules 1 to 2 mm in diameter that often have hemorrhagic puncta
    • Lesions mainly seen on legs (sock area) and belt line but can be widespread
    • Wheals, papules, or papulovesicles in sensitized individuals
    • Bullae or purpuric lesions with secondary hypersensitivity reaction
    • Intense pruritus reaching a peak on the second day and decreasing over the next 5 to 6 days, but can persist for months
    • Possible secondary impetigo from scratching lesions
    • May see the embedded chiggers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment for chigger bites

A
  • Cool compresses
  • Topical corticosteroids (e.g., 1% hydrocortisone cream)
  • Topical antipruritic agents, such as calamine lotion; avoid topical diphenhydramine
  • Oral antihistamines (e.g., diphenhydramine) if topical corticosteroids do not provide relief
  • Removal of embedded chiggers (can be withdrawn by covering the insect with alcohol, mineral oil, nail polish, or ointment)
  • Colloidal oatmeal baths (clean tub thoroughly after bath to avoid fall risk from oil residue left behind)
  • Treatment of secondary skin lesions as indicated
  • Elimination of fleas by treating animals and cleaning carpets, bedding, upholstered furniture; avoid areas that are potentially infested with mosquitoes, fleas, or chiggers
  • Insecticides should be used with caution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Pediculosis

A
  • August to November is lice season
  • Head lice not a health hazard, do not spread disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Symptoms of pediculosis

A
  • History of infestation friend/family
  • Itching
  • Dandruff
  • Crawling sensation of the scalp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Physical exam findings for pediculosis

A
  • Nits attached to the hair shaft and will grow out
  • Commonly found back of neck, head, ears, eyelashes
  • Occipital or cervical lymphadenopathy
  • Treat head lice – rinse with shampoo in sink with warm (not hot) water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Body lice

A
  • Excoriated macules
  • Belt, collar, and underwear lines common
  • Pinpoint macule where the louse has extracted blood
  • Axillary, inguinal, regional lymphadenopathy present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pubic lice

A
  • Excoriation and small bluish macules and papules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Treatment for pediculosis

A
  • Permethrin 1% (widespread resistance) – safe for children older than 1 month old
  • Topical ivermectin
  • Malathion lotion

Steps
* Apply pediculicide – permethrin
* Remove nits with comb
* Cleanse environment
* Return to school after permethrin treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Nevi

A

Most commonly vascular.

Vascular nevi are caused by a structural abnormality (malformations) or by an overgrowth of blood vessels (hemangiomas) and are flat, raised, or cavernous.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Salmon patch

A

light pink macule usually seen at back of neck, forehead or upper eyelids – fade with time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pigmented nevi

A

present at birth or acquired during childhood. Includes dermal melanocytosis, cafe au lait spots, acquired melanocytes nevi, acanthuses nigricans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Dermal melanocytosis

A

Blue or slate gray irregular nevi. Benign, more common in dark skin. Usually fade over time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Café au lait spots

A

tan to light brown macules, oval, irregular, increase in numbers with age,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Acquired melanocytic nevi

A

light to dark brown, flat or slightly raised usually found in sun exposed areas above the waist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Acanthosis nigricans

A

velvety brown rows of hyperpigmentation in irregular folds of skin, usually the neck and axilla; tags may also be present.

Not treatable. Associated with insulin resistance and internal tumor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Hemangiomas

A

Manifest initially as a pale macule, a telangiectatic lesion, or a bright red nodular papule. After appearing, hemangiomas go through a proliferative phase during which they grow rapidly and form nodular compressible masses, ranging in size from a few millimeters to several centimeters. Occasionally they may cover an entire limb, resulting in asymmetric limb growth. Rapidly growing lesions may ulcerate. (treat with propranolol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Atypical nevi

A

larger than aquired nevi, irregular, poorly defined borders and variable pigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Port wine stain

A

A permanent defect that grows with the child, so cosmetic covering is often used. If forehead and eyelids are involved, there is potential for multiple syndromes, including Sturge-Weber, Klippel-Trenaunay-Weber, and Parkes Weber. Neurodevelopmental and ophthalmologic follow-up is needed. Referral to a dermatologist for possible laser treatment or cosmesis is required.

