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Foundations II Exam 1 > 2- Midle Ear > Flashcards

2- Midle Ear Flashcards

1
Q

What is acute otitis media

A

bacterial infection of middle ear

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2
Q

What are potential reasons for bacteria getting caught in the middle ear

A

Eustachian tube obstructed by mucus s/p URI

Poor eustachian tube drainage (young age, inflammation, congenital defect)

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3
Q

What bacteria cause acute otitis media

A

Strep Pneumo and H. Influenza!!

(if recurrent, probs due to allergies or secondhand smoke

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4
Q

How does acute otitis media present clinically

A 
otalgia
pressure
hearing loss
fever
URI Sx
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5
Q

What does a TM look like in acute otitis media

A

immobile, bulging

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6
Q

What organism are bullae associated with

A

Mycoplasma infection

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7
Q

What are signs of a perforated TM

A

Previous pain, now resolved but with drainage

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8
Q

How do you treat acute otitis media

A 
Amoxicillin first (2-3 days for improvement)
-Cephalosporin if PCN allergy)
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9
Q

What is amoxicillin doesn’t work after 2-3 days

A

high dose amoxicillin-clavulanate or cephalosporin

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10
Q

What antibiotic would you give with a perforated TM

A

Ofloxacin, it is not ototoxic

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11
Q

What are important patent education pieces to give your patient

A

don’t bottle feed laying down

Pneumo vaccine

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12
Q

What are potential complications of acute otitis media

A

labrynthitis
hearing loss
mastoiditis

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13
Q

When and who is acute otitis media most common in

A

kids 4-24, esp. those sucking on pacifier

fall and winter

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14
Q

What did Feirstein say abx tx should be for acute otitis media

A

Observation (abx if same or worse in 2-3 days): 6mo-2yo with unilateral, mild sx, OR, 2+yo if uni/bilateral and not severe
Immediate abx: <6 mo, OR, <24 mo and severe (pain 2+ days, Temp >102.2, bilateral)

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15
Q

What causes chronic otitis media

A

recurrent acute otitis media

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16
Q

What will you see on chronic seborrheic otitis media exam

A

chronic otorrhea
perforated TM
conductive hearing loss

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17
Q

What is treatment for chronic seborrheic otitis media

A

remove infected debris, use earplugs, topical/oral and

TM repair surgically

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18
Q

What is serous otitis media in ADULTS

A

Eustachian tube blocked for long time fluid to go into the middle ear
More common in kids because they have shorter eustachian tubes

19
Q

What is the cause of serous otitis media

A

S/p URI, barotrauma, chronic allergies

20
Q

How does serous otitis media present clinically

A

conductive hearing loss
fullness
NO acute illness/edema

21
Q

What will you see on serous otitis media physical exam

A

HYPOmobile TM, bubbles behind TM
TM bulging or retracted
conductive hearing loss

22
Q

How can you treat serous otitis media

A

decongestants
anti-histamine
nasal steroids
vent tubes if resistant

23
Q

What is a cholesteatoma

A

a type of chronic otitis media characterized by prolonged eustachian tube dysfunction creating a keratin sac in the middle ear

24
Q

What is a secondary cause of cholesteatoma

A

pseudomonas or proteus

25
Q

How does cholesteatoma present clinically

A

hearing loss and ear drainage

26
Q

What will you see on cholesteatoma PE

A

TM pocket/TM perforation exuding debris

27
Q

How do you treat a cholesteatoma

A

abx drops

surgical removal

28
Q

What are complications of cholesteatoma

A

erosion into inner ear, facial nerve, or brain abscess

29
Q

What is Eustachian tube dysfunction

A

When the normally closed tube connecting ear to nasopharynx develops negative pressure (edema, or air trapped inside)

30
Q

What causes eustachian tube dysfunction

A

Viral URI, allergies

31
Q

What are symptoms of eustachian tube dysfunction

A

fullness
fluctuating hearing
pan with pressure change
popping/cracking

32
Q

What will you see on PE with eustachian tube dysfunction

A

TM retraction

DECREASED TM mobility

33
Q

How do you treat eustachian tube dysfunction

A

decongestant
autoinflation
desensitization
intranasal corticosteroid

34
Q

What should patients with eustachian tube dysfunction avoid while symptomatic

A

air travel
altitude change
underwater diving

35
Q

What are eustachian tube dysfunction patients more at risk for

A

otitis media

36
Q

What is otic barotrauma

A

When you can’t equalize pressure in the middle ear with altitude change causing TM rupture

37
Q

What causes otic barotrauma

A

poor eustachian tube function d/t mucosal edema or congenital narrowing

38
Q

What Sx will you see with otic barotrauma

A

otalgia, more on descent than ascent

patient education to auto inflate during descent

39
Q

How do you treat otic barotrauma

A

systemic decongestant before take off

topical nasal decongestant 1 hr before descent

40
Q

What if otic barotrauma persists after landing

A

decongestants
autoinflation
Myringotomy
PE tubes

41
Q

What can occur if divers descend too quickly

A

Hemotympanum

Perilymphatic fistula; oval window rupture, sensory hearing loss, vertigo, vomiting

42
Q

How do you heal a TM perforation

A

small perforations heal on their own

Large perforations require tympanoplasty

43
Q

What should you NEVER use with a TM perforation

A

ototoxic ear drops (ahminoglycosides)

also don’t let water in

Foundations II Exam 1 (25 decks)

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