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PEDS FINAL > HEENT > Flashcards

HEENT Flashcards

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1
Q

What condition involves unilateral eye injection with thick, purulent discharge?

A

Bacterial Conjunctivitis

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2
Q

What are the three possible etiologies of Bacterial Conjunctivitis?

A
  • Strep pneumonia
  • H. influenzae
  • M. catarrhalis
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3
Q

What are the two recommended treatments for Bacterial Conjunctivitis?

A
  • Erythromycin ophthalmic ointment

- Trimethoprim-Polymyxin B drops

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4
Q

What condition involves watery, mucopurulent/bloody discharge from the eyes?

A

Neonatal Conjunctivitis

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5
Q

What is the etiology of Neonatal Conjunctivitis?

A

Chlamydia trachomatis

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6
Q

What condition uses NAAT (Nucleic Acid Amplification Test) as the cold standard diagnostic test?

A

Neonatal Conjunctivitis

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7
Q

What is the recommended treatment for Neonatal Conjunctivitis?

A

ORAL Erythromycin

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8
Q

What condition involves rapidly progressive profuse, purulent discharge + chemosis; urethritis?

A

Hyperacute Bacterial Conjunctivitis

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9
Q

What is the etiology of Hyperacute Bacterial Conjunctivitis?

A

Neisseria gonorrhoeae

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10
Q

What is the recommended treatment for Hyperacute Bacterial Conjunctivitis?

A

Immediate ophtho referral and hospitalization (severe and life-threatening)

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11
Q

What condition are contact lens wearers at high risk of contracting?

A

Pseudomonal keratitis

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12
Q

What is the recommended treatment for possible Pseudomonal keratitis (2)?

A
  • Antibiotics (must be anti-pseudomonal)

- Urgent ophtho referral in 12-24 hours

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13
Q

What condition involves watery, burning/gritty sensation in eye?

A

Viral Conjunctivitis

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14
Q

What is the most common etiology of Viral Conjunctivitis?

A

Adenovirus

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15
Q

What is the recommended treatment for Viral Conjunctivitis?

A

SYMPTOMATIC CARE

  • Avoid touching eyes and wash hands frequently
  • Do NOT return to sports/school until discharge resolves
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16
Q

What condition involves bilateral injection, itchy (ocular pruritus), watery/stringy discharge?

A

Allergic Conjunctivitis

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17
Q

What is the recommended treatment for Allergic Conjunctivitis?

A

Antihistamines with mast-cell stabilizing

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18
Q

What should be avoided in treatment of Allergic Conjunctivitis, and why?

A

NO topical steroids

- Potentially sight-threatening

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19
Q

If a patient is diagnosed with Neonatal Conjunctivitis, what are they also at risk for contracting?

A

Chlamydial pneumonia

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20
Q

What are three signs/symptoms of Keratitis?

A
  • FB sensation
  • Blepharospasm
  • Visible corneal opacity on penlight exam
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21
Q

What condition is CRASH associated with, and what does it stand for?

A

Kawasaki disease

  • Conjunctivitis
  • Rash (mibiliform)
  • Adenopathy
  • Strawberry tongue
  • Hands red and swollen → desquamation

AND FEVER

(could also use warm CREAM)

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22
Q

What diagnosis should be considered in all children with prolonged, unexplained fever >5 days?

A

Kawasaki disease

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23
Q

What additional testing should always be ordered in addition to normal workup for Kawasaki disease, and why?

A

Echocardiogram due to high risk for CV complications

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24
Q

What is the recommended treatment for Kawasaki disease (3)?

