ENT

Question 1

AAP guidelines to get ear checked?

Answer 1

newborn

4, 5, 6, 7, 8, 10yo

Question 2

Cx for hearing loss?

Answer 2

craniofacial
external: cerumen, FB
middle: otits media
inner ear: meds (gentamycin)

Question 3

What does peds ask re: hearing?

Answer 3

family hx of hearing loss?
meds?
anatomy of ear
FB
infxn

Question 4

Hearing loss for external-cerumen impaction -tx?

Answer 4

DO NOT USE Q TIP

Question 5

Otits externa - sx?

Answer 5

tugging of ear
hearing loss
discharge

Question 6

Otitis externa - bug?

Answer 6

pseudomonas

staph

Question 7

Otitis externa -tx?

Answer 7

quinolone abx drops

Question 8

Ear pain DESPITE tx?

Answer 8

malignant OE

Question 9

Acute otitis media - sx?

Answer 9

OE sx (ear pain, discharge, hearing loss)
URI sx
fevers

Question 10

Acute otitis media - bugs?

Answer 10

VIRAL > BACTERIAL

s. pneumonia
h. influenzae
m. catarrhalis

Question 11

Acute otitis media - tx?

Answer 11

first line: HD Amox 80mg/kg/day

severe: Augmentin 90mg/kg/day BID
failure: Ceftriaxone 50mg/kg/day x 3 days

Question 12

Acute otitis media - criteria?

Answer 12

1) abrupt onset
2) effusion
3) inflammation: erythema, otalagia

Question 13

Gold standard for acute otitis media?

Answer 13

insufflation to check for effusion

if it doesn’t move - EFFUSION

Question 14

Complication of acute otitis media: Bullous myringitis - tx?

Answer 14

azithormyocin to cover mycoplasma

Question 15

Complication of acute otitis media: cholesteatoma?

Answer 15

epithelial tissue gets stuck and will not go away unless surgically removed

Question 16

Cholesteaetoma - cx?

Answer 16

complication of acute otitis media
progress hearing loss
destruction of the bones
erosion of the mastoid bone

Question 17

Acute serious otitis media?

Answer 17

d/t URI

Question 18

Acute serous otitis media -tx?

Answer 18

nothing

Question 19

Chronic serous otitis media?

Answer 19

more than 3mo

Question 20

Chronic serous otitis media - tx?

Answer 20

tubes

Question 21

Purpose of tympanostomy tubes?

Answer 21

stabilizes the pressure in the eustachian tube until child grows

Question 22

Indications for tympanostomy tubes?

Answer 22

1) chronic serous otitis media (even w/ 6-12wks)
2) recurrent AOM (3x/6mo or 4x/12mo)
3) complication of AOM
4) complication of eustachian tubes

Question 23

Choanal atresia?

Answer 23

blockage of the nasal passage way

Question 24

Choanal atresia - bilateral at birth?

Answer 24

respiratory probs

Question 25

Choanal atresia - unilateral?

Answer 25

discharge unilateral

Question 26

Choanal atresia - dx?

Answer 26

endoscopy

Question 27

Nasal polyps >10yo?

Answer 27

allergies

Question 28

Nasal polyps <10yo?

Answer 28

cystic fiborsis - do Cl sweat test

Question 29

Foul smell from <5yo?

Answer 29

FB!

Question 30

Medical emergencies w/ nose?

Answer 30

displaced fractures septal deviations naso septal hematomas

Question 31

Epistaxis <2yo?

Answer 31

rare

Question 32

Epistaxis unilateral/bilateral?

Answer 32

unilateral: minor trauma bilateral: major trauma

Question 33

Epistaxis prolonged bleeding?

Answer 33

bleeding disorder - vita k def?

Question 34

Epistaxis + ecchymosis?

Answer 34

bleeding disorder

Question 35

Epistaxis + HA?

Answer 35

intracranial bleeding

Question 36

Prevention of recurrent epistaxis?

Answer 36

humidifier saline gel control underlying cx (allergies) no nose picking

Question 37

Sinusitis vs OM?

Answer 37

OM >> sinusitis b/c sinuses aren not developed until 8yo

Question 38

Sinusitis bugs?

Answer 38

S. pneumonia H. influenzae Moraxella same as OM

Question 39

Sinusitis tx?

