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Tag ENT

Question: ENT

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 2-month-old infant brought in by parents because they notice the center and mid-back of the tongue is black in color. The… Continue Reading →

Question: Nosebleed

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an 8-year-old boy for prolonged nosebleed last night and this morning. Last night it happened on the right nares, and this morning… Continue Reading →

Question: ENT/ID

(Click the link to comment and to vote – voting not working through email, sorry!) A previously-healthy 12-year old girl who was allowed to get a high cartilage ear piercing after much begging now comes in with evidence of infection… Continue Reading →

Question: ENT

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10 year old boy with 3 days of submandibular swelling. On exam, he has a 2cm x 3cm tender swelling in… Continue Reading →

Question: ID

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Question: Trauma

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 15 year old boy who was “jumped” by a group of boys at school today and hit in the head area…. Continue Reading →

Question: ENT

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 3 year old boy with unresolving right-sided ear infection. He was first seen 1 month ago and diagnosed with right AOM… Continue Reading →

Question: ENT / ID

(Click the link to comment and to vote – voting not working through email, sorry!) During the recent “tri-demic” of influenza, RSV, and COVID disease, there was also a nationwide shortage of common oral liquid antibiotics used to treat otitis… Continue Reading →

Wait & Watch OM Rx

(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Pediatric throat exam Pt 2

Here is our prior post on getting that pediatric throat examined Another method for older children that can follow commands: ask them to try to touch their chin with their tongue (try it on yourself)

Question: Oral

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 1 week old with the pictured oral lesions. 

Question: Onc

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 3 year old whose parent noticed a lump in the neck while bathing her. You palpate posterior cervical node(s). 

Question: HEENT

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 12 year-old with 2 weeks of nasal congestion, rhinorrhea, sneezing, and sore throat, especially in the mornings. She has had no… Continue Reading →

Question: Lac

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Question: ENT

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 3 year old child with acute onset draining right ear. The child has no fever and no history of recent swimming… Continue Reading →

Otitis Externa

When treating otitis externa, placement of an ear wick can help direct topical antibiotics into a swollen canal. If you don’t have a commercially sold ear wick, you can make one by cutting a small strip of merocel or even… Continue Reading →

Question: ENT

(Click the link to comment and to vote – voting not working through email, sorry!) A 2yo child presents with a 1.5cm diameter erythematous tender fluctuant swelling in the right preauricular area. There is a small pinhole sized indentation in… Continue Reading →

Question: OM

(Click the link to comment and to vote – voting not working through email, sorry!) Match the child with acute otitis media to appropriate therapy per AAP guidelines (all children well-appearing, non-toxic, no distress or indications of severe otalgia, symptomatic… Continue Reading →

Question: ENT

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Penetrating Palate Injury

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Question: Respiratory

(Click the link to comment and to vote – voting not working through email, sorry!) Which of the following is/are true of bacterial tracheitis? Children presenting with bacterial tracheitis tend to be older than children presenting with viral croup Children… Continue Reading →

Question: ENT

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 16 year old boy with sore throat, worse on the left side, dysphagia, low-grade fever, difficulty fully opening jaw (trismus), and… Continue Reading →

Question: FBs

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Pediatric Ear Exams

My husband the internist likes to say that we peds MDs are pretending to see the TM, but I say the MDs for adults are pretending to hear diastolic murmurs. Kidding aside, you really can get good at seeing TMs… Continue Reading →

Question: Otitis Media

(Click the link to comment and to vote – voting not working through email, sorry!) About 70% of ear infections improve spontaneously. Which of the following patients is NOT a candidate for the “wait and watch” no-antibiotics option (for all… Continue Reading →

Question: Swelling

(Click the link to comment and to vote – voting not working through email, sorry!) A 10-year old child is brought in for swelling that developed 2 hours ago around the mouth as well as a sensation of difficulty swallowing… Continue Reading →

Question: ENT

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an 8 month old child with viral URI symptoms and pulling at the left ear. The child has not had any fever,… Continue Reading →

Question: ID

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 5 year old child with cochlear implants placed 8 months ago. The child has fever, headache, vomiting, altered mental status, and… Continue Reading →

Question: 5yo with tachycardia

(Click the link to comment and to vote – voting not working through email, sorry!) A previously healthy 5 year old boy with PMH of ADHD presents with 9 days of lethargy, fever, vomiting, diarrhea, and weight loss. He recently… Continue Reading →

Question: Rash

http://diseasespictures.com/ What is the best treatment for this 3 year old patient’s rash? (Click the link to comment and to vote – voting not working through email, sorry!)

Pediatric throat exam

Some tips and tricks for examining children’s throats: Don’t do it until after you’ve gotten your lung, heart, and abdomen exam – once you make them cry, it’s game over A helpful position for young children is to sit on… Continue Reading →

Question: ENT

A 17yo boy comes in with complaint of inability to breathe from the right nares. He was seen 2 days ago by his PMD and prescribed amoxicillin for sinusitis, but is not improving. He denies placing any foreign body in… Continue Reading →

Question: ENT

You are seeing a 12yo child with right ear pain for 2 days. He has been swimming recently. On examination, he has pain when you pull on the pinna of the ear to straighten the canal, and the canal is… Continue Reading →

Nasal foreign body removal balloon catheter

The Katz extractor is a great tool for removing nasal foreign bodies, as shown on the video here (I have no financial interests in this product). But, if you don’t have one available, get a Fogarty cardiac embolectomy catheter from… Continue Reading →

Question: HEENT

A 17yo boy presents with severe sore throat for two days, and fever to 39. He has difficulty swallowing due to pain. He has no cough, congestion, nor ill contacts. His immunizations are up to date. On examination, he is… Continue Reading →

Pharyngitis in toddler

You are seeing a 35 month old boy with fever and sore throat x 2 days. He has no cough or runny nose, but his sister also had fever and sore throat recently, and his mom has a cough. His… Continue Reading →

Rule out airway foreign body

Nearly 3 year old girl was eating nuts and had a coughing episode. 6 year old sibling told parents “she’s choking on the nuts.” In the ED, patient is completely asymptomatic, has a normal CXR and a 100% O2 sat… Continue Reading →

ETT as suction catheter for FB removal

Cut a narrow caliber ETT short to create a semi-rigid suction catheter for foreign body removal of the nose or ears.  (From EM News September 2009, Tricks of the Trade: An Improvised, Semi-Rigid, Nasal/Aural Suction Catheter, by Timothy McGuirk DO)

Question: Trauma

A 2 year old is brought in that has chewed on an electrical cord. He has a scab in the corner of his mouth and no active bleeding and is otherwise well appearing with no other trauma. What delayed complication… Continue Reading →

Light source for peritonsillar abscess drainage

Use a laryngoscope upside down as a tongue blade, or use a self-lighting pelvic exam speculum (remove top half of the speculum)

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