41
Q

When to refer nevi to a dermatologist?

A
  • Suspicious-appearing nevus (as identified by ABCDE signs—asymmetry, border, color, diameter, evolving)
  • Rapidly growing or changing nevus
  • More than 50 nevi
  • One or more atypical nevi
  • History of one or more first-degree relatives with melanoma
  • Presence of a giant or large congenital nevus
  • Signs of excessive sun exposure (increased nevi and freckles in exposed areas)
  • History of immunosuppression and multiple nevi on examination
42
Q

Most likely cause of eye injuries?

A

sports injuries, airbags and abuse

43
Q

Subconjunctival hemorrhage

A
  • splotchy bulbar conjunctival redness that occurs spontaneously or is secondary to increased intrathoracic pressure (from coughing, sneezing, straining, or trauma) that results in the bursting of conjunctival vessels
  • painless, resolve spontaneously in 2-3 weeks
  • treatment indicated only for pain, vision loss, photophobia –> refer to ophthalmologist
44
Q

Eyelid contusion (black eye)

A
  • Bruising and swelling from blunt injury
  • Elevate the head and do intermittent ice compresses for 48 hours
  • For pain or swelling, decrease in visual acuity, double vision, flashing lights or “floaters,” or develops a bilateral “raccoon eyes” appearance, an ophthalmologic evaluation is needed
45
Q

Corneal abrasion

A
  • Damage to or loss of the epithelial cells of the cornea in the form of a corneal abrasion or tear
46
Q

Causes of corneal abrasion

A

Scratches from forceps delivery, paper, brushes, fingernails, contact lens overuse, improperly fitted cosmetic contact lenses, airbag deployment, plants, or foreign body in the conjunctival sac are often responsible.

47
Q

Symptoms of corneal abrasion

A
  • Evidence and sensation of a foreign body; conjunctival erythema
  • Severe pain, photophobia, and decreased vision
  • Tearing, blepharospasm
  • Disrupted tear film over the corneal
  • Fluorescein staining with superficial uptake indicative of a minor corneal abrasion
48
Q

Management of corneal abrasion

A
  • Refer severe injuries to ophthalmology
  • Refer those with contacts to ophthalmology to rule out bacterial corneal infection (prophylactic topical antibiotic – cipro or gentamycin)
  • No signs of infection treat with 0.5% erythromycin or polymycin/trimethoprim, cipro or ofloxacin drops 4xday for 3-5 days
  • Oral analgesics and topical NSAIDS
49
Q

Foreign body in the eye
Clinical presentation

A
  • Pain and foreign body sensation, foreign body visible in the conjunctival sac, perforating wound to the cornea or iris
  • Tearing, photophobia, inflammation
  • Irregular or peaked pupil, opaque lens
50
Q

How to diagnose optic foreign body

A
  • Fluorescein staining, US or CT for diagnosis
51
Q

Management of optic foreign body

A
  • Do not remove intraocular object, refer to ophthalmology immediately
  • Have patient look down and pull upper lid away from the globe
  • Use topical anesthetic for exam if needed
  • If you can see the object, irrigate or lift object gently away with moistened cotton swab
  • After removal apply fluorescein stain and check for corneal abrasion, check visual acuity
  • For airbag deployment irrigate with sterile saline and examine for signs of trauma
52
Q

S/S of Eye burns

A
  • Pale or necrosed appearance of the surrounding skin and eyelids
  • Opacity of corneal tissue, swollen corneas
  • Visual impairment (decreased acuity)
  • Initial exquisite pain or delayed complaints of pain (e.g., in UV burns, pain emerges about 6 hours after exposure)
  • Photophobia; tearing within 12 hours of exposure
  • Fluorescein stain revealing pinpoint uptake
53
Q

Management of eye burns (chemical)

A
  • Topical anesthetic
  • Immediate, copious, ongoing irrigation of water, saline, or LR for 30 minutes
54
Q