Answer 39

HD Amox 80mg/kg/daily macrolide if allergic to amox same as OM

Question 40

What is ankyloglossia?

Answer 40

tongue tie

Question 41

Frenulectomy if?

Answer 41

speech impairment | feeding difficulties

Question 42

Cleft palate association?

Answer 42

trisomies 13&18

Question 43

Cleft related morbidities?

Answer 43

poor feeding choking eustachian tube dysfxn speech difficulties

Question 44

Adenoidal tonsiller hypertrophy- cx?

Answer 44

allergies recurrent infxn familial

Question 45

Adenoidal tonsiller hypertrophy - sx?

Answer 45

chronic congestion | obstructive sleep apnea

Question 46

When to remove tonsils?

Answer 46

OSA asymmetry - malignancy recurrent infxn

Question 47

Sore throat - bug?

Answer 47

VIRAL > BACTERIAL

Question 48

Strep throat - criteria?

Answer 48

high fever tonsil exudates cervical adenopathy NO URI sx

Question 49

Group A strep throat complications?

Answer 49

scarlett fever peritonsiller abscess post strep glomerulonephritis

Question 50

Scarlett fever?

Answer 50

complication from group A strep

Question 51

Scarlett fever - classic?

Answer 51

sand paper rash pharyngitis pastias lines (found in skin creases)

Question 52

Scarlett fever - tx?

Answer 52

PCN

Question 53

Peritonsilar abcess - sx?

Answer 53

hot potato voice | deviation of uvula

Question 54

Post strep Glomerulonephritis -sx?

Answer 54

hematuria post strep (1-2days after) HTN

Question 55

Post strep Glomerulonephritis-dx?

Answer 55

RBC + casts | ASO titers

Question 56

Post strep Glomerulonephritis - tx?

Answer 56

control HTN | supportive

Question 57

Rheumatic fever?

Answer 57

complication of group A strep | autoimmune -attacking mitral valve

Question 58

Rheumatic fever major criteria?

Answer 58

``` JONES Joint arthritis O-carditis: valvular dz Nodules on skin Erythema marginatum (pink rings) Sydenhamm chorea (jerking movements) ```

Question 59

Rheumatic fever minor criteria?

Answer 59

fever arthalgias incr ESR prolonged PR interval

Question 60

Rheumatic fever -dx?

Answer 60

2 major OR 1 major and 1 minor

Question 61

Rheumatic fever - tx?

Answer 61

ASA | PCN

Question 62

Rheumatic heart dz - tx?

Answer 62

ASA longterm abx (PCN G) valve replacement

Question 63

Peritonsilar - age?

Answer 63

older kids

Question 64

Retropharyngeal-sx?

Answer 64

along the retropharyngeal lymph nodes | complication of group A strep

Question 65

Retropharygneal - age?

Answer 65

younger

Question 66

Epiglottitis?

Answer 66

infxn of the epiglottitis d/t h influenzea

Question 67

Epiglottitis - sx?

Answer 67

Dsyphagia Distress Drooling

Question 68

Epiglottitis-tx?

Answer 68

ER | abx: ceftriaxone + clindamycin/vancomycin

Question 69

Epiglottitis - labs?

Answer 69

XRAY: thumbs sign

Question 70

Laryngeal abnormalities?

Answer 70

laryngomalacia vocal chord paralysis juvenile laryngeal papillomatosis

Question 71

Laryngomalacia?

Answer 71

common INSPIRATORY stridor

Question 72

Laryngomalacia - sx?

Answer 72

stridor worse in supine | BUT EVERYTHING IS NORMAL

Question 73

Laryngomalacia - tx?

Answer 73

reassurance

Question 74

Croup?

Answer 74

aka laryngotracheitis

Question 75

Croup - bug?

Answer 75

Parainfluenza RSV influenza

Question 76

Croup - sx?

Answer 76

stridor - worse in evenings runny nose barky cough fever

Question 77

Croup dx?

Answer 77

clinical

Question 78

Mild croup sx?

Answer 78

only barky cough

Question 79

Croup tx?

Answer 79

mild and mod: corticosteroids (dexa) | severe: Epinephrine

Question 80

Severe croup sx?

Answer 80

stridor at rest