Rita's random HEENT questions Flashcards by Meredith Thompson

When do you refer a child with a chalazion for exclusion?

a) when it is so big that there’s a lid lag
b) when it has persisted for over 2 weeks
c) when the child has a hx of hordeolum
d) when the mother wants referral

a) when it is so big that there’s a lid lag

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What’s the first action you take with hyphema from a baseball bat injury to the eye?

a) patch it
b) raise the head
c) refer to ophthalmology +/or shield it
d) Bed rest

c) refer to ophthalmology +/or shield it

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You are examining an eardrum and note pearly, white cyst on the drum. What is the most likely diagnosis?

a) Cholesteatoma
b) Foreign body
c) Otitis media
d) Otitis externa

a) Cholesteatoma

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Which of the following children should have an immediate ophthalmology referral?

a) 1 yo with lifelong anisocoria
b) 3 yo with leukocoria
c) 4 yo with strabismus

b) 3 yo with leukocoria

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What are the most common bacteria in AOM?

a) Strep pneumonia
b) H. flu
c) Moraxella catarrhalis
d) Streptococcus Group A

a) Strep pneumonia

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What is the tx for a newborn with Chlamydia conjunctivitis?

a) Azithromycin
b) Erythromycin
c) Amoxil

b) Erythromycin

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What is the most common midline neck mass in a child?

a) thyroglossal cyst
b) thyroid gland
c) lymphadenopathy

a) thyroglossal cyst

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An 8 month old presents with conjunctivitis. What is the most likely organism?

a) H. influenza
b) Strep Pneumoniae
c) M. Cattarhalis
d) Staph aureus

a) H. influenza

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A 3 week old presents with a staccato cough and conjunctivitis. What is the most likely organism?

a) Gonococcus
b) Chlamydia
c) M. Cattarhalis
d) Staph aureus

b) Chlamydia

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What drug will help a 3 yo with allergic rhinitis?

a) Afrin
b) Nasonex
c) Astelin

b) Nasonex

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A newborn presents with photophobia, large pupils, and tears. What is the most likely dx?

a) conjunctivitis
b) glaucoma
c) strabismus
d) porphyria

b) glaucoma

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What is the first line treatment for Otitis media?

a) Trimethoprim sulfa
b) Cefdinir
c) Amoxil/clav
d) Amoxil

d) Amoxil

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What is the most likely sequelae of a strep tonsillitis?

a) strep pneumonia
b) glomerulonephritis
c) scarlet fever
d) rheumatic fever

b) glomerulonephritis

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Which of the following children need an immediate referral to an ophthalmologist?

a) A 3 yo with a hx of getting glue near the eye.
b) A 7 yo with a corneal abrasion.
c) A 4 yo with dendrites on fluorescence.
d) a 10 yo with subconjunctival hemorrhage

c) A 4 yo with dendrites on fluorescence.

–> herpes!

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A 1 week old infant has been diagnosed with nasolacrimal duct obstruction. What should the initial therapy include?

a) surgical referral
b) referral to a pediatric ophthalmologist
c) use of prophylactic antibiotic
d) nasolacrimal massage

d) nasolacrimal massage

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Which one of the following is not an appropriate tx for otitis externa?

a) Keflex
b) Cortisporin otic
c) Floxin otitis
d) Ciprofloxacin otic solution

a) Keflex

Who is at risk for a conductive hearing loss?

a) child with a hx of hyperbilirubinemia
b) child with otitis media
c) child with a stomach virus
d) child with a sore throat

b) child with otitis media

Who is not at risk for a sensorineural hearing loss?

a) hyperbilirubinema
b) low birth weight
c) ear infections
d) exposure to gentamicin

c) ear infections

–> risk for conductive hearing loss!

At what age do you need to treat strabismus to prevent amblyopia?

a) 3 yrs
b) 5 yrs
c) 7 yrs
d) 9 yrs

c) 7 yrs

A healthy 4 yo has +3 tonsils without a hx of sleep apnea. What is the best course of management?

a) Do nothing
b) Refer to ENT
c) Give antihistamines

a) Do nothing

When can a child who has been treated for strep throat go back to school?

a) 24 hrs
b) 48 hrs
c) 72 hrs
d) 96 hrs

a) 24 hrs

What is the first line tx for streptococcal pharyngitis?

a) Penicillin
b) Azithromycin
c) Trimethoprim sulfa
d) Cefdinir

a) Penicillin

Which of the following is the most likely dx for a child with hypernasal voice and snoring?

a) Polyp
b) Nasopharyngeal tumor
c) Hypertrophied tonsils
d) Mastoiditis

c) Hypertrophied tonsils

Which of the following is the most likely diagnosis in a 14 yo with pain on movement of the auricle?

a) Acute otitis media
b) Otitis externa
c) Otitis media with effusion
d) Mastoiditis

b) Otitis externa

Which of the following is the most likely dx in a child with cobblestoning of the palpebral conjunctiva? a) Bacterial infection b) Chemical exposure c) Severe allergies d) Viral illness

c) Severe allergies

What is the most common nonsuppurative complication of Group A strep infections? a) Rhematic fever b) Acute glomerulonephritis c) Scarlatinaform rash d) Carditis

b) Acute glomerulonephritis | nonsuppurative = inflamed, without pus

What bone do you see when you look in the ear? a) Incus b) Stapes c) Malleus d) Mastoid

c) Malleus

Which of the following would you use to treat an otitis if they were non severe allergic to penicillin? a) Reflex b) Augmentin c) Zithromax d) Ceftin

d) Ceftin | Zithromax = high resistance

A child has epistaxis. What advice do you give the parent? a) Use neosynephrine for 4-5 days. b) Refer to ENT. c) Put a cotton ball in the nose. d) Cold compress at the nape of the neck.

a) Use neosynephrine for 4-5 days. --> v. helpful!

A child presents with unilateral, malodorous discharge from the nare. Examination reveals a small pea stuck into the nasal passage. What is the next best step? a) Refer to ENT. b) Attempt to remove the pea. c) Start on Amoxil. d) Flush the nose with normal saline.

a) Refer to ENT.

A 10 yo has a hard, non-tender cyst on the eyelid with no other signs. What is the most likely dx? a) Hordeolum b) Conjunctivitis c) Chalazion d) Dacrocystitis

c) Chalazion - -> chalazion is non-tender. - -> hordeolum and dacrocystitis = painful!

Which of the following are the responsible pathogens in External otitis media? a) H. flu and Strep pneumo b) Moraxella cattarhalis and H. flu c) Staph aureus and group A strep d) Staph aureus and P aeruginosa

d) Staph aureus and P aeruginosa --> pseudomonas smells BAD

Which of the following children would need to be treated based on the new guidelines for otitis media? a) A 5 yo with new onset ear pain, a bulging red TM with an effusion, and a fever of 101.4. b) A 12 month old with a fever of 102.4 for 2 days, bulging red TM with an effusion, and irritability when not receiving pain medication. c) A 3 yo with a fever of 103, a red TM, and URI sx. d) A 24 month old with a fever of 101 for one day, bulging red TM with an effusion, and more crying than usual.

b) A 12 month old with a fever of 102.4 for 2 days, bulging red TM with an effusion, and irritability when not receiving pain medication.

A child presents with unilateral foul-smelling purulent nasal d/c. Which of the following is the most likely dx? a) Sinusitis b) URI c) Nasal foreign body d) Nasotonsillarpharyngitis

c) Nasal foreign body