Orbital laceration symptoms

A
  • Anterior segment: irregular pupil (retracted or peaked), iris prolapsed
  • Posterior segment: poor red light reflex, decreased vision, black tissue or fluid seen under the conjunctiva
55
Q

Management of orbital laceration

A
  • Eye shield (can be made from cup) to protect the eye, refer immediately to ophthalmology
56
Q

Hyphema

A
  • accumulation of visible blood or blood products in the anterior chamber of the eye and is the result of blunt trauma to the globe without penetration or perforation. This condition is most often caused by balls, fists or fingers, elbows, rocks, exploding airbags, and sticks.
57
Q

Symptoms of hyphema

A
  • History of traumatic eye injury; somnolence (associated with intracranial trauma)
  • Blood (appearing as a dark red fluid level between the cornea and iris) on gross examination or as a hazy-appearing iris
  • Inability to detect a bilateral red light reflex
  • Pain, photophobia, and tearing; abnormal pupillary reflex
  • Visual acuity changes and impaired vision (light perception and hand motion perception)
58
Q

Management of hyphema

A
  • Refer the patient immediately to an ophthalmologist. A slit-lamp examination is indicated.
  • Restrict oral intake until the child has been seen by an ophthalmologist.
  • Place a perforated eye shield (not a patch) over the eye; avoid pressure to prevent reinjury.
  • If a hematologic disorder is detected, ensure quick intervention and close follow-up.
    *Outpatient management if small
  • Hospital and surgery to remove if large
59
Q

Retinal detachment

A
  • the neurosensory retina separates from its retinal pigment epithelium base within the globe
60
Q

Clinical findings for retinal detachment

A
  • Blurry vision that becomes progressively worse
  • Dark cloud in one visual field, flashing lights, or a “shower of floaters”
  • Darkening of retinal vessels on funduscopic examination
  • Gray elevation at the site of detachment
61
Q

Management of retinal detachment

A
  • Instruct the patient not to eat and refer him or her to an ophthalmologist for emergent evaluation.
62
Q

Orbital hematoma and contusion to the globe

A
  • Blunt trauma to the globe
  • Common causes include sports activities, motor vehicle accidents, assault, BB gun accidents, or airbag deployment.
63
Q

Clinical findings for orbital hematoma/contusion

A
  • Milky white retina
  • Visual acuity changes
  • Severe bruising of eyelids and periorbital tissues
  • Lens dislocation, retinal detachment or edema, rupture of eyeball
  • Vitreous, retinal or choroid hemorrhage
64
Q

Management of orbital hematoma

A

Refer immediately to opthalmologist

65
Q

Orbital fracture

A

Fracture of the walls of the orbit secondary to blunt trauma to the eye or orbital rims

66
Q

Clinical findings for orbital fracture

A
  • Pain, numbness below the orbit; trouble chewing; nosebleed
  • Diplopia, irregular pupil, limited ocular movement (especially upward)
  • Corneal laceration, hyphema, and/or absent red light reflex
  • Globe displacement (sunken or protruding) or enophthalmos (recession of the eyeball within the orbit)
  • Bony discontinuity or “step-off”
  • Ecchymosis of the lids; subcutaneous emphysema in surrounding tissues, and edema
67
Q

Management of orbital fracture

A
  • Ophthalmologic emergency – needs immediate Xray or CT
  • Ice for 48 hours and sleep with HOB elevated
  • Prophylactic abx if orbital fracture involves the sinuses
  • Nasal decongestants to reduce blowing/sniffing
68
Q

Congenital cataracts

A
  • recommended lab workup of a child with bilateral congenital cataracts includes titers for TORCH (toxoplasmosis, other, rubella, cytomegalovirus, herpes), syphilis (the Venereal Disease Research Laboratory [VDRL] test), serum calcium and phosphorus levels, and urine testing for reducing substances
  • Genetic testing is recommended if there are dysmorphic features.
  • A small or partial congenital or infantile cataract can be monitored over several years for a progression that could produce amblyopia; some types of cataracts do not progress. Patients should be monitored by an ophthalmologist as amblyopia may develop.
  • Removal and insertion of new lens
69
Q

Topical antibiotics used for eye infections

A
  • Fluoroquinolones
  • sulfacetamide
  • bacitracin
  • bacitracin/polymyxin B
70
Q

Antibiotics for periorbital cellulitis

A

Amoxicillin with clavulanic acid, cefdinir, and cefpodoxime are first-line choices for treatment.

