Pediatrics Questions Channel πŸ’‰πŸ’Š
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🩺 Daily Pediatrics Q&A | Clinical Scenarios | Evidence-based Notes | For Med Students & Practitioners.

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🦻 CHOLESTEATOMA | SOMedEd

Cholesteatoma is a collection of keratinizing squamous epithelium in the middle ear. It is not malignant but is locally destructive.

Usually follows chronic otitis media or a retraction pocket where skin gets trapped.

βš™οΈ Key pathology
Expands and erodes bone
Affects ossicles, mastoid air cells, sometimes facial nerve

πŸ‘‚ Clinical features
Foul-smelling chronic ear discharge
Painless progressive conductive hearing loss
Ear fullness

πŸ” Diagnosis
Otoscopy: pearly white mass
CT temporal bone: bone erosion

πŸ›  Treatment
Surgical removal

🚨 Complications
Conductive hearing loss
Mastoiditis
Facial nerve palsy
Intracranial infection

⭐️ Key clue
Chronic foul-smelling discharge + painless hearing loss = cholesteatoma until proven otherwise
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🦻 LARYNGOMALACIA | SOMedEd

🦻 Laryngomalacia is the most common cause of inspiratory stridor in infants.

It occurs due to collapse of the supraglottic tissues during inspiration, leading to noisy breathing that typically worsens when the baby is supine and improves when prone.

πŸ“Œ Laryngoscopy may show the classic omega-shaped epiglottis (Ξ©).

Most cases are mild and resolve spontaneously by 18 months with reassurance and close follow-up. Concurrent gastroesophageal reflux should also be managed when present.
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The most common suppurative complication of AOM is:
Anonymous Quiz
10%
Labyrinthitis
64%
Acute mastoiditis
6%
Facial palsy
20%
Brain abscess
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Mastoid tenderness with ear displacement suggests:
Anonymous Quiz
11%
Otitis externa
71%
Acute mastoiditis
14%
Cholesteatoma
4%
Viral labyrinthitis
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πŸ–Š Acute Mastoiditis | SOMedEd

🦻 Acute mastoiditis is the most common suppurative complication of acute otitis media.

It presents with fever, postauricular tenderness/swelling, a bulging tympanic membrane, and outward displacement of the ear.

πŸ“Œ Consider mastoiditis in any child with acute otitis media who develops tenderness behind the ear.
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Is vitamin toxicity more likely with water-soluble or fat-soluble vitamins?
Anonymous Quiz
30%
Water-soluble vitamins
70%
Fat-soluble vitamins
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Key differentiating feature of peritonsillar abscess from tonsillitis:
Anonymous Quiz
1%
Cough
64%
Trismus
7%
Rhinorrhea
27%
Bilateral tonsillar swelling
A child with β€œhot potato voice”, drooling, uvular deviation, and trismus most likely has:
Anonymous Quiz
6%
Acute tonsillitis
39%
Peritonsillar abscess
42%
Epiglottitis
13%
Retropharyngeal abscess
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🧠 Eustachian Tube in Young Children | SOMedEd


In young children, the Eustachian tube is short, narrow, and more horizontal. This causes poor drainage and easy blockage, especially after viral URIs or AOM. Fluid then gets trapped in the middle ear, leading to OME.
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