PAEA Pediatrics EOR Topics Questions and Answers Rated A+.
what is the MC conjunctivitis seen in children? what is the cause? source?
... [Show More] ✔✔viral
conjunctivitis; Adenovirus; swimming pools
Dx? preauricular lymphadenopathy, copious watery eye discharge, scanty mucoid discharge,
usually unilateral with punctate staining on slit lamp examination; Tx? ✔✔dx: viral conjunctivitis
tx: supportive (cool compresses, artificial tears) +/- antihistamines for itching (Olopatadine)
Dx? bilateral eye itching, tearing, redness, string discharge, chemosis (conjunctival swelling)
with cobblestone appearance to inner/upper eyelids; Tx? ✔✔dx: allergic conjunctivitis
tx: topical antihistamines (H1 blockers) (Olopatadine, Pheniramine/Naphazoline, Emedastine),
topical NSAID (ketorolac), topical corticosteroids (but s/e of long term use = glaucoma,
cataracts, HSV keratitis)
Dx? purulent eye discharge, lid crusting, no visual changes, absence of ciliary injection; Tx?
✔✔dx: bacterial conjunctivitis (MC S. aureus, Strep pneumo, H. influenzae)
tx: topical abx (erythromycin, fluoroquinolones, sulfonamides, aminoglycosides); if contact lens
wearer cover for pseudomonas w/ fluoroquinolone or aminoglycoside
if bacterial conjunctivitis is found to be chlamydia or gonorrhea what is the tx? ✔✔admit for IV
and topical abx (ophtho emergency)
-gonoccoccal: IV ceftriaxone + topical
-chlamydia: IV azithromycin
neonatal conjunctivitis is aka? if left untreated can develop what? ✔✔ophthalmia neonatorum;
corneal ulceration, opacification/scarring, visual impairment/blindness
PAEA Pediatrics EOR Topics Questions and
Answers Rated A+
standard prophylaxis given immediately after birth to prevent ophthalmia neonatorum
(neonatal conjunctivitis) includes: ✔✔erythromycin ointment, tetracycline ointment, silver
nitrate, or povidone-iodine
if ophthalmia neonatorum (neonatal conjunctivitis) develops on day 1 after birth what is the
most likely cause? day 2-5? day 5-7? day 7-11? ✔✔day 1: silver nitrate (chemical causeprophylaxis is what can cause the condition)
day 2-5: gonococcal
day 5-7: chlamydia
day 7-11: HSV
orbital (septal) cellulitis is usually secondary to _________ infection in most commonly what
age group? ✔✔sinus; 7-12y; other causes include dental/facial infxns or bacteremia
what is the most common sinus infection (90%) that causes secondary orbital cellulitis? what
organisms are the cause? ✔✔ethmoid; S. aureus, Strep. pneumo, GABHS (Strep. pyogenes), H.
influenzae
work up/Dx? decreased vision, pain w/ ocular movement, proptosis (bulging eye), eyelid
erythema and edema; tx? ✔✔dx: orbital cellulitis
work up: CT scan (showing infxn of fat & ocular muscles) or MRI
tx: IV antibiotics (Vanc, Clinda, Cefotaxime, Ampicillin/Sulbactam)
what is the difference b/t orbital (septal) cellulitis and preseptal cellulitis? ✔✔preseptal may still
have ocular pain, redness and swelling but NO visual changes or pain w/ ocular mvmt (hasn't
affected the muscles)
misalignment of the eyes is aka? when does stable ocular alignment present in infants?
✔✔strabismus; 2-3 mos
convergent strabismus is aka? divergent strabismus is aka? ✔✔convergent: esotropia (deviated
inward "cross eyed")
divergent: exotropia (deviated ouward)
a + Hirschberg corneal light reflex test, diplopia, scotomas (blind spots), or amblyopia (lazy eye)
are clinical manifestations of what condition? what other tests can be performed?
✔✔strabismus; cover-uncover test to determine the angle of strabismus, cover test,
convergence testing
how can strabismus be treated? ✔✔-patch therapy: normal eye is covered to stimulate and
strengthen the affected eye
-eyeglasses
-corrective therapy: if severe or unresponsive to conservative therapy
if not treated before 2 y/o, amblyopia may occur and cause decreased visual acuity that is not
correctable
Dx? 1-2 days of ear pain, pruritis in the ear canal, auricular discharge, pressure/fullness, hearing
usually preserved, pain with tug test and tragus pressure, auditory canal
erythema/edema/debris, recent swimming pool use; MC organisms? Tx? ✔✔Dx: otitis externa
MC organisms: *pseudomonas*, proteus, s. aureus, s. epidermis, GABHS, anaerobes
(peptostreptococcus), aspergillus
Tx: 1. protect ear against moisture (isopropyl alcohol and acetic acid) 2.
ciprofloxacin/dexamethasone (ofloxacin safe if there is an associated TM perf) 3.
Aminoglycoside combo (neomycin/polytrim-B/hydrocortisone -BUT not used if perf suspected
bc ototoxic 4. amphotericin B if fungal
malignant otitis externa is osteomyelitis at the skull base secondary to ___________ infxn; MC
seen in what pt populations; Tx? ✔✔pseudomonas; MC in DM and immunocompromised pts;
Tx w/ IV Ceftazidime or Piperacillin + FQ or Aminoglycoside
acute otitis media is an infection of the middle ear, temporal bone and mastoid air cells that is
MC preceded by ✔✔a viral URI that causes edema of eustachian tube, negative pressure,
transudation of fluid and mucus in middle ear that allows for bacterial growth. [Show Less]