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IBI Test 2 > B3-054 Otitis Media > Flashcards

B3-054 Otitis Media Flashcards

1
Q

AOM usually occurs with or following

A

a viral URTI

**eustachian tube dysfunction occurs in 75% of children with viral UTRI

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2
Q

Four bacterial pathogens consistent with AOM

A

S. pneumoniae
NTHi
M. catarrhalis
S. pyogenes

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3
Q

NTHi otitis media is often seen with

A

conjunctivitis

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4
Q

risk factors for AOM

A

daycare attendance
non-hispanic white
atopy
having siblings
family hx of recurrent AOM

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5
Q

breastfeeding is

A

protective for AOM

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6
Q

AOM usually presents with

A

rapid onset of pain

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7
Q

in preverbial children, otalgia is suggested by

A

tugging, rubbing, holding ears
excessive crying
changes in sleep/behavior

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8
Q

which symptom of AOM is most useful in diagnosis?

A

ear pain

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9
Q

what is the best predictor of AOM using symptom-based diagnosis?

A

cloudy, bulging TM with impaired mobility

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10
Q

Impaired mobility has [specificity/sensitivity]

A

high specificity, high sensitivity

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11
Q

TM bulging has [sensitivity/ specificity]

A

high specificity; low sensitivity

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12
Q

OME may occur

A

after AOM
due to eustachian tube dysfunction

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13
Q

OME and AOM are segments of

A

disease continuum

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14
Q

OME may precede

A

AOM

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15
Q

does OME indicate infection?

A

no

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16
Q

does OME indicate infection?

A

no

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16
Q

does OME indicate infection?

A

no

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17
Q

does OME require antibiotics?

A

no

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18
Q

moderate-severe bulging of TM
OR
new onset otorrhea

A

AOM

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19
Q

mild-bulging of TM and recent onset of ear pain
OR
intense erythema of the TM

A

AOM

20
Q

clinicians should not diagnose AOM in children who do not have

A

MEE on otoscopty or tympanometry

21
Q

bulging of TM or limited/absent motility
Air-fluid level behind TM
otorrhea

A

MEE

22
Q

AOM treatment should include a plan for

A

pain

23
Q

treatment option for uncomplicated AOM

A

observation

**based on illness, age, severity, and availability to follow up

24
Q

severe illness in AOM is considered

A

moderate to severe otalgia
fever >39

25
Q

if observation is chosen as the treatment method, what must be in place?

A

mechanism for followup and plan to start antibiotics if condition worsens in 48-72 hours

26
Q

observation is an option under two years of age if

A

AOM is unilateral and not severe

27
Q

If the child is more than two years old, is observation an option for bilateral AOM?

A

yes

28
Q

Antimicrobial therapy is always recommended in AOM with

A

otorrhea

29
Q

initial antimicrobial treatment for AOM

A

amoxicillin

30
Q

when should you prescribe additional beta-lactamase coverage for AOM?

A

if the child has received amoxicillin in the past 30 days
OR
has a history of recurrent AOM unresponsive to amoxicillin

31
Q

when might you use ceftriaxone to treat AOM?

A

48-72 hours after failure of initial treatment

OR

as an alternative treatment for penicillin allergy

32
Q

presence of fluid in the middle ear without symptoms of acute infection

A

OME

33
Q

____% of children have OME before school age

A

90

***greater than 50% will experience in first year of life

34
Q

most episodes of OME resolve spontaneously within

A

3 months

35
Q

persistant OME causes

A

decreased mobility of TM

36
Q

OME can cause

A

conductive hearing loss

37
Q

OME is the most common cause of ________ in children in developed countries

A

hearing loss

38
Q

pneumatic otoscopy should be performed in a child with

A

otalgia, hearing loss, or both

39
Q

clinicians should document MEE with ________ when diagnosing OME

A

pneumatic otoscopy

40
Q

tympanometry should be performed when

A

diagnosis is uncertain after otoscopy

41
Q

watchful waiting

A

managing a child with OME not at risk for 3 months from the date of effusion onset/diagnosis

42
Q

no antibiotics
no antihistamines/decongestants
no intranasal or systemic steroids

A

watchful waiting

43
Q

when should clinician perform a hearing test?

A

if OME persists longer than 3 months
OR
OME of any duration in at risk child

44
Q

risk factors for hearing loss with OME

A

autism, down syndrome, cleft palate, developmental delays

45
Q

healthy children with persistent OME who do not have at risk criteria can be observed for

A

6-12 months

46
Q

clinicians should reevaluate OME at _________ intervals until it resolves or a cause if found

A

3-6 months

47
Q

what is recommended when surgery is performed for OME <4 years?

A

tympanostomy tubes

48
Q

what is recommended when surgery is performed for OME >4 years?

A

tympanostomy tubes and/or adenoidectomy

IBI Test 2 (14 decks)

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