Paediatric ENT

Question 1

Airway problems in children?

Answer 1

inhaled foreign body
subglottic stenosis
RRP- recurrent respiratory papillomatous disease

Question 2

ENT investigation?

Answer 2

nasoendoscopy in stable patients

Question 3

What does obligate nasal breathing mean?

Answer 3

0-6 months mechanism for breathing

Question 4

Name a condition which would impact obligate nasal breathing?

Answer 4

choanal atresia

Question 5

Cause of stertor?

Answer 5

Micronathia- small jaw- pio raban sequence??
enlarged tonsils and adenoids

Question 6

Name a paediatric airway condition that can cause apnoea?

Answer 6

enlarged tonsils + adenoids

Question 7

What is the most common cause of stridor in children?

Answer 7

laryngomalacia

Question 8

Differentials for stridor?

Answer 8

webs
cysts
clefts
vocal cord paralysis
subglottic stenosis
tracheal stenosis
foreign bodies

Question 9

What is tracheomalacia?

Answer 9

?

Question 10

What is the grading for airway stenosis?

Answer 10

Cotton-Myer grading

Question 11

Stertor?

Answer 11

Above larynx- upper airway

Question 12

Stridor?

Answer 12

just below larynx

Question 13

Stertor common cause?

Answer 13

adenotonsillar hypertrophy

Question 14

Midline neck lump most common cause?

Answer 14

Thyroglossal duct cyst

Question 15

Investigation for midline lump?

Answer 15

ultrasound

Question 16

Management of thyroglossal cyst?

Answer 16

infection

Question 17

Are thyroid lumps in children common?

Answer 17

rare

Question 18

Most common malignancy teenagers? neck lumps

Answer 18

Lymphoma

Question 19

Paediatric ENT emergencies?

Answer 19

foreign bodies in ears
button battery

Question 20

How to get rid of insect in ear?

Answer 20

drown the bug- syringe with water, oil??

Question 21

What is the most obvious sign of nasal foreign body?

Answer 21

unilateral nasal discharge

Question 22

How to get foreign body out of nose?

Answer 22

Mother’s kiss
crocadile forceps

Question 23

Is aural or nasal RB more of en emergency?

Answer 23

nasal is an emergency due to risk of airway obstruction. Any batter related obstruction is always an emergency

Question 24

Why are button batteries dangerous?

Answer 24

strictures and perforations

Question 25

What is the collection of arterial vessels in the nose?

Answer 25

Little's area/kesselbach area

Question 26

Treatment for epistaxis?

Answer 26

naseptin silver nitrate cutery

Question 27

Causes of epistaxis?

Answer 27

coagulopathies juvenile nasal angiofibroma idiopathic

Question 28

What is a fluid bolus in children?

Answer 28

10-20ml/kg!!!!!!!

Question 29

Infectious emergencies of the airway?

Answer 29

croup epiglottitis

Question 30

What is the treatment for croup?

Answer 30

steroids adrenaline nebs

Question 31

Why is epiglottitis rare?

Answer 31

vaccination of H.influenzae?

Question 32

Airway obstruction management?

Answer 32

adrenaline nebs dexamethasone oxygen- waft oxygen secure airway

Question 33

Red swelling in neck of lymph node?

Answer 33

infection of lymph node (overreactive lymph node) - abscess or atypical

Question 34

What is trismus?

Answer 34

When your jaw muscles become so tight that you can't open your mouth, you may have a condition known as trismus. Trismus refers to muscle spasms in your temporomandibular joint. Head and neck cancer treatment is the most common reason why people develop trismus.

Question 35

Is quinsy unilateral or bilateral?

Answer 35

quinsy= unilateral tonsillitis= bilateral

Question 36

Signs of deep neck infections?

Answer 36

torticolis trismus drooling pyrexial

Question 37

Source of peri-orbital infections?

Answer 37

sinusitis conjunctivitis

Question 38

Evidence of abscess with eye infection?

Answer 38

double vision chemosis restriction of eye movement

Question 39

First line treatment of acute otitis media antibiotic?

Answer 39

amoxicillin second line augmentin

Question 40

Management of mastoiditis secondary to otitis media?

Answer 40

IV antibiotics surgical drainage

Question 41

What is a sign of mastoiditis?

Answer 41

Drooping of ears Erythema around mastoid process

Question 42

What is the hearing screening test in neonates?

Answer 42

universal hearing screening programme

Question 43

Why is it important to test for hearing problems?

Answer 43

important for speech

Question 44

First word milestone?

Answer 44

1 year

Question 45

How many words ay 2 years?

Answer 45

150-300 words, 2-3 word sentences

Question 46

Another term for glue ear?

Answer 46

otitis media with effusion= OME

Question 47

Risk factors for OME?

Answer 47

parental smoking siblings with OME bottle feeding low socioeconomic groups acute otitis media nursery attendance

Question 48

Name two conditions associated with OME

Answer 48

cleft palate down's syndrome primary ciliary dyskinesia craniofacial abnormalities

Question 49

Complications of AOM?

Answer 49

facial nerve palsy mastoiditis

Question 50

external ear abnormalities? /prominent ears

Answer 50

microsia atresia

Question 51

Name a hearing test in children?

Answer 51

visual response audiometry play audiometry tympanometer distraction testing 6-9 months subjective vs objective (e.g. tympanometry), others above are subjective

Question 52

Neonatal hearing screening test in Scotland?

Answer 52

Aoutomated brainstem responses ABR

Question 53

Name of pinna abnormality?

Answer 53

microtia?

Question 54

What is Chandler Classification used for?

Answer 54

orbital cellulitis

Question 55

Which scan do you request for orbital cellulitis?

Answer 55

CT head, orbits, sinuses

Question 56

Signs of mastoiditis on examination?

Answer 56

post auricular erythematous swelling with pain

Question 57

Which organisms cause acute otitis media?

Answer 57

resp epithelial organisms- s pneumoniae and pyogenes, h.influenzae

Question 58

Name one complication of mastoiditis

Answer 58

facial nerve palsy abscess meningitis

Question 59

Name one initial management for foreign body in nose

Answer 59

mother's kiss - ask parent to occlude patent nasal passage and breathe into mouth

Question 60

Where do foreign bodies in the throat typically get stuck in children?

Answer 60

cricopharyngeus= upper oesphageal sphincter

Question 61

Why do you worry about cervical lymphadenitis?

Answer 61

can progress to abscess

Question 62

WHat are the signs of abscess cervical lymphadenitis

Answer 62

fluctuant puss erythematous hot

Question 63

Why do children get retropharyngeal abscesses and not adults?

Answer 63

associated with inflammation of node of rouviere which disappear after the age of 4

Question 64

Child with retropharyngeal abscess now develops chest pain. What are you worried about?

Answer 64

mediastinitis

Question 65

Name one sign on CT of retropharyngeal abscess

Answer 65

loss of cervical lordosis collection of gas narrowing of airway and deviation

Question 66

Which vaccine has reduced the occurence of epiglottitis?

Answer 66

H/ influenzae B HIB

Question 67

How to manage epiglottitis child?

Answer 67

do not touch!!! manage airway nebulised adrenaline

Question 68

What is the thumb sign on XR?

Answer 68

sign of epiglottitis