Common Ped Ear Conditions Flashcards
What are the most common causes of Otitis Media (organisms)
S. pneumo, H. flu, M. Cat, GAS
What are risk factors for devloping an Otitis Media?
Bac colonization, Recurennt viral URIs, smoke exposure, immunocompromised, bottle feeindg, young age, sibling, daycare
patient presents with fever, ear pain. upon exam, you see a red bulging TM.
Acute Otits Media
patient presents with ear pain. upon examination, you see air bubbles behind the TM. patient recently had a URI
otitis media with effusion
Although visual confirmation of otitis media is usually enough, what other methods can be used for diagnosis?
pneumatic otoscopy, tympanometry
how is “recurrent” otitis media defined
3 infections in 6 months or 4 in one year
What should your first “treatment” be in OM?
WATCHFUL WAITING
When is watchful waiting contraindicated?
fever present, ear symptoms greater than 48 hours, children under 2, severe pain not relieved by analgesics.
will most OMs get better on their own?
yes, 80%
patient presents to clinic, 4 years old. has been digging and tugging at ears. upon exam, you see AOM. What should you do?
watchful wait
patient presents, 1 years old, has had fever, AOM and has not seen symptoms improve in over 3 days. what should you do.
abx (amoxiciillin, augmentin, cephalosporins), and pain management (topical drops) if necessary
What might a child be at risk for if they have had chronic OMs?
myringotomy tubes. they bypass the obstructed eustachian tubes. They spontaneously fall out in 6-12 months.
Patient presents with a cough. Upon your ENT exam, you see bullae on the TM. What organism and what condition are you worrieda bout?
walking pneumonia, mycoplasma
Bullous myringitis is caused by what two organisms generally?
strep pneumo or mycoplasma
Patient presents with ear infection, you prescribe abx. patient doesnt get better and returns. you notice a red bulging behind the ear. What will you use to diagnose? What are you worried about? what are the complications?
CT scan, mastoiditis,
meningitis
brain abcess
facial palsy
Patient presents with ear infection, you prescribe abx. patient doesnt get better and returns. you notice a red bulging behind the ear. how will you treat?
myringotomy for culture and sensitivity. REFER. hospitalize for IV ABX (ceftriaxone, nafcillin or clindamycin)
immediate surgery is needed.
What is the most causative organism of Otitis Externa?
P aeruginosa.
Mom brings patient in because they are not eating. They pull away when mom tries to touch their ears. On exam you see white exudate in the inflammed canal. What is the treatment?
topical abx ONLY IF TM IS INTACT and acetic acid preps to help dry and kill microbes.
Mom brings patient in because they are not eating. They pull away when mom tries to touch their ears. On exam you see white exudate in the inflammed canal. Child has tubes. How do you treat?
quinolone otic drops
cerumen is..
sterile and has a bacteriostatic effect
how can impacted cerumen be removed by provider?
currettage, lavage, irrigation, suction, cerumenoltyic agents. NEVER QTIPS!
What should you do if you try to remove a foreign body but it is not coming out easily?
REFER TO ENT
How should you remove a bug from the ear?
oil then try to forcep it out
as a follow up to foreign body removal, what might you prescribe?
abx drops.
