Pediatric ENT
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| What are some tx options for a child with URI rhinorrhea and congestion? | Saline spray (2 sprays q nostril)
Follow w/bulb suction syringe or nose-blowing
Cool-mist humidifier
Steamy bath
Elevated head of bed (under mattress for infants)
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| What is the most common cause of URI/cold in peds? | Virus
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| What is the most appropriate type of tx for URIs in peds (think viral vs. bacterial)? | Supportive
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| What is common in peds in regards to persistent rhinorrhea and congestion? | Typical to have 1 URI/month
Each URI typically lasts ~21 days
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| When do allergies begin to develop in a child? | At about 12 months old
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| An 9-month-old is brought into your office by her mother. The child has a cold, and the mother wants you to treat it so it will go away quickly. She is also concerned that the child is allergic to their dog. What would you tell her? | Colds/URIs are typically viral in children
Abx are not indicated at this point
Suggest supportive tx for URIs
URIs also usually last for ~21 days and recur often
Allergies will not develop until 12 months of age
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| What peds does allergic rhinitis affect? | 20-40% of peds
Occurs in peds > 1 year old
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| What percentage of allergic rhinitis cases in peds are seasonal? | 20%
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| Common signs/symptoms of allergic rhinitis | Rhinorrhea
Nasal congestion
Sniffling
Mouth-breathing
Allergic salute
Nasal crease (due to salute)
Snoring
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| Allergic rhinitis tx | Avoid allergens
Nasal steroids
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| What is a concern about treating with nasal steroids? | Can be drying
Epistaxis
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| How can the side effects of nasal steroids be reduced? | Use 2 sprays saline before the steroid spray
Point spray laterally towards side of head
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| How long does allergic rhinitis take to resolve? | About 2-3 weeks
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| Common co-morbidities of allergic rhinitis | Chronic sinusitis
Asthma (38% have asthma)
If asthma is present, may check for atopic dermatitis
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| What is the only sinus cavity that is pneumatized until ~4 years old? | Ethmoid
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| At ~4 years old, what sinus cavities are pneumatized? | Maxillary
Ethmoid
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| At ~5 years old, what sinus cavities are pneumatized? | Sphenoid
Maxillary
Ethmoid
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| At 6-8 years old, what sinus cavities are pneumatized? | Frontal
Sphenoid
Maxillary
Ethmoid
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| What sinus cavity is pneumatized at birth? | Ethmoid
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| At ~4 years old, what sinus cavities are pneumatized? | Maxillary
Ethmoid
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| At ~5 years old, what sinus cavities are pneumatized? | Sphenoid
Maxillary
Ethmoid
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| At 6-8 years old, what sinus cavities are pneumatized? | Frontal
Sphenoid
Maxillary
Ethmoid
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Created by:
Carrie D.
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