A
  • Hospitalization with cardio and I&D consults
  • IVIG to provide antibodies and reduce prevalence of carotid artery aneurysms
  • High-dose ASA
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25
What condition involves misalignment of eyes; can lead to amblyopia (lazy eye)?
Strabismus
26
What is the most common cause of persistent tearing/ocular discharge in children?
Dacryostenosis
27
What condition involves nasolacrimal duct obstruction; chronic tearing, mucoid discharge, lashes debris?
Dacryostenosis
28
How does Dacryostenosis typically progress, and what two treatments are recommended? What is the definitive treatment, and when would this treatment be recommended (think time)?
Often resolves on its own... - Lacrimal sac massage - Warm compress Definitive: surgical probe (>12 months)
29
What condition involves inflammation/infection of lacrimal sac; erythema, swelling, warmth, lacrimal sac tender? What condition is this a possible complication of?
Dacryocystitis | - Rare complication of Dacryostenosis
30
What are the two recommended treatments for Dacryocystitis? What should also be done diagnostically?
- Treat with empirical abx x7-10 days - Ophthalmology referral - Diagnostic: obtain cultures
31
What are the three possible etiologies of Acute Otitis Media (AOM)? Bonus: what other HEENT condition has the same etiologies?
- Strep pneumonia - H. influenzae - M. catarrhalis Also seen with bacterial conjunctivitis
32
What condition involves otalgia; fever, irritability?
Acute Otitis Media (AOM)
33
What condition shows bulging TM or acute inflammation AND middle ear effusion on PE?
Acute Otitis Media (AOM)
34
What is the diagnostic criteria for Acute Otitis Media (AOM) - ___ or ___ AND ___?
Bulging TM OR acute inflammation | AND middle ear effusion
35
What is considered recurrent Acute Otitis Media (AOM)? What is the recommended treatment if prophylactic antibiotics (Amoxicillin, Sulfa) are not effective?
- 3+ episodes in 6 months - 4+ episodes in 12 months If abx are ineffective, consider T-Tubes
36
What is the recommended treatment for Acute Otitis Media (AOM) - with dose? When should a patient follow up?
High-dose Amoxicillin (90 mg/kg/day BID) or Augmentin | - Follow up in 48-72 hours
37
What condition involves middle ear effusion with no signs of acute infection?
Otitis Media with Effusion (OME)
38
What condition involves amber/gray/blue, cloudy, opaque TM; retracted TM on PE?
Otitis Media with Effusion (OME)
39
What condition involves inflammation of EAC causing otalgia?
Otitis Externa
40
What is the most common etiology of Otitis Externa?
P. aeruginosa
41
What condition involves tender tragus/pinna OR diffuse erythema/edema of EAC on PE?
Otitis Externa
42
What is the recommended treatment for Otitis Externa (2)?
- Floxin otic solution (Ofloxacin) | - Avoid promoting factors
43
What is the most important risk factor associated with Allergic Rhinitis?
FH of atopy
44
What condition involves allergic shiners, Dennie-Morgan lines, “allergic salute”, pale/bluish/boggy/edematous turbinates; cobblestoning?
Allergic Rhinitis
45
What condition involves allergic shiners?
Allergic Rhinitis
46
What condition involves “allergic salute”; cobblestoning?
Allergic Rhinitis
47
What condition involves pale/bluish/boggy/edematous turbinates?
Allergic Rhinitis
48
What condition involves Dennie-Morgan lines?
Allergic Rhinitis
49
What is the recommended pharmacologic treatment for Allergic Rhinitis? What other two treatments are recommended in conjunction?
INTRANASAL STEROIDS - Allergen avoidance - Allergen immunotherapy
50
What condition is very common in children; non-toxic appearing; low-grade fever, rhinorrhea?
Viral URI
51
What is the most common etiology of Viral URI?
Rhinoviruses
52
What are the two most common symptoms seen with Viral URI in INFANTS?
- Nasal discharge | - Fever
53
What are the three most common symptoms seen with Viral URI in CHILDREN?
- Nasal discharge - Nasal congestion - Cough
54
For what condition should OTC decongestants be avoided, and for what specific age range should they be not used/avoidance recommended?
