Ear disease 2

Question 1

List 4 things to examine on otoscope exam

Answer 1

canal
drum
discharge/ cerumen
smell

Question 2

define biofilm

Answer 2

extracellular matrix material produced by bacteria, usually when the bacteria are in larger numbers and in close proximity.

Question 3

List 2 things that bacteriology of ear can provide

Answer 3

presence of bacteria/ disease
provides susceptibility data

Question 4

What can affect bacteriology results

Answer 4

previous Ab ear creams or otic cleaners

Question 5

List 2 cytological reasons to perform bacterial culture in otitis

Answer 5

rods are seen
Marked purulent or pyogranulomatous discharge without organisms being noted.

Question 6

List 3 clinical reasons to perform bacterial culture in otitis

Answer 6

treatment of failure
suspicion of meticillin-resistant staphylococcus species (MRS)
if considering video otoscopy

Question 7

List 2 diagnostic advantages of flushing the ears

Answer 7

See epithelium of the ear canal
check the integrity of the drum

Question 8

List 4 therapeutic consequences of flushing the ears

Answer 8

Dilutes and removes bacteria, yeasts and inflammatory mediators
With appropriate cleaners anti-microbial effects
Removes pus which may inactivate antibiotics
Removes old treatments

Question 9

List 3 possible solutions to use to flush ears

Answer 9

normal saline
squalene- can dissolve waxy discharges
chlorohexidine- use commercial products

Question 10

what are the properities of cleanaural

Answer 10

good cleaner and good antimicrobial properities
can be stingy in inflamed ear
good for general purpose

Question 11

what are the properties of epiotic

Answer 11

good cleaner and antimicrobial properities
drying effect on the ear

Question 12

what are the properties of otodine

Answer 12

does not sting
use for purulent otitis
good to fair antimicrobial action

Question 13

which pre-med should you not uese when anaesthetising for ear flushing

Answer 13

medetomidine- hearing will still be present

Question 14

List the 3 aims of treating otitis

Answer 14

Remove/reduce microbes
Reduce swelling, discomfort or pain
Normalise canal lumen and function

Question 15

List 2 ear drusg that are not affective against rods

Answer 15

neptra
osurnia

Question 16

Describe Erythroceruminous otitis

Answer 16

Red, waxy itchy ear
Often a feature of allergic skin disease
Cytology shows cocci ± Malassezia, squames, but no neutrophils

Question 17

Describe how to treat Erythroceruminous otitis

Answer 17

Cleaner appropriate for the level of discharge
Corticosteroid alone

Question 18

Describe what is seen with Purulent otitis – acute

Answer 18

Redness, pruritus, pain and discharge
May be secondary features of lichenification on the pinna
Neutrophils and bacteria (intra and extracellular)

Question 19

Describe how to treat Purulent otitis – acute

Answer 19

First-line ointment based on cytology and otoscopy- e.g. canaural or neptra
combined with suitable cleaner

Question 20

Describe Chronic allergic otitis

Answer 20

Long term Malassezia and S. pseudintermedius dysbiosis and overgrowth

Question 21

Describe how to treat Chronic allergic otitis

Answer 21

treat prophylactically with steroids and cleaner to prevent flares

Question 22

Describe exudate in staphylococcus or Malassezia infections

Answer 22

moist brown exudate

Question 23

Describe exudate in otodectes cynotis infections

Answer 23

dry coffee grounds

Question 24

Describe exudate in Pseudomonas infections

Answer 24

Purulent yellow/green exudates

Question 25

Describe exudate in allergy or endocrine diseases

Answer 25

ceruminous discharge

Question 26

how can we tell if ear cytology is a dysbiosis or an infection

Answer 26

dysbiosis will have no inflammatory cells

Question 27

what will we see on pseudomonas ear infection cytology

Answer 27

lots of nuclear streaming from damaged cells

Question 28

what is the issue with biofilms

Answer 28

it makes antibiotic penetration difficult and it makes cleaning difficult

Question 29

does bacteria in the ear mean that this is the disease

Answer 29

no

Question 30

what are the properties of cerumaural and otoact - squalene-based cleaners

Answer 30

dissolve and mobilise waxy/greasy discharge not antimicrobial

Question 31

What are the properties of TRIZ EDTA and N-acetyl cysteiene

Answer 31

disrupts biofilm antimicrobial activity otosafe

Question 32

what are the common precursors to pseudomonas otitis infections in the ear

Answer 32

immunosuppression swimming or prior use of antibacterials

Question 33

what do you need to warn owners about when they are cleaning or treating ears

Answer 33

that there are a lot of risks and that no products are licensed in ruptured ear drums

Question 34

why can you not give NSAIDs to dogs that are having their ears treated

Answer 34

because the topical antibiotics usually have steroids in

Question 35

what can we do to treat an end stage ear

Answer 35

total ear canal ablation