Ear

Question 1

Otalgia due to neuritis

Answer 1

Carbamazepine 100-300mg PO q 8 hr

Question 2

ETD orally

Answer 2

pseudoephedrine (sudafed) 60 mg PO q 8 hr

Question 3

ETD intranasal

Answer 3

afrin - dont use

Question 4

ETD allergic

Answer 4

antihistamine - allegra, claritin, zrytec

Question 5

ETD expectorant

Answer 5

Mucinex OTC

Question 6

ETD >6 wks

Answer 6

myringotomy with PE tubes

Question 7

Serous Otitis Media

Answer 7

amoxicillin - 1st line

Question 8

Serous otitis media if pen allergic

Answer 8

azithromycin

Question 9

Serous otitis if resitant

Answer 9

cefuroxime or augmentin

Question 10

Serious otitis media if not bacterial

Answer 10

prednisone 10 mg, 1 tablet bid x 7d

Question 11

Serous otitis media >6 wk

Answer 11

myringotomy

Question 12

OM

Answer 12

ABX

Question 13

OM antipyretic

Answer 13

acetaminophen or iburofen >6 mo

Question 14

OM analgesics

Answer 14

auralgan ear drops

Question 15

OM ABX

Answer 15

amoxicillin

Question 16

OM w/ ABX in last 30 days

Answer 16

Augmentin, cefuroxime, azithromycin, bactrim

Question 17

Mastoiditis

Answer 17

vanco and ceftriaxone IV

Question 18

Cholesteatoma

Answer 18

surgical removal

Question 19

Chronic OM

Answer 19

dry ear, granulation removed, topical steroids and ABX

Question 20

Tympanosclerosis

Answer 20

None, exploratory tympanotomy

Question 21

Acute TM rupture

Answer 21

dry ear, no tx

Question 22

TM perf due to infection

Answer 22

ABX ear drops

Question 23

TM perf with contaminated water

Answer 23

prophylaxis and ABX drops

Question 24

Otosclerosis

Answer 24

Total stapedectomy
Partial stapedectomy
Stapedotomy

Question 25

Bacterial AOE

Answer 25

Ciprodex or Ofloxacin 4 gtt bid 5-7 d

Question 26

Fungal OE

Answer 26

Acetic acid otic (VoSol), 4 gtt in ear q4-8 hrs for 5-7 days
NOT in Perforated Tympanic Membrane! (or PE tubes)

1% clotrimazole

Question 27

Malignant OE

Answer 27

IV Antibiotics

Ciprofloxacin, aminoglycoside, 3rd generation cephalosporin, imipenem, ticarcillin/clavulante

Question 28

Perf TM w/ fungal OE

Answer 28

(Refer to Specialist- ENT): Gentian violet paint, and CSF powder (chloramphenicol, sulfamethoxazole, fungizone/amphotericin-B)

Question 29

Eczematoid OE

Answer 29

fluocinolone Otic (DermOtic), 0.01% oil, apply 5 gtt in ear(s) BID for 7-14 days

Question 30

Herpes Zoster Oticus

Answer 30

Antiviral
Acyclovir 800mg PO 5 times per day for 7 days
Famciclovir 500mg PO 3 times per day for 7 days
Valcyclovir 1000mg PO 3 times per day for 7 days
Oral Steroid
Prednisone or Medrol “Dose Pack”

Question 31

Presbycusis

Answer 31

Hearing aid

Question 32

SNHL

Answer 32

hearing aid

Question 33

Tinnitus

Answer 33

underlying dz

Question 34

Tinnitus - Herbal

Answer 34

poflavinoids, Zinc

Question 35

Tinnitus - Antidepressants

Answer 35

nortriptyline (10-50 mg at bedtime)

Often 3-4 weeks of therapy are necessary before benefits appear

Question 36

Tinnitus - sleep

Answer 36

melatonin

Question 37

Symptoms of vertigo

Answer 37

Antihistamines
Meclizine 12.5-25mg every 8 hours PRN vertigo
Benadryl 25-50mg every 4-6 hours PRN
Anticholinergics
scopolamine – transdermal patch, apply q72 hours

Question 38

Vestibular suppressants for vertigo

Answer 38

diazepam (Valium) 2mg, every 8 hours PRN

Question 39

Antiemetic for vertigo

Answer 39

Ondansetron (Zofran) 4mg, every 4-6 hours PRN
Phenothiazines
prochlorperazine, promethazine

Question 40

BPPV

Answer 40

Epley, meds for symptoms

Question 41

Labyrinthitis

Answer 41

Steroids
Diazepam
Antiviral - acyclovir, famciclovir, and valacyclovir

Question 42

Meniere’s

Answer 42

low sodium
Diuretics - hydrochlorothiazide and triamterene [Dyazide] *
Steroid injections
surgery

Question 43

Acoustic Neuroma

Answer 43

surgical excision