EAR

Question 1

Otitis media bacterial causes

Answer 1

strep pna, H. flu, m. cat

Question 2

OM mgmt

Answer 2

most will resolve w/in 7 days
if sx last 48-72 hrs or worsening=
amoxicillin
amoxcillin/clavulanate or 2nd/3rd gen ceph (cefdinir, rocephin)

Question 3

OM mgmt if pcn allergy

Answer 3

azithromycin or clindamycin

Question 4

Myringotomy tube to correct

Answer 4

Horizontal ET

Question 5

OM complications

seen d.t poss strep pna resistance

Answer 5

TM perforation, tympanosclerosis (vHearing), Mastoiditis, meningitis,

Question 6

Otitis externa causes
bacterial
fungal

Answer 6

pseudomonas, staph, strep

aspergillus, candida albicans

Question 7

OE tx drops

Answer 7

gentamycin>1mo
Cipro+dexamethasone >6mo
ofloxacin>6mo-13yrs
cipro+hydrocortisone >1yr
neomycin+polymixin >2yrs
dexamethasone+tobramycin>2yrs
hydrocortisone+acetic acid>3yrs

Question 8

Vertigo tx

Answer 8

antihistamine, anticholinergic
gentamicin (meniere’s disease)
corticosteroids

Question 9

BPPV cause

Answer 9

sediment moves into inner ear if move quickly, lasts 60 sec (rolling over in bed)

Question 10

BPPV mgmt

Answer 10

epley manuver- reposition otoliths into vestibule
can require retreatment
dont use vestibular suppressant meds

Question 11

Labyrnthitis

Answer 11

inflammation of vestibular portion of 8CN or vestibular labyrinth
associated w URI
will awaken with vertigo can last weeks-yrs

Question 12

labryinthitis tx

Answer 12

vestibular suppressant medications
antiemetics
short tapering PO steroids

Question 13

Menieres disease

dx by hx

Answer 13

intense episodic vertigo lasting 30min-4hrs

vHearing, roaring tinnitus, aural fullness sensation

Question 14

Menieres tx

Answer 14

vEndolymphatic fluid pressure in inner ear
vSalt and thiazide diuretics are 1st line
vestibular ablation via ototoxic med (gentamycin) into middle ear