3. MTB Step 3 - Head & Neck Flashcards
Cards Complete: Day 1 - 5/1/2019 * Day 2 - 5/3/2019 * Day 3 - 5/11/2019 * Day 4 - 5/31/2019 Day 5 - 6/30/2019
OTITIS EXTERNA
What are (4) Signs/Symptoms of Otitis Externa?
- Itching
- Pain, especially on manipulation of the Tragus
- Drainage from & Swelling in the External Auditory canal
- Tympanic Membrane hard to visualize
OTITIS EXTERNA
Which Infection is Otitis Externa a form of, specifically on the Skin of the External Auditory canal?
Cellulitis of the External Auditory canal
OTITIS EXTERNA
What Activity is Otitis Externa associated with?
Swimming - washes out the acidic environment
Other causes of OE = foreign objects (e.g., cotton swabs, hearing aids, etc.)
**OE is a Clinical Diagnosis**
OTITIS EXTERNA
What are (3) Topical Antibiotics used to treat suspected Otitis Externa?
- Ciprofloxacin
- Ofloxacin
- Polymyxin/Neomycin
“Top COP”
OTITIS EXTERNA
What Medication can be added to the treatment for Otitis Externa to Decrease the Swelling & Itching?
Hydrocortisone (topical)
OTITIS EXTERNA
In the treatment of Otitis Externa, what can be added to reacidify the ear to help eliminate the infection?
Acid & Water solution
MALIGNANT OTITIS EXTERNA
What Form of infection is Malignant Otitis Externa a form of, but specifically of the skull?
Osteomyelitis
MALIGNANT OTITIS EXTERNA
What is the Causal Agent of Malignant Otitis Externa?
Pseudomonas in a patient with Diabetes
MALIGNANT OTITIS EXTERNA
What can Malignant Otitis Externa lead to, and the reason why it is such an extremely serious disease?
Brain Abscess & Destruction of the Skull
MALIGNANT OTITIS EXTERNA
What are the (2) Best Initial Tests and the Most Accurate Test for Diagnosing Malignant Otitis Externa?
Best Initial Tests:
- CT
- MRI
Most Accurate Test
- Bone Biopsy/Culture
MALIGNANT OTITIS EXTERNA
What are the (2) Treatments for Malignant Otitis Externa?
- Surgical Debridement
-
Antibiotics (active against Pseudomonas)
- Aztreonam
- Carbapenem
- Cefepime
- Ciprofloxacin
- Piperacillin
OTITIS MEDIA
What are (5) Signs/Symptoms associated with Otitis Media?
- Redness
- Bulging
- Decreased Hearing
- Loss of Light Reflex
-
Immobility of the Tympanic Membrane (MOST SENSITIVE)
- If there is TM mobility of insufflation then it’s NOT Otitis Media
**OM is a Clinical Diagnosis**
OTITIS MEDIA
What is the Best Initial Treatment for Otitis Media?
Amoxicillin: 7 - 10 day (Shorter for Older patients; Longer for Younger patients.)
**Same as for Sinusitis**
OTITIS MEDIA
What is the Next Step in management for a patient with Recurrent OM or Persistent OM that Fails 1st and 2nd Line Therapy?
Tympanocentesis & Aspirate of the TM for Culture
OTITIS MEDIA
What should be tried as 2nd Line Therapy in a patient with Otitis Media that is not improving with 1st Line Therapy?
Switch from Amoxicillin (1st line therapy) to one of the following:
- Amoxicillin-Clavulanate
- Cefdinir
- Ceftibuten
- Cefuroxime
- Cefprozil
- Cefpodoxime