71
Q

Antibiotics for bacterial conjunctivitis

A
  • Erythromycin 0.5% ophthalmic ointment
72
Q

Antibiotics for dacrocystitis

A
  • eythromycin ophthalmic ointment, or a fluoroquinolone (moxifloxacin, ciprofloxacin, ofloxacin, norfloxacin) for 1 to 3 weeks
73
Q

Retinoblastoma

A
  • Intraocular tumor that develops in the retina, most common tumor in childhood.
  • May be hereditary through the RB1 gene (all bilateral disease is considered hereditary)
  • Some evidence HPV may play a role in development
  • Screening guidelines
  • all infants and children should have a red reflex exam before discharge from the newborn nursery and thereafter at every health maintenance visit
74
Q

Clinical findings that indicate retinoblastoma

A
  • Strabismus (crossed eyes)
  • Decreased visual acuty
  • Uni or bilateral white pupil, usually seen in low-light settings
  • Abnormal red reflex
  • Nystagmus
  • Glaucoma
75
Q

How is retinoblastoma diagnosed?

A

ophthalmic exam under anesthesia, US, or MRI

76
Q

Management of retinoblastoma

A
  • Refer patients with abnormal findings suspicitous for retinoblastoma for diagnosis and management by a MDT
  • treatment may involve cryotherapy, laser photocoagulation, episcleral plaque brachytherapy, systemic chemotherapy, or enucleation
  • frequent follow up required
  • 95% cure rate in US children – unilateral has the best prognosis
  • Children with germinal retinoblastoma have higher risk for other cancers
77
Q

Three components for diagnosing otitis media

A
  • Abrupt onset of ear pain, irritability, otorrhea and/or fever
  • Bulging TM or otorrhea
  • s/s of inflammation confirmed by distinct TM erythema or ear pain
78
Q

Causes of AOM

A

S. pneumoniae, h influenzae , Moraxella catrrhalis and s pyogenes most common causes of AOM.

Usually virus is the initial causative factor. – majority of causes caused by bacteria or virus and bacteria together

79
Q

Clinical findings for AOM

A
  • Ear pain that interferes with activity especially when lying flat
  • Irritability or ear pulling in toddler
  • Otorrhea
  • Fever
80
Q

Symptoms of middle ear inflammation

A
  • TM Amber –> fluid only behind
  • White/yellow TM –> AOM, OME
  • Increased vascularity of TM with obscured or absent landmarks
  • Red/yellow/purple TM
  • Thin-walled, sagging bullae filled with straw coloroed fluid with bullous myringitis
81
Q

Physical exam findings for AOM

A
  • Bulging TM
  • Decreased TM translucency
  • Absence or decreased TM mobility
  • Air-fluid behind TM
  • Otorrhea
82
Q

When to treat AOM

A
  • Moderate/severe bulging TM with otorrhea not associated with AOM
  • Mild bulging of TM with onset of pain in last 48 hours or intensely erythematous TM
  • Babies under 6 months with acute bilateral OM without sever symptoms sick less than 24 hours
83
Q

When to wait to treat AOM

A
  • Young children with unilateral AOM without severe symptoms and fever less than 102.2
  • Child older than 2 without severe symptom
84
Q

When to reassess AOM

A
  • Children not treated and no improvement within 48-72 hours
85
Q

Management of AOM

A
  • Pain management with Tylenol or brufen
  • Heat/cold externally
  • Amoxicillin is first line 80-90mg/kg/day 2xday , augmentin (amoxicillin/clafulanate for allergies to PCN or treated prior with amoxicillin w/in 30 days)
  • Amoxicillin, augmentin, azithromycin,ceftriaxone clinda)
  • Under 2 then 10 days treatment, over 2 then 5-7 days treatment
  • Watchful waiting 48-72 hours, give pain relief, schedule follow up parameters  not needed if improvement in 48 hours
  • If TM is perforated, include otic drops (oxo or cipro)
86
Q

