CLIPP 14 - AOM Flashcards
1
Q
DDX congestion, cough fever (4)
A
- AOM
- pneumonia
- sinusitis
- URI
2
Q
Toddler PE Order
A
- observation
- eyes
- H/L/A
- ears, mouth
3
Q
Normal tympanic membrane PE findings (3)
A
- translucent
- neutral/retracted
- normal mobility
4
Q
AOM PE findings (2)
A
- moderate/severe bulging
- mild bulging w/ pain or intense erythema
5
Q
OME PE findings (2)
A
- fluid in middle ear space
- no s/s of acute inflammation
6
Q
otitis externa PE findings (3)
A
- edematous external auditory canal
- pain with traction on ear lobe
- occasionally follows TM perforation in AOM
7
Q
AOM guidelines (diagnosis, management)
A
- all kids 6mo-2yo with bilateral AOM should be treated with abx regardless of symptoms
- toxic appearing, ear pain for 48 hours, fever >39C
8
Q
Hearing assessment options (4)
A
- tympanogram (TM mobility)
- conventional audiometry (behavioral test - headphones)
- visual reinforcement audiometry (behavioral test - speakers)
- Otoacoustic emissions (physiologic test - cochlear function)
9
Q
OME management
A
- normal speech/language, no hearing loss: f/u every 3-6mos until effusion resolves
- hearing loss, language/developmental delay: tympanostomy tube placement
10
Q
AOM risk factors (12)
A
- day care
- tobacco exposure
- allergies
- bedtime bottle propping
- pacifier use
- formula fed
- significant family hx
- male gender
- lower SES
- respiratory allergies
- altered craniofacial structure
- genetic predisposition
11
Q
AOM common pathogens (4)
A
- strep pneumo (25-50%)
- H. influenza (15-52%)
- Moraxella catarrhalis (3-20%)
- Strep pyogenes (<5%)
12
Q
How long might middle ear effusion persist even after treatment with abx?
A
up to 3 months (8-15%)
13
Q
What to look for in an ear exam (5)
A
COMPT
- Color (gray, white, red, yellow)
- Other (bubbles, aire-fluid interface, scarring, perforation)
- Mobility (absent, reduced, normal, hypermobile)
- Position (normal, retracted, bulging)
- Translucency (opaque, translucent)
14
Q
AOM management
A
-amoxicillin
15
Q
AOM complications (5)
A
-mastoiditis (<2), facial nerve palsy, labrynthitis, cholesteatoma, CNS infection
