Derm, ENT, opthal Flashcards
(21 cards)
management of otitis media with EFFUSION
observation and follow up!!!!
if associated hearing loss -> tympanomestry tube
contrast to otitis media as it does not cause erythema or tympanic membrane bulging, just an air fluid level. usualy develops following viral infection or otitis media
chronic supporatative otitis media = ottorrhea nd hearing loss >6 weeks and perforated TM
different types of neonatal conjuctivitis?
treatment?
gonococcal starts from 2 !days = purulent discharge and eyelid edema = IM/IV cefotaxime!
chlamydial starts from 5! days = watery mucopurlent discharge and mild eyelid swelling = oral erythromycin!
chemical = less than 24 hours, mild conjuctival iritiation and tearing. medication side effect eg erythromycin = aritifical tears!
epiglottitis treatment?
ceftriaxone + vancomycin!!!
burn characteristics seen in child abuse?
sparing of flexural creases!!
also sharp lines of demarcation, uniform depth, lack of splash marks
recent contact with people with viral illness. however eyes are water, red and ITCHY. next step in management?
topical antihistamines!!!!
allergic conjuctivitis!!
macules papules and pustules on trunk of newborn.
maternal history of cold sores during stressful events
next step in management
reassurance only!!! = erythema toxicum neonatorum
NOT iv valacyclovir as used to treat neonatal herpes which presents differently as clustered vesicles on erythematous base
also millia = firm white papules on face that is self resolving
played in snow all day on ski trip.
severe bilateral eye pain and redness.
fluorescein dye reveals diffuse punctate corneal staining
UV light exposure!!! (photokeratitis)
severe bilateral eye pain and photophobia
foreign body sensation in eye
decreased vision
conjuctival erythema, chemosis, tearing
areas with increased uv light = sand, water, snow. high altitude
acute otitits media is always oral antibiotics
topical antibiotics for otitis externa
typanocentesis `and culture only done for at least 3 episodes of AOM in 6 months or persistent >3 months middle ear effusion with hearing loss
changes in tarsal conjuctiva (palpebral inflammation) + pale follicles (follicular conjuctivitis) + red eye = trachoma!
lens dislocation after minimal trauma.
next step after correction?
echocardiography!!!!
rule out marfans syndrome - aortic root disease - dilation, dissection
only other cause of lens dislocation would be homocystinuria which is associated with intellectual disability
laryngomalcia confirmed using?
laryngoscopy
child otherwise normal but has sensorineural hearing loss as air conduction is > bone conduction in both ears!!!
congenital infection!!
congenital CMV - can be asymptomatic in infant and then cause hearing loss later as child
not cholesteatoma as it causes conductive hearing loss
linear pattern of bites with central hemorrhagic punctum.
spider webs in house
bites on cousin too
most likely cause?
bed bugs
not spider bite - isolated bite
patient with strabismus, what test do you do?
dilated funduscopy!! -> to detect retinoblastoma, a life threatening cause
impetigo management
bullous = oral cephalexin
non bullous = limited = topical mupirocin
diffuse = oral cephalexin
no external eye abnormalities suggestive of strabismus, no dull red reflex suggestive of lens opacity
4 year old. decreased visual acuity in one eye.
most likely cause?
uncorrected refractory error!!
ambylopia!!
acute rhinosinusitis. 3 days, no fever. next step in management?
supportive care = nasal saline, irrigation
bacterial and so antibioitcs if symptoms at least 10 days + fever
7 yo. patchy hair loss with no scale, itching, or pain. diagnosis?
alopecia areata
Re-apply sunscreen every 2 hours!!!! and after swimming
apply 15-30 minutes before sun exposure
wear long clothing and dark colours!!
Candida diaper rash in addition to
Involving skin folds, also sharply demarcated borders, satellite papilla and pustules!!!
Management?
Topical nystatin
1 day fever, vomiting, pain during urination, widespread red bumpy rash. Began amoxicillin 3 days ago for exudative pharyngitis. Blistering rash. Cervical lymphadenopathy, bilateral conjunctival erythema and photophobia. Several oral ulcers. Most likely diagnosis?
Steven’s-Johnson syndrome.
some drugs trigger
Not staphylococcus scalded skin syndrome as that causes diffuse erythematous rash that starts in skin folds and peri-oral areas and then progresses to generalised superficial desquamation with fevers and malaise.