Persistent AOM

A
  • Abx complete but still present or recurs within days of completing treatment  broader spectrum ABX
  • ENT referral
87
Q

Otitis media with effusion

A
  • Buildup of fluid behind the TM due to increase mucous production, mucous absorbs water and becomes stuck behind TM
  • Can occur after viral illness, barotrauma, allergies
88
Q

S/S of AOM with effusion

A
  • Hearing loss
  • Feeling of fullness in ear
  • Dizziness/impaired balance
  • Popping feeling
89
Q

Physical exam findings for AOM with effusion

A
  • Decreased TM mobility
  • TM is dull, bulging, opaque, no visible landmarks, retracted, air fluid or bubble may be seen
90
Q

Management of AOM with effusion

A
  • Pneumatic otoscopy
  • Watchful waiting for 3 months after diagnosis
  • intranasal steroids, antihistamines, antibiotics, decongestants not recommended
  • check hearing if it last more than 3 months
  • reevaluate q3 months until resolved
  • educate family on duration and course and when to follow up
  • refer to ENT if otoscopy suggests structural damage of TM, significant hearing loss, chronic persistent OME for 6+ months
91
Q

Otitis externa

A

Diffuse inflammation of the EAC, can involve pinna or TM

92
Q

Cause of AOE

A

Protective barriers of the EAC are damaged by mechanical or chemical mechanisms, usually caused by retained moisture that changes the acidic environment to neutral or basic promoting bacterial/fungal growth

93
Q

Clinical findings for AOE

A
  • Itching/irritation
  • Pain
  • Pressure/fullness of ear
  • Hearing loss
  • Periauricular edema
  • Pre and posterior lymphadenopathy
94
Q

Physical exam findings for AOE

A
  • Pain with tragus or pinna
  • Swollen EAC with debris – hard to see TM
  • Regional lymphadenopathy
  • Tragal tenderness
  • Red, crusty, pustular lesions
  • pruritis with thick otorrhea (drainage)
  • tympanostomy or TM perf
  • dry appearing ear canal with atrophy or thinning of canal and no cerumen
95
Q

Management AOE

A
  • Eardrops – ciprodex (ciprofloxacin and dexamethasone)
  • No systemic abx unless signs of systemic infection
  • Patient education on drop instillation (child lying on side with ear up and instilled until EAC is filled, pump the tragus to remove trapped air and ensure filling. Remain lying down 3-5 minutes leaving ear open to air
  • No swimming during acute infection
  • Analgesics for pain
96
Q

Otic Foreign Body

A
  • items put in ear or thrown by another child. May involve leaves/plants/toys/bugs
97
Q

Symptoms associated with foreign body in the ear

A
  • Child reports putting something in ear or having something thrown at them
  • Itching, buzzing, fullness or object in ear
  • Persistent cough or hiccups
  • Unilateral otalgia and otorrhea (bloody/purulent)
98
Q

Management of foreign body in the ear

A
  • Being able to visualize object is important
  • Soft, irregular shaped objects easily removab le with forceps or curved hook
  • Round or breakable objects can be removed with wire loop, curette, or right angle hook
  • Irrigate only if TM is intact  irrigation can push further into ear canal
  • Button batteries require immediate removal due to the risk of leakage – do not irrigate
  • Metal objects can be removed with magnets
  • Insects can be suffocated with mineral oil and then irrigated – or refer to ENT
  • If it cannot be removed within the first few attempts or without risking damage to EOC or TM or pain is worse refer to ENT
  • Topical antibiotic drops with steroid are recommended post removal
99
Q

The American Association of Ophthalmic Oncologist and Pathologists (AAOOP) screening recommendations for children at risk for retinoblastoma

A

All infants and children should have a red reflex exam before discharge from the newborn
nursery and after that at every health maintenance visit

NR602 - Primary Care of the Childbearing (18 decks)

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