Viral URI - Avoid if <6 years - Recommended avoidance if 6-12 years
55
What condition has a timeline of NOT improving; >10 days but <30 days?
Acute Rhinosinusitis (bacterial)
56
What condition has a timeline of NOT improving; >12 weeks AND 2+ of drainage, nasal obstruction, facial pain/pressure/fullness or decreased sense of smell
Chronic Rhinosinusitis
57
What condition involves a “pealed grape” appearance on PE?
Nasal polyps
58
What condition is associated with SAMTERs triad, and what are the three components?
Nasal polyps - Nasal polyps - ASA sensitivity - Asthma
59
What are three potential complications of Viral URI?
- AOM - Asthma exacerbation - Acute bacterial sinusitis
60
What condition involves "double worsening"?
Acute Rhinosinusitis (bacterial)
61
What is the recommended treatment for Acute Rhinosinusitis (bacterial)? What if this is ineffective - with dose?
Supportive care | - Ineffective? Try Augmentin 45/kg/day
62
What is the most common cause of pharyngitis - provide two examples?
VIRAL - Adenovirus - Coxsackie A
63
What are the two most common symptoms associated with Pharyngitis?
- Sore throat | - Fever
64
What condition involves fatigue; tender cervical LAD, splenomegaly?
Infectious Mononucleosis
65
What is the etiology of Infectious Mononucleosis?
EBV
66
What is the recommended diagnostic test for Infectious Mononucleosis?
Heterophile antibody test (Monospot)
67
With what condition is activity restriction for 4 weeks recommended, and why?
Infectious Mononucleosis | - Prevent splenic rupture
68
During what time of year is peak incidence of Bacterial Pharyngitis?
Winter/early spring
69
What is the etiology of Bacterial Pharyngitis?
Group A Streptococci (GAS)
70
What condition involves abrupt onset, fever; absence of usual URI symptoms?
Bacterial Pharyngitis
71
What condition involves exudate, palatal petechiae, tender cervical LAD, possible "sandpaper" rash on PE?
Bacterial Pharyngitis
72
What treatment (and timeline) is recommended for Bacterial Pharyngitis? What are the two potential complications associated with Bacterial Pharyngitis?
Antibiotics in first 48 hours to prevent complications... - Acute Rheumatic Fever (ARF) - Post-Streptococcal Glomerulonephritis (PSGN)
73
What condition is common in 5-12 years; presents with generalized edema, gross hematuria, HTN; treatment is symptomatic care? What is this a complication of?
Post-Streptococcal Glomerulonephritis (PSGN) | - Complication of Bacterial Pharyngitis
74
What condition is common in 5-15 years; manifests into migratory arthritis, carditis, CNS involvement, subQ nodules and erythema marginatum? What is this a complication of?
Acute Rheumatic Fever (ARF) | - Complication of Bacterial Pharyngitis
75
What is the Centor Criteria, and for what condition is it used?
Centor Criteria helps diagnose Bacterial Pharyngitis... If 3+ present, order culture: - Tonsillar exudate - Tender cervical LAD - Fever - NO cough
76
What is the Paradise Criteria, and for what condition is it used to determine treatment?
Paradise Criteria is used to determine if tonsillectomy is necessary in treatment of Bacterial Pharyngitis... Tonsillectomy recommended if: - 7+ episodes per 1 year - 5+ episodes/year in last 2 years - 3+ episodes/year in last 3 years
77
What condition is more common after abx therapy?
Oral Candidiasis (Thrush)
78
What is the etiology of Oral Candidiasis (Thrush)?
Candida albicans
79
What is the recommended treatment for Oral Candidiasis (Thrush)?
Nystatin
80
In what two age populations is Mumps most common?
- School-age children | - College-aged adults
81
What condition involves initial fever, HA, myalgias, fatigue; parotitis within 48 hours?
Mumps
82
What is the most common cause of parotitis?
Mumps
83
What is the recommended treatment for Mumps?
Supportive care | - Self-limiting
84
What is the test used to diagnose Bacterial Pharyngitis?
RADT (rapid antigen detection testing)

PEDS FINAL (3 decks)

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