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D2 E1 Shea > PEDS HEENT 1 > Flashcards

PEDS HEENT 1 Flashcards

1
Q

Thick, purulent, ropy disharge

Usually starts unilaterally

Eyelids may be “crusted shut” in a.m.

+/- preauricular lymphadenopahty

Clinical px of what condition?

A

Bacterial conjunctivitis

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2
Q

Cause of Bacterial conjunctivitis

A

S. pneumoniae, H. influenza, M. cattarhalis, S. aureus

Newborns: Chlamydia trachomatis #1

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3
Q

Tx of bacterial conjunctivitis

A

Antibiotic ointment-infants

Antibiotic drops- older children

_**treat both eyes!!_

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4
Q

Cause of viral conjunctivitis

A

adenovirus: one of the primary causes of ‘colds’ (URI)

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5
Q

conjunctival injection of one or both eyes

watery ocular discharge, some crusting in a.m.​

Typically bilateral

May be accompanied by URI sx, feels “gritty”

Clinical Px of what?

A

Viral conjunctivitis

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6
Q

Viral conjunctivitis Tx

A

self-limited

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7
Q

bilateral itchy, watery, red eyes

watery discharge/tearing

“Bumpiness” of tarsal conjunctivae

Accompanied by sx of allergic rhinitis

Sneezing, dry cough, atopic dermatitis

Clinical Px of what?

A

Allergic Conjunctivitis

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8
Q

Allergic conjunctivitis Tx

A

symptomatic:

olopatadine in children > 2 years

Reduce exposure

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9
Q

Cause of Periorbital cellulitis (preseptal)

(Infection ANTERIOR to orbital septum)

A

exogenous source ( eyelid abrasion, horedolum, chalazion, dacrocystitis, insect bite)

MC pathogen = Staph aureus & S. pyogenes

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10
Q

2 MC pathogens of peri-orbital cellulitis

A

Staph aureus & S. pyogenes

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11
Q

T/F:

Periorbital cellulitis/orbital cellulitis infections arise POSTERIOR to the orbital septum

A

False, Periorbital cellulitis/orbital cellulitis infections arise ANTERIOR to the orbital septum

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12
Q

T/F:

Periorbital cellulitis has mild, minimal complications

A

TRUE

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13
Q

Periorbital Cellulitis Tx

A

oral/systemic abx

(Augmentin)

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14
Q

infection POSTERIOR to the orbital serum

may cause serious complications- such as an acute ischemic optic neuropathy or cerebral abscess

This describes which condition?

A

Orbital cellulitis

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15
Q

Cause of Orbital cellulitis

(2 MC pathogens?)

A

Staph or Strep (S. aureus)

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16
Q

T/F:

Orbital cellullitis is almost always associated w rhinosinusitis or sinus infection

A

True

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17
Q

+/- fever (if present, it is high)

lid swelling & erythema

vision disturbances/decreased vision

Pain w EOMs, proptosis (protruding eye)

Clinical px of which condition?

A

Orbital Cellulitis

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18
Q

Dx of orbital cellulitis

A

CT or MRI

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19
Q

Tx of orbital cellulitis

A

Emergent Opthalmology Consult; IV abx

+/- surgical drainage

20
Q

Widespread inflammation of medium and small arteries, including the coronary arteries

aka “mucocutaneous lymph node syndrome”

Which condition?

A

Kawasaki Dz

21
Q

Dx of Kawasaki Dz

A

+/- anemia & thrombocytosis

no specific dx criteria

22
Q

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

A

Kawasaki Dz

23
Q

Boys>girls (1.5:1)

Transmissible to household contacts; clustering

Some clinical features similar to adenovirus and scarlet fever

Seasonality (winter and spring)

80% of cases occur in children < 5 yo (median age at diagnosis is 2yo)

Epidemiology of which condition?

A

Kawasaki Dz

24
Q

Dx criteria of Kawasaki Dz

A

Fever plus:

- Conjunctivitis: bilateral, bright-red, non-exudative

- Mucositis: cracked lips, strawberry tongue

- Polymorphous rash & desquamation: starts in perineum, skin peels, then spreads

  • Lymphadenopathy: cervical
  • Extremity changes: edema, redness of palms/soles

“Can’t make pain leave, eek!”

25
Q

Details of Mgmt of Kawasaki Dz: IVIG

A

IVIG (intravenous immune globulin) + Aspirin (ASA) (80-100mg/kg/d)

IVIG reduces incidence of aneurysms

DO NOT admin live vaccines within 11 mos of IVIG

26
Q

General Mgmt of Kawasaki Dz

A

IVIG + Aspirin

Baseline Echo + repeat @ 2 & 6 wks

27
Q

Complications of Kawasaki Dz

A

CV: coronary artery aneurysms –> myocardial ischemia, infarction, sudden death

Highest risk: < 1yr & >9yrs

28
Q

Loss of the most superficial layer of corneal cells

What is this?

A

Corneal Abrasion

29
Q

Red eye, watery d/c (tearing)

blephorospasm (tight closure of eyelid)

Severe ocular pain

Fussy baby, irritable toddler

Rubbing at eye

“squinting”/photophobia

A

Corneal Abrasion

30
Q

Corneal Abrasion Dx

A

fluorescein stain, Wood’s lamp**

If foreign body refer to Opthalmology

31
Q

Corneal Abrasion Tx

A

erythromycin ointment & recheck in 24-48 h

patching the affected eye?

If no decrease in size, refer to Opthalmology

32
Q

Most common cause of persistent tearing & eye discharge in infants & children

Which condition?

A

Dacryostenosis

33
Q

chronic or intermittent tearing, debris on lashes

generally NO conjunctival irritation, however, injection may occur from irritation or overflow tearing

palpable nasolacrimal sac +/- discharge or reflux of tears

Clinical Px of which condition?

A

Dacryostenosis

34
Q

Tx of dacryostenosis

A

lacrima sac massage in downward direction 2-3x a day

refer to optho if sx persist >6mo

35
Q

infection of the nasolacrimal sac that causes erythema & edema over the nasolacrimal sac

commonly caused by bacteria that colonize upper respiratory tract

S. aureus, S. pneumoniae, S. pyogenes, S. viridans, M. catarrhalis & Haemophilus species

Which condition?

A

Dacryocystitis

36
Q

Tx of dacryocystitis

A

milder cases = PO+ topical abx

severe acute = IV antibiotics (after culture & staining)

37
Q

Functional reduction in visual acuity

Caused by abnormal vision development early in life

What dz?

A

amblyopia

38
Q

Most common cause of pediatric visual impairment

A

Amblyopia

39
Q

T/F: amblyopia is usually bilateral

A

False, amblyopia is usually unilateral

40
Q

Can occur only during the critical period of visual development in the 1st decade of life when the visual nervous system is plastic

Which condition?

A

Amblyopia

41
Q

Misalignment of the eyes

Categorized by the direction of the deviation: esotropia, exotropia, hypertropia, hypotropia

constant or intermittent

Which condition?

A

Strabismus

42
Q

Risk factors for strabismus

A

+ FH

low birth weight (prematurity)

43
Q
A
44
Q

Periorbital or Orbital?

  • Vision & EOMs are normal
  • Erythematous & edematous eyelids, main, mild fever
A

Peroribital Cellulitis (pre-septal)

45
Q

Periorbital or Orbital?

  • Pain w/ EOMs
  • Proptosis (protruding eye)
  • Emergent Opthalmology Consult: IV abx
A

D2 E1 Shea (13 decks)

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