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Paediatric ENT Summary

A summary of key knowledge related to Paediatric ENT required for the ENT exam.
Course

Medicine (MBCH11002)

185 Documents
Students shared 185 documents in this course
Academic year: 2016/2017
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The University of Edinburgh

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ENT Hx and Exam

Sore Throat  Viral more common  S. pyogenes: o Spots of white o Rx:  Penicillin V (NOT amoxicillin, as if EBV  full-body rash)  Painkillers  If can’t swallow, IV fluids  EBV: o Carpet of white o Red petichiae on soft palate o Usually the cause if airway obstruction o Hepatosplenomegaly:  Take LFTs  Beware alcohol, contact sport  Tonsillectomy indications: o 3/yr for 3 yrs o 5/yr for 2 yrs o 7/yr for 1 yr o Obstructive sleep apnoea o Malignancy o Bad halitosis  Tonsillectomy complications: o Worsening pain in throat o Bleeding::  W/in 24 hours = primary  Later = secondary (probably infection)  1 in 100 back to theatre due to bleeding

Adenoids  Symptoms: o OSA o Mouth-breathing o Nasal discharge, PND  Can get desaturation after removal due to increased O2 w/ hypoxic drive

Acute Otitis Media  Often caused by common cold, congested pharynx  blocked Eustachian tube  Child Eustachian tube:

o Shorter o More horizontal  Exam: o Bulging ear drum w/ pus behind o Eventualy perforates, see discharge  Rx: o Wait for resolution o If still painful after 72 hours, give amoxicillin o If <2yrs, AMOX straight away

Recurrent AOM  4/year or 3 in <1/2 a year  Avoid smoking around them  If persistent despite changes: o 6 weeks ABs o If persists, grommets

Mastoiditis  Result of AOM  Rx: o ABs and drainage o May need cortical mastoidectomy

Glue Ear (Otitis media with Effusion)  NOT infected  Bubbles in fluid behind TM  Due to Eustachian tube dysfunction  transudate from –ve pressure  Symptoms: o Hearing loss o NOT usually painful o Speech delay  Ix: o Conductive loss on audiogram  Rx: o Give Dx o If persists, grommit (to let air in, not to drain)

Cholesteatoma  Chronic –ve pressure in middle ear – pars flacida retraction pocket formation  Rx: o Excision! o Close follow-up, as can often recur

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Paediatric ENT Summary

Course: Medicine (MBCH11002)

185 Documents
Students shared 185 documents in this course

University: The University of Edinburgh

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ENT Hx and Exam
Sore Throat
Viral more common
S. pyogenes:
oSpots of white
oRx:
Penicillin V (NOT amoxicillin, as if EBV full-body rash)
Painkillers
If can’t swallow, IV fluids
EBV:
oCarpet of white
oRed petichiae on soft palate
oUsually the cause if airway obstruction
oHepatosplenomegaly:
Take LFTs
Beware alcohol, contact sport
Tonsillectomy indications:
o3/yr for 3 yrs
o5/yr for 2 yrs
o7/yr for 1 yr
oObstructive sleep apnoea
oMalignancy
oBad halitosis
Tonsillectomy complications:
oWorsening pain in throat
oBleeding::
W/in 24 hours = primary
Later = secondary (probably infection)
1 in 100 back to theatre due to bleeding
Adenoids
Symptoms:
oOSA
oMouth-breathing
oNasal discharge, PND
Can get desaturation after removal due to increased O2 w/ hypoxic drive
Acute Otitis Media
Often caused by common cold, congested pharynx blocked Eustachian
tube
Child Eustachian tube:

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