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PEDIATRIC SLEEP APNEA
CPG's
SURGERY
TRIVIA
INFECTIONS
100
Anything over this number is considered sleep apnea in a child.
What is 1
100
7,5,3.
What are the numbers of infections that are required to recommend tonsillectomy per 1, 2, and 3+ years. Paradise criteria
100
The drainage technique(s) that are most effective in drainage peritonsillar abscess.
What are needle aspiration, I&D and quinsy tonsillectomy All are effective with a recurrence rate of 10-15% Powell, Clin Otolaryngol. 2012 Apr;37(2) Johnson:Otolaryngol Head Neck Surg. 2003 Mar;128(3) Herzon/Nicklaus: Curr Probl Pediatr. 1996 Sep;26(8):270-8 Herzon,Laryngoscope. 1995 Aug;105(8 Pt 3 Suppl 74):1-17.
100
President who was thought to have died from a "quinsy tonsillitis" (but may have been epiglottitis)
Who is George Washington.
100
This disease process is an indication for tonsillectomy and includes episodes of fever, sores in the mouth, inflamed tonsils and neck swelling.
What PFAPA. Periodic fevers, Apthous Ulcers, Pharyngitis, Adenopathy. One of only 2 syndromes with predictible fevers. Begins between the ages of two and five years
200
The 2 medications that have been shown to be effective for treatment of mild OSA in children.
What are montelukast (singulair) and nasal steroids Montelukast for Children With Obstructive Sleep Apnea: A Double-blind,Aviv D. Goldbart, Sari Greenberg-Dotan and Asher Tal DOI: 10.1542/peds.2012-0310 Pediatrics 2012;130;e575
200
The subgroup of children the AAP recommends should ideally have a sleep study prior to Adenotonsillectomy.
What is all children. The AAP recommendations for sleep study are quality grade A, strength recommendation. For evaluation by a specialist (sleep or ENT) quality grade D, strength recommendation.
200
These are 4 potential methods for adenoid removal.
What are: curette, cautery, coblator, adenotome, laser, microdebrider.
200
An adenoidectomy is recommended despite the size of the adenoids for second sets of tubes in this age group and for this ear pathology.
What is an over 2 year old with chronic serous effusion.
200
The Viral Capsule Antigen that is elevated only in acute mononucleosis.
What is VCA IgM.
300
Anything over this number is the AHI that the american academy of anesthesia uses to describe severe sleep apnea in children.
What is 10.
300
6 of the 9 groups of children who should spend the night after tonsillectomy, based on the AAP and ENT CPG's for obstructive sleep apnea syndrome.
What are: 1. Younger than 3 y of age 2. Severe OSAS on polysomnography 3.Cardiac complications of OSAS 4. Failure to thrive 5. Obesity 6. Craniofacial anomalies 7. Neuromuscular disorders 8. Current respiratory infection 9. Prematurity
300
The initial treatment for the complication of VPI occuring after adenoidectomy.
What is speech therapy. Most cases are transient. True VPI after adenoidectomy ranges from 1 in 750 to 1500.
300
The more common name for fetor oris.
What is halitosis or bad breath. A common complaint with tonsil concretions or tonsiloliths.
300
The virus that causes herpangina in children.
What is coxsackie A virus (it also causes hand foot and mouth)
400
Surgerical procedure that most effectively treats obstructive sleep apnea in all children.
What is a tracheotomy.
400
Sore throat plus one of these 5 findings equal an EPISODE of tonsillitis when counting numbers for tonsillectomy.
What are 1. Temperature > 38.3°C (101 F) , OR 2. Cervical lymphadenopathy (tender lymph nodes or >2 cm), OR 3. Tonsillar exudate, OR 4.Positive culture for group A b-hemolytic streptococcus OR 5. Antibiotics had been administered in conventional dosage for proven or suspected streptococcal episodes
400
The treatment for your patient who had adenotonsillectomy for SDB, and in the recovery room desaturates and is coughing up pink/red phelgm.
What is intubation and positive pressure ventilation. Post operative pulmonary edema is a rare but potential complication after T&A.
400
The tonsils and adenoids are primarily ____ cell organs.
What is B cell The adenoids and tonsils are primarily B cell organs: B lymphocytes comprise 50-65% of lymphoctyes, T cells about 40%. (perhiperal blood lymphocytes are 70% t-cells)
400
The bacterial infection found on positive throat culture in a 4 year old that would need to be reported to social work/child abuse clinic.
What is Neisseria gonorrhoeae
500
These are 4 potential methods for adenoid removal.
What are: curette, cautery, coblator, adenotome, laser, microdebrider..
500
The specific pain medication that was recommended per CPG to give the best relief of pain after adenotonsillectomy.
What is none. There was some level of pain after all pain medications. "No ideal postoperative medication has been identified for postoperative pain following tonsillectomy, nor has the frequency of administration of pain medication been detailed."
500
The approximate century that tonsillectomy was first described.
What is 1000 BC. This was actually as partial tonsillectomy because if too much of the tonsil is removed "so much blood will be discharged so as to destroy the individual"
500
What group of patients are most likely to develop Grisel's syndrome after adenotonsillectomy.
What is Down syndrome. Grisel's syndrome - atlanto axial subluxation Grisel syndrome is defined as nontraumatic subluxation of the atlantoaxial joint [26]. It is a rare complication that can occur after adenoidectomy (image 1) or other otolaryngologic procedures. Key features include severe neck pain accompanied by torticollis and pain upon head rotation [27,28].
500
The caustive organism of Lemierre syndrome as well as part of a mixed infection in Vincents Angina and Trench Mouth.
What is Fusobacterium necrophorum