Pediatric HEENT
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| 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)
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| 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)
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| 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.
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| 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
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| 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.
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| Strabismus | abnormal ocular alignment | Corneal light reflex test | referral to pediatric opthamologist | (blank)
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| 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
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| 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)
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| 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)
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| 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)
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| 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)
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| 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)
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| 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
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