1
PAEAPediatrics EOR Topics Excellent
g g g g g
Questions & QualityAnswers |Latest U
g g g g g
pdate | Grade A+
g g g
whatgisgthegMCgconjunctivitisgseengingchildren?gwhatgisgthegcause?gsource?
➹➹:g viralgconjunctivitis;gAdenovirus;gswimminggpools
Dx?gpreauricularglymphadenopathy,gcopiousgwaterygeyegdischarge,gscantygmucoidgdischarge
,gusuallygunilateralgwithgpunctategstaininggongslitglampgexamination;gTx?
➹➹:g dx:gviralgconjunctivitis
tx:gsupportiveg(coolgcompresses,gartificialgtears)g+/-gantihistaminesgforgitchingg(Olopatadine)
Dx?gbilateralgeyegitching,gtearing,gredness,gstringgdischarge,gchemosisg(conjunctivalgswelling)
withgcobblestonegappearancegtoginner/uppergeyelids;gTx?
g
➹➹:g dx:gallergicgconjunctivitis
tx:gtopicalgantihistaminesg(H1gblockers)g(Olopatadine,gPheniramine/Naphazoline,gEmedastin
e),gtopicalgNSAIDg(ketorolac),gtopicalgcorticosteroidsg(butgs/egofglonggtermguseg=gglaucoma,gc
ataracts,gHSVgkeratitis)
, 2
Dx?gpurulentgeyegdischarge,glidgcrusting,gnogvisualgchanges,gabsencegofgciliaryginjection;gTx?
➹➹:g dx:gbacterialgconjunctivitisg(MCgS.gaureus,gStrepgpneumo,gH.ginfluenzae)
tx:gtopicalgabxg(erythromycin,gfluoroquinolones,gsulfonamides,gaminoglycosides);gifgcontactgl
ensgwearergcovergforgpseudomonasgw/gfluoroquinolonegorgaminoglycoside
ifgbacterialgconjunctivitisgisgfoundgtogbegchlamydiagorggonorrheagwhatgisgthegtx?
➹➹:g admitgforgIVgandgtopicalgabxg(ophthogemergency)
-gonoccoccal:gIVgceftriaxoneg+gtopical
-chlamydia:gIVgazithromycin
neonatalgconjunctivitisgisgaka?gifgleftguntreatedgcangdevelopgwhat?
➹➹:g ophthalmiagneonatorum;gcornealgulceration,gopacification/scarring,gvisual
impairment/blindness
standardgprophylaxisggivengimmediatelygaftergbirthgtogpreventgophthalmiagneonatorumg(neo
natalgconjunctivitis)gincludes:
➹➹:g erythromycingointment,gtetracyclinegointment,gsilvergnitrate,gorgpovidone-iodine
, 3
ifgophthalmiagneonatorumg(neonatalgconjunctivitis)gdevelopsgongdayg1gaftergbirthgwhatgisgth
egmostglikelygcause?gdayg2-5?gdayg5-7?gdayg7-11?
➹➹:g dayg1:gsilvergnitrateg(chemicalgcause-
prophylaxisgisgwhatgcangcausegthegcondition)gdayg2-5:ggonococcal
g
dayg5-7:gchlamydia
dayg7-11:gHSV
orbitalg(septal)gcellulitisgisgusuallygsecondarygtog
infectiongingmostgcommonlygwha
tgageggroup?
➹➹:g sinus;g7-12y;gothergcausesgincludegdental/facialginfxnsgorgbacteremia
whatgisgthegmostgcommongsinusginfectiong(90%)gthatgcausesgsecondarygorbitalgcellulitis?g
whatgorganismsgaregthegcause?
➹➹:g ethmoid;gS.gaureus,gStrep.gpneumo,gGABHSg(Strep.gpyogenes),gH.ginfluenzae
workgup/Dx?gdecreasedgvision,gpaingw/goculargmovement,gproptosisg(bulginggeye),geyelidger
ythemagandgedema;gtx?
➹➹:g dx:gorbitalgcellulitis
workgup:gCTgscang(showingginfxngofgfatg&goculargmuscles)gorgMRI
, 4
tx:gIVgantibioticsg(Vanc,gClinda,gCefotaxime,gAmpicillin/Sulbactam)
whatgisgthegdifferencegb/tgorbitalg(septal)gcellulitisgandgpreseptalgcellulitis?
➹➹:g preseptalgmaygstillghavegoculargpain,grednessgandgswellinggbutgNOgvisualgchangesgor
paingw/goculargmvmtg(hasn'tgaffectedgthegmuscles)
misalignmentgofgthegeyesgisgaka?gwhengdoesgstablegoculargalignmentgpresentginginfants?
➹➹:g strabismus;g2-3gmos
convergentgstrabismusgisgaka?gdivergentgstrabismusgisgaka?
➹➹:g convergent:gesotropiag(deviatedginwardg"crossgeyed")gdi
vergent:gexotropiag(deviatedgouward)
ag+gHirschberggcornealglightgreflexgtest,gdiplopia,gscotomasg(blindgspots),gorgamblyopiag(lazyg
eye)garegclinicalgmanifestationsgofgwhatgcondition?gwhatgothergtestsgcangbegperformed?
➹➹:g strabismus;gcover-uncovergtestgtogdeterminegtheganglegofgstrabismus,gcovergtest,
convergencegtesting
howgcangstrabismusgbegtreated?
