14- congestion

Question 1

can you give OTC cough and cold products to kids under two?

Answer 1

NO

Question 2

acute otitis media presentation

Answer 2

3-5 days after onset of upper respiratory symptoms.

otalgia (ear pain, tugging at ears).

fever, irritability, cough, anorexia, and, less commonly, vomiting and diarrhea.

bulging TM

Question 3

sinusitis presentation

Answer 3

begin with a viral URI, followed by superinfection of pathogenic bacteria (the same organisms as in OM).
A diagnosis of sinusitis should be considered when symptoms are persistent (>10 days), worsening, or severe (e.g. fever > 39 degrees).

Question 4

what color is TM when child cries

Answer 4

red

Question 5

otitis externa presentaiton

Answer 5

“swimmer’s ear,” is manifested by an edematous external auditory canal, and pain with traction on the ear lobe.

Question 6

risk factors for otitis media

Answer 6

allergies
smoke
day care
Bottle propping at bedtime
Pacifier use
Drinking formula from a bottle rather than breastfeeding
Significant family history of AOM
Male gender
Lower socioeconomic status
Respiratory allergies

Question 7

two most common pathogens to cause otitis media and third and 4th place

Answer 7

strep pneumo
hemophilus influenza

moraxella
then strep pyogenes

Question 8

first-line therapy for bilateral acute ottis media in kid 6 mo-2 yrs

Answer 8

amoxicillin

Question 9

use antibiotics if bilateral acute otitis media under 2 years old or if over 2 years old if…(rather than wait it out)

Answer 9

Toxic-appearing child, or
Persistent ear pain for 48 hours, or
Fever > 39 C within the past 48 hours

Question 10

middle ear effusion TM exam

Answer 10

amber, non- or poorly mobile, opaque and retracted tympanic membrane

Question 11

children with persistent effusion for >3 mo should have what test

Answer 11

hearing assessment

Question 12

Tympanostomy tube placement indications

Answer 12

children with otitis media with effusion persisting 4 months or longer and accompanied by hearing loss, documented language or other developmental delay, risk of developmental delay, or structural abnormality of the tympanic membrane or middle ear.

Question 13

when is Amoxicillin/clavulanate used in acute otitis media

Answer 13

moderate to severe otalgia or high fever,

additional beta-lactamase coverage for Haemophilus influenzae and Moraxella catarrhalis,

when failure with amoxicillin is suspected.

Question 14

sinuses inflamed in which years

Answer 14

maxillary and ethmoid (largest) in infancy.

sphenoid sinuses - third to fifth year of life,

frontal sinuses are rarely large enough until the sixth to tenth year of life.

Question 15

frontal sinusitis presentation

Answer 15

pain over the frontal bone and perhaps facial swelling in an older child or adolescent.

Question 16

bilateral otitis media with effusion

Answer 16

fluid in the middle ear space without signs and symptoms of acute inflammation (bulging or fullness of the tympanic membrane, fever and/or otalgia).

Question 17

viruses known to be associated with AOM

Answer 17

RSV
influenza
rhinovirus

help bacteria colonize and resist antibiotics

Question 18

Potential Testing Performed by an Audiologist

Answer 18

Tympanogram- mobility of TM

Conventional audiometry- auditory threshold via earphones

Visual reinforcement audiometry- auditory threshold via speakers

Otoacoustic emissions- measure cochlear function in response to stimulus

Question 19

what you should look for in ear exam

Answer 19

COMPT

Color
Other (bubbles, scarring, perforation)
Mobility
Position- bulging, retracting
Translucency