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Flashcards in PEDS HEENT 1 Deck (45)
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1

Thick, purulent, ropy disharge

Usually starts unilaterally

Eyelids may be “crusted shut” in a.m.

+/- preauricular lymphadenopahty

Clinical px of what condition? 

Bacterial conjunctivitis

2

Cause of Bacterial conjunctivitis

S. pneumoniae, H. influenza, M. cattarhalis, S. aureus

Newborns: Chlamydia trachomatis #1

3

Tx of bacterial conjunctivitis

Antibiotic ointment-infants

Antibiotic drops- older children

**treat both eyes!!

4

Cause of viral conjunctivitis 

adenovirus: one of the primary causes of ‘colds’ (URI)

5

conjunctival injection of one or both eyes

watery ocular discharge, some crusting in a.m.​

Typically bilateral

May be accompanied by URI sx,  feels “gritty”

Clinical Px of what? 

Viral conjunctivitis 

6

Viral conjunctivitis Tx

self-limited

7

bilateral itchy, watery, red eyes

 watery discharge/tearing

“Bumpiness” of tarsal conjunctivae

Accompanied by sx of allergic rhinitis

Sneezing, dry cough, atopic dermatitis

Clinical Px of what? 

Allergic Conjunctivitis

8

Allergic conjunctivitis Tx

symptomatic: 

olopatadine in children > 2 years

Reduce exposure

9

Cause of Periorbital cellulitis (preseptal) 

(Infection ANTERIOR to orbital septum)

exogenous source ( eyelid abrasion, horedolum, chalazion, dacrocystitis, insect bite) 

MC pathogen = Staph aureus & S. pyogenes

10

2 MC pathogens of peri-orbital cellulitis

Staph aureus &  S. pyogenes

11

T/F: 

Periorbital cellulitis/orbital cellulitis infections arise POSTERIOR to the orbital septum

 

False, Periorbital cellulitis/orbital cellulitis infections arise ANTERIOR to the orbital septum

12

T/F: 

Periorbital cellulitis has mild, minimal complications

TRUE

 

13

Periorbital Cellulitis Tx

oral/systemic abx

(Augmentin)

14

infection POSTERIOR to the orbital serum

may cause serious complications- such as an acute ischemic optic neuropathy or cerebral abscess

This describes which condition? 

Orbital cellulitis

15

Cause of Orbital cellulitis

(2 MC pathogens?)

 

Staph or Strep (S. aureus)

16

T/F: 

Orbital cellullitis is almost always associated w rhinosinusitis or sinus infection

True

17

+/- fever (if present, it is high)

lid swelling & erythema

vision disturbances/decreased vision

Pain w EOMs, proptosis (protruding eye)

Clinical px of which condition? 

Orbital Cellulitis

18

Dx of orbital cellulitis

CT or MRI

19

Tx of orbital cellulitis

Emergent Opthalmology Consult; IV abx

+/- surgical drainage

20

Widespread inflammation of medium and small arteries, including the coronary arteries

aka “mucocutaneous lymph node syndrome”

Which condition? 

Kawasaki Dz

21

Dx of Kawasaki Dz

+/- anemia & thrombocytosis

no specific dx criteria

22

What is the leading cause of acquired heart dz in children in US? 

Kawasaki Dz

23

Boys>girls (1.5:1)

Transmissible to household contacts; clustering

Some clinical features similar to adenovirus and scarlet fever

Seasonality (winter and spring)

80% of cases occur in children < 5 yo (median age at diagnosis is 2yo)

Epidemiology of which condition? 

Kawasaki Dz

24

Dx criteria of Kawasaki Dz

Fever plus: 

- Conjunctivitis: bilateral, bright-red, non-exudative

- Mucositis: cracked lips, strawberry tongue

- Polymorphous rash & desquamation: starts in perineum, skin peels, then spreads

- Lymphadenopathy: cervical

- Extremity changes: edema, redness of palms/soles

"Can't make pain leave, eek!"

25

Details of Mgmt of Kawasaki Dz: IVIG 

IVIG (intravenous immune globulin) + Aspirin (ASA) (80-100mg/kg/d)

IVIG reduces incidence of aneurysms 

DO NOT admin live vaccines within 11 mos of IVIG 

26

General Mgmt of Kawasaki Dz

IVIG + Aspirin 

Baseline Echo + repeat @ 2 & 6 wks

27

Complications of Kawasaki Dz

CV: coronary artery aneurysms --> myocardial ischemia, infarction, sudden death 

Highest risk: < 1yr & >9yrs

28

Loss of the most superficial layer of corneal cells

What is this? 

Corneal Abrasion

29

Red eye, watery d/c (tearing)

blephorospasm (tight closure of eyelid)

Severe ocular pain

Fussy baby, irritable toddler

Rubbing at eye

“squinting”/photophobia

Corneal Abrasion

30

Corneal Abrasion Dx

fluorescein stainWood’s lamp**

If foreign body refer to Opthalmology