ENT+opthalm
high BMI
Loud breathing
Restless sleep
Daytime sleepiness
Anxiety
Irritability
OSA
Excess weight, poor laryngeal tone increases risk
MC cause: adenotonsillar hypertrophy
gold standard is sleep study
14 yr old campy diarhhea
now has leg paralysis
gullian barre
what structure is origin of bleeding in most cases of epistaxis
kiesselbach plexus
10yr old boy with trauma to eye with baseball
Layer of blood obscuring lower third of iris
pupil ok
diagnoiss?
hyphema
blood in ant chamberoccasionally blowout fracture and ruputred glove
Protect eye with rigid shield, control pain and nausea and consult dr mikler
complications: glaucoma and rebleed
13yr old with worsening ms weakness exacerbated by repetitive ms use
ocular ms weakness and ptosis
juvenile myasthenia gravis
rare but can be >10yrs
usual age for cleft palate repair
9-18months
address feeding issues first
LIP: 2-6m
Unilateral foul smelling nasal discharge
diagnosos?
nasal FB
positive gowers sign in
duchenne muscular dystrophy
XR
Most common cause of congenital sensorineural hearing loss
CMV infection
dysfunction of cn8
other causes are toxo, rubella, syphillis
genetic jervell and lange neilsen
bacterial meningitis
ototoxic drug
trauma
Full term, normal weight newborn are?
Far sighted
Near sighted
or normal vision
Far sighted
Hyperopic: due to size and shape
As they mature, eye elongates and becomes less far sighted
premature can bee less hyperopic even myopic
3m old with hypotonia and weakness that is symmetric and more with proximal ms involvement
legs more affected than arns
difficulty feeding
tongue fasciculations
no sensory deficits
SMA type 1
werdnig hoffmann
second mc lethal AR disorder (CF is 1st)
10yr old with GAS pharyngitis
given 1.2 million units of Pen G
when can he retyrn to school
10yr old with nasal stuffiness
mouth breathing
h/o recurrent pneumonia
nasal voice
exam: nasal polyps
What illness should be evaluated
Cystic fibrosis<12yr with polyps eval CF
other causes: allergic rhinitis, chronic sinusisits
t/t nasal steorids
14yr old with vertigo
syncope
dysarthria
visual alterations
loss of consciousness
what is this unusual type of migraine
mc in teen girls
13m F with coryza
post nasal discharge
high fevers 104
poor apetite
tender cervical LNadenitis
streptoccosis
most likely viral but in <2yrs consider strep
After lab: penicillin
use erythromycin, clinda or azithro for allergy