PAEAPediatrics EOR Topics Excellent
g g g g g
Questions & QualityAnswers |Latest U
g g g g g
pdate | Grade A+
g g g
whatgisgthegMCgconjunctivitisgseengingchildren?gwhatgisgthegcause?gsource?
➹➹:g viralgconjunctivitis;gAdenovirus;gswimminggpools
Dx?gpreauricularglymphadenopathy,gcopiousgwaterygeyegdischarge,gscantygmucoidgdischarge
,gusuallygunilateralgwithgpunctategstaininggongslitglampgexamination;gTx?
➹➹:g dx:gviralgconjunctivitis
tx:gsupportiveg(coolgcompresses,gartificialgtears)g+/-gantihistaminesgforgitchingg(Olopatadine)
Dx?gbilateralgeyegitching,gtearing,gredness,gstringgdischarge,gchemosisg(conjunctivalgswelling)
withgcobblestonegappearancegtoginner/uppergeyelids;gTx?
g
➹➹:g dx:gallergicgconjunctivitis
tx:gtopicalgantihistaminesg(H1gblockers)g(Olopatadine,gPheniramine/Naphazoline,gEmedastin
e),gtopicalgNSAIDg(ketorolac),gtopicalgcorticosteroidsg(butgs/egofglonggtermguseg=gglaucoma,gc
ataracts,gHSVgkeratitis)
, 2
Dx?gpurulentgeyegdischarge,glidgcrusting,gnogvisualgchanges,gabsencegofgciliaryginjection;gTx?
➹➹:g dx:gbacterialgconjunctivitisg(MCgS.gaureus,gStrepgpneumo,gH.ginfluenzae)
tx:gtopicalgabxg(erythromycin,gfluoroquinolones,gsulfonamides,gaminoglycosides);gifgcontactgl
ensgwearergcovergforgpseudomonasgw/gfluoroquinolonegorgaminoglycoside
ifgbacterialgconjunctivitisgisgfoundgtogbegchlamydiagorggonorrheagwhatgisgthegtx?
➹➹:g admitgforgIVgandgtopicalgabxg(ophthogemergency)
-gonoccoccal:gIVgceftriaxoneg+gtopical
-chlamydia:gIVgazithromycin
neonatalgconjunctivitisgisgaka?gifgleftguntreatedgcangdevelopgwhat?
➹➹:g ophthalmiagneonatorum;gcornealgulceration,gopacification/scarring,gvisual
impairment/blindness
standardgprophylaxisggivengimmediatelygaftergbirthgtogpreventgophthalmiagneonatorumg(neo
natalgconjunctivitis)gincludes:
➹➹:g erythromycingointment,gtetracyclinegointment,gsilvergnitrate,gorgpovidone-iodine
, 3
ifgophthalmiagneonatorumg(neonatalgconjunctivitis)gdevelopsgongdayg1gaftergbirthgwhatgisgth
egmostglikelygcause?gdayg2-5?gdayg5-7?gdayg7-11?
➹➹:g dayg1:gsilvergnitrateg(chemicalgcause-
prophylaxisgisgwhatgcangcausegthegcondition)gdayg2-5:ggonococcal
g
dayg5-7:gchlamydia
dayg7-11:gHSV
orbitalg(septal)gcellulitisgisgusuallygsecondarygtog
infectiongingmostgcommonlygwha
tgageggroup?
➹➹:g sinus;g7-12y;gothergcausesgincludegdental/facialginfxnsgorgbacteremia
whatgisgthegmostgcommongsinusginfectiong(90%)gthatgcausesgsecondarygorbitalgcellulitis?g
whatgorganismsgaregthegcause?
➹➹:g ethmoid;gS.gaureus,gStrep.gpneumo,gGABHSg(Strep.gpyogenes),gH.ginfluenzae
workgup/Dx?gdecreasedgvision,gpaingw/goculargmovement,gproptosisg(bulginggeye),geyelidger
ythemagandgedema;gtx?
➹➹:g dx:gorbitalgcellulitis
workgup:gCTgscang(showingginfxngofgfatg&goculargmuscles)gorgMRI
, 4
tx:gIVgantibioticsg(Vanc,gClinda,gCefotaxime,gAmpicillin/Sulbactam)
whatgisgthegdifferencegb/tgorbitalg(septal)gcellulitisgandgpreseptalgcellulitis?
➹➹:g preseptalgmaygstillghavegoculargpain,grednessgandgswellinggbutgNOgvisualgchangesgor
paingw/goculargmvmtg(hasn'tgaffectedgthegmuscles)
misalignmentgofgthegeyesgisgaka?gwhengdoesgstablegoculargalignmentgpresentginginfants?
➹➹:g strabismus;g2-3gmos
convergentgstrabismusgisgaka?gdivergentgstrabismusgisgaka?
➹➹:g convergent:gesotropiag(deviatedginwardg"crossgeyed")gdi
vergent:gexotropiag(deviatedgouward)
ag+gHirschberggcornealglightgreflexgtest,gdiplopia,gscotomasg(blindgspots),gorgamblyopiag(lazyg
eye)garegclinicalgmanifestationsgofgwhatgcondition?gwhatgothergtestsgcangbegperformed?
➹➹:g strabismus;gcover-uncovergtestgtogdeterminegtheganglegofgstrabismus,gcovergtest,
convergencegtesting
howgcangstrabismusgbegtreated?
