PAEA PEDIATRICS EOR EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

PAEA PEDIATRICS EOR EXAM 2023-2024 ACTUAL

EXAM 300 QUESTIONS AND CORRECT DETAILED

ANSWERS WITH RATIONALES (VERIFIED ANSWERS)

|ALREADY GRADED A+

how can strabismus be treated? - ANSWER- -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? - ANSWER- 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/polytrimB/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? - ANSWERpseudomonas; 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 - ANSWER- a viral URI that

causes edema of eustachian tube, negative pressure, transudation of fluid

and mucus in middle ear that allows for bacterial growth

what are the 4 MC organisms seen in acute otitis media? - ANSWER-

*Strep pneumo*, H. influenza, Moraxella catarrhalis, Strep pyogenes

(same as seen in acute sinusitis)

Dx: fever, otalgia, ear tugging in infants, conductive hearing loss,

stuffiness, possible drainage from ear, bulging/erythematous TM w/

effusion, dec TM mobility on pneumatic otoscopy; Tx? - ANSWER- dx:

acute otitis media

tx: 1st line- amoxicillin, 2nd line- augmentin (amoxicillin-clavulate); if

PCN allergy- azithromycin, clarithromycin, erythromycin-sulfisoxazole,

trimethoprim/sulfamethoxazole, if PCN adverse effect but not allergyceftriaxone, cefdinir, cefixine

don't forget to treat pain as well (ibuprofen or tylenol); can also perform

myringotomy (surgical drainage) to relieve pain

tympanostomy if recurrent >4 times in 1 yr

if bullae are seen on the TM of a pt with AOM what should you suspect?

- ANSWER- mycoplasma pneumoniae

Dx? deep ear pain (worse at night), fever, mastoid tenderness and

possibly fluctuance (abscess), following AOM infxn; complications? -

ANSWER- -dx: mastoiditis (inflammation of the mastoid air cells of the

temporal bone- mastoid and middle ear are connected)

-complications: hearing loss, labyrinthitis, vertigo, CN VII paralysis,

brain abscess

how is mastoiditis diagnosed and treated? - ANSWER- dx: by CT scan

is 1st line test

tx: IV abx (same as w/ AOM- amoxicillin 1st line, augmentin 2nd line,

azithromycin for allergy to PCN, ceftriaxone for ADR to PCN) + middle

ear/mastoid drainage (myringotomy +/- tympanostomy tube placementcan obtain Cx)

if mastoiditis refractory to tx or complicated = mastoidectomy

what are the 2 auditory examination tests (and what order do you

perform them in)? - ANSWER- 1st Weber (tuning fork placed on top of

head)

2nd Rinne (tuning fork placed on mastoid bone by ear)

if a child has conductive hearing loss in their L ear what will the Weber

and Rinne tests show? - ANSWER- Weber: lateralizes to L ear

Rinne: BC > AC

if a child has sensorineural hearing loss in the R ear what will the Weber

and Rinne tests show? - ANSWER- Weber: lateralizes to L ear (the

normal one)

Rinne: AC > BC (shows normal L ear)

what are the causes of conductive vs sensorineural hearing loss? -

ANSWER- conductive: *cerumen impaction* MC, damage to ossicles

(otosclerosis, cholesteatoma), mastoiditis, otitis media

sensorineural: *presbyacusis* MC (age-related hearing loss), chronic

loud noise exposure, CNS lesions (acoustic neuroma), labyrinthitis,

meniere syndrome

how is cerumen impaction treated? - ANSWER- 1. cerumen softening:

hydrogen peroxide 3% or carbamide peroxide (Debrox)

2. aural toilet: irrigation (as long as no TM perf- H2O must be at body

temp to prevent vertigo), curette removal, suction

Dx? acute ear pain, hearing loss, break in the tympanic membrane, +/-

conductive hearing loss, +/- bloody otorrhea, +/- tinnitus & vertigo; Tx?

- ANSWER- dx: tympanic membrane perforation

tx: observation (most heal spontaneously) but can do surgical repair;

avoid water/moisture/topical aminoglycoside (ototoxic) in ear

Dx: sneezing, nasal congestion/itching, clear rhinorrhea, worse in the

morning, pale/blue turbinates, +/- nasal polyps, +/- eye, ear, throat

involvement; Tx? - ANSWER- dx: allergic rhinitis