EENT 1

Question 1

what are the eye pediatric differences

Answer 1

visual acuity in neonates is 20/100-400
age 2: 20/50
age 6/7: 20/20 (have vision checked if not)
*if make it through adolescent with 20/20 likely have it through adulthood

Question 2

what are the ear pediatric differences

Answer 2

eustachian tubes lie more horizontally and shorter, wider, straighter in infants (at risk for ear infections d/t horizontal)

Question 3

nose, throat and mouth pediatric differences

Answer 3

• infants < 6 months have nasal breathers
• may have visible palatine tonsils (tonsils decrease in size with age)
• taste sensation present before birth (do NOT put medicine in formula, can taste change)

Question 4

diagnostic tests of EENT

Answer 4

audiologic screening
newborn hearing screening 
tympanogram
vision screening
labs: CBC, culture and sensitivity for strep

Question 5

disorders of the eye

Answer 5

conjunctivitis
periorbital cellulitis
strabismus
amblyopia

Question 6

describe conjunctivitis

Answer 6

pink eye
inflammation of conjunctiva
caused by bacterial, viral or allergic agents

Question 7

s/s of conjunctivitis

Answer 7

redden swollen eye, excessive tearing, w/ clear, watery yellow/green drainage and eyelid crusting
yellow/green may indicate bacterial

Question 8

what do allergic eyes look like and what helps relieve

Answer 8

itchy eyes, red d/t rubbing eyes (watery)

*antihistamine may help relieve s/s of itchy eyes

Question 9

what do you teach about eye drops

Answer 9

• eye drops should not let bottle touch eye and contaminate it
• pull eyelid down and place drops in corner of eye
• use drops for 5-7 days (will improve after 24 hrs)
• do NOT encourage OTC eyedrops

Question 10

how do you administer ointment

Answer 10

start at inside of eye and ribbon to outside

Question 11

what are you most concerned about forming from a bacterial conjunctivitis

Answer 11

periorbital cellulitis

Question 12

describe cellulitis

Answer 12

• forms from bacterial conjunctivitis
• does NOT respond to treatment, vision changes after eye drops
• infection of eyelid surrounding tissue, caused by bacteria
• complication of sinusitis

Question 13

s/s of periorbial cellulitis

Answer 13

edematous , tender red/purple eyelids, restricted painful movement of the area around eyelid, FEVER

Question 14

clinical management of periorbital cellulitis

Answer 14

hospitalization

IV antibiotics

Question 15

describe strabismus

Answer 15

cross eye
one eye deviates from point of rxation
weak eye becomes lazy
can be congenital or acquired

Question 16

what can strabismus lead to

Answer 16

amblyopia

Question 17

describe amblyopia

Answer 17

aka lazy eye

vision is reduced in one or both eyes

Question 18

what can amblyopia lead to

Answer 18

disuse blindness if pt only uses dominant eye

Question 19

what is disuse amblyopia

Answer 19

• follows undetected strabismus

- strabismus need to be detected/corrected by age 4-6 yrs to prevent this

Question 20

what is the cause amblyopia

Answer 20

• untreated strabismus
• congenital cataract
• uncorrected refractive errors causes visual differences between eyes

Question 21

describe ottis media

Answer 21

ear infection
acute or chronic
very common in 6 mos-2 years
occurs often in winter
children are at greater risk d/t horizontal Eustachian tubes 
eustachian tube opens during sucking

Question 22

describe what bubbles behind ear drum mean

Answer 22

• not infection
• mean fluid is present
• do NOT treat with antibiotics
• sinuses, allergies

Question 23

how to determine if bubbles behind ear

Answer 23

• pump air through otoscope to see if eardrum moves to determine if ear infection
• should be mobile (normal)
• not moving… fluid buildup!

Question 24

s/s of AOM (acute ottis media)

Answer 24

• fever
• bulging, red, tympanic membrain
• pain

Question 25

s/s of ottis media with effusion

Answer 25

• dull, retracted TM

- fullness

Question 26

what can AOM be caused by

Answer 26

strep or flu

Question 27

treatment for ottis media

Answer 27

• antibiotics
• analgesic/antipyretic (give ibuprofen if >6 mos to manage ear pain and fever for AOM)
• antihistamine for OME (decrease fluid buildup)
• tympanostomy tubes (PE) work well

Question 28

who is at risk for ear infections

Answer 28

smoking and going to day care

Question 29

complications of ottis media

Answer 29

chronic OM
hearing loss
meningitis
eardrum perforation
cystic mass (cholesteatoma)

Question 30

where is fluid located if allergies

Answer 30

sinuses and ears

Question 31

what is the cover and uncover test

Answer 31

used for strabismus

when uncover hand from over eye, eye should stay still otherwise abnormal and know its strabismus