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Pediatric HEENT

DiseaseEtiology/Cause/DescriptionDiagnosis/LabsManagement/TreatmentPt Education/FU
Conjuctivitis inflammation of the conjunctiva. Haemophilus influenzae and Streptococcus Pneumoniae ar the most common -bacterial agents Tearing, injection, discharge, cursting of the lases and chemosis Good hygiene, cold compress, topical antibiotic (blank)
Positional Head deformity external pressures on the rapidly deveoping skull from polonged exposure to one position Ear on flattened side more anterior than other. Paralleogram-shaped. Forehead protruding on the side of the flattening. Unilateral bald spot Early recognition. Supervised Tummy time. therapy. Xray (blank)
Hordeolum (stye) sudden onset of localized tenderness, redness and swelling of the eylid warm moist compress. children>2mos topical antibiotic (blank) Cenase eyelids daily with a netural soap. if not responsive refer to expert for incision and drainage.
Chalazion chronic infalmmation of the meibomian gland. hard, non-tender nodule on the midportion of thetarus away from the lid border small, asympt do not need Rx. Large => warm compress, topical antibiotic If not responsive to therapy rferr to an expert of I&C
Blepharitis an inflammation of the eyelid margins often due to coliznation of eyelash follicles and meibomian glands with staphylococci hypertrophy & desquamation of the epidermis near the lid margin which results in erythema and scaling of the lid border. apply warm wet compress, gently scurb eyelids once a day with fingertips, or using diluted baby shampoo. For flares topical antibiotic Refer to opth for recurrent cases.
Strabismus abnormal ocular alignment Corneal light reflex test referral to pediatric opthamologist (blank)
Acute otitis media infection of the middle ear with middle ear effusion. Haemonfluos Influenza & S. pneumoneit most common casative organisms otalgia, bulgin TM, limited or absent mobility of the TM, air fluid level behind the TM purulent discharge Amox 80-90 Pain med Healthy children 6mos-2 year (observation. Antbx if severe. <6 mos antibx SNAP (safety net antibiotic prescription) to be filled if illness doesn't imporve in 48-72 h
Otitis Media with Effusion fluid in the middle ear without s/s of ear infection.following an acute episode of AOM._ or absent moblity of the TM and varying degress of hearing loss. fPneumatic otoscopy. TM dull, opague, with fludi level and air bubble visualized from behind the TM observation for 3 months w/o risk factors.Watchful waiting is preferred approach. >3mos antbx (blank)
Otitis externa inflammation of the external auditory canal. Pseudomona aerogninos most common causitive agent. Staph aureus common. Ear pain ! when pressure is placed on the targus.Sensation of fullness, itching, otorrhea Cortisporin otic suspension (blank)
Sinusitis acute subacute or chronic inflammation of the mucous membranes that line the paranals sinus. S. Pnue. Haemophil influenzae Gold standard: rcovery of bacteria in high density from the avity of a paranasal sinus (invasive performed only by specialist). Dx is based on clinical criteria in children who present with UR s that are persistne for 10-14 days but <20 Antbx Amoxicillin mild to mod illness.or high dose amoxicillin clavunate(augmentin) PCN allergy => cefdnir (blank)
Nose bleed Trauma, infection, inflammation FBA, desiccation, tumors, septal deviation postsurgical bleeding Kiesselback' Plexus (anteror 90% of epistaxis) Sit upright, lean forward slightly, apply direct pressure. 5-10 min (blank)
Oral Candidaisis Thrush infection of themucous membrans caused by candida albicans white play on erythematos base nystatin susp 1 cc each sid of mouth qid (blank)
Pharyngitis inflammation of the pharynx and surrounding lymp tissue (tonsils) Viruses most common pathogens (rhinovirus, adenovirus, RSV, coxscakie virus Epstei Barr virus. Bacteria: Goup a Bhemolytic strep. Do not atteptm to exmine pharyn of a pt who has drooling, stridor or trouble breathing (epiglotitis) Do a ANA, Viral Rx symptoms. Bacterial PCN V 250 mg goals of RX for Strept pharyng is to prevent Rheumatic fever
Created by: lknightly