Periorbital and Orbital Cellulitis – Board-Style Questions

Periorbital and Orbital Cellulitis — Board-Style Questions
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Pediatric Case ReviewBoard-Style Questions
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What this deck covers

periorbital and orbital cellulitis in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

  1. A blocked nose first
  2. What the scan shows
  3. When to scan
  4. The swinging torch
  5. An early warning
  6. A small collection
  7. Two days in
  8. The first drip
  9. The other eye too
  10. A soft forehead
  11. After a bite
  12. An unvaccinated infant
  13. Well and bright
  14. Both eyes puffy
  15. Below the inner corner
  16. Who looks after him
  17. How long in total
  18. A black patch

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Through the bloodstream from a distant source, An abscess lifting the periosteum off the bone, No, because imaging should wait for a failed course, Spread of the infection backwards to the orbit on the other side, Red colour vision using a red target or plates, Immediate drainage of the collection through the nose tonight, Switch to oral treatment since vision is normal, Aciclovir with an oral macrolide, Cavernous sinus thrombosis spreading across the midline, A sebaceous cyst that has become infected over the eyebrow, Pseudomonas acquired from contaminated water, Neisseria gonorrhoeae acquired from the mother, Co-amoxiclav by mouth, reviewed again within a day, Start intravenous antibiotics for both eyes.

Clinical pearls from this deck

  • Orbital cellulitis in a child: think ethmoid sinusitis.
  • Medial wall collection pushing the eye out: subperiosteal.
  • Cannot open the eye to examine it: image the orbit.
  • Swinging torch dilates the pupil: the nerve is in danger.
  • Early optic nerve trouble: red colour vision fades first.
  • Small medial abscess, normal vision, young child: drip first.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Infectious Disease case decks · pediatric reference values.

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