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20- SA- Dermatology > Ear disease 2 > Flashcards

Ear disease 2 Flashcards

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Dermatology Board Prep flashcards
1
Q

List 4 things to examine on otoscope exam

A

canal
drum
discharge/ cerumen
smell

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2
Q

define biofilm

A

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

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3
Q

List 2 things that bacteriology of ear can provide

A

presence of bacteria/ disease
provides susceptibility data

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4
Q

What can affect bacteriology results

A

previous Ab ear creams or otic cleaners

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5
Q

List 2 cytological reasons to perform bacterial culture in otitis

A

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

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6
Q

List 3 clinical reasons to perform bacterial culture in otitis

A

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

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7
Q

List 2 diagnostic advantages of flushing the ears

A

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

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8
Q

List 4 therapeutic consequences of flushing the ears

A

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

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9
Q

List 3 possible solutions to use to flush ears

A

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

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10
Q

what are the properities of cleanaural

A

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

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11
Q

what are the properties of epiotic

A

good cleaner and antimicrobial properities
drying effect on the ear

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12
Q

what are the properties of otodine

A

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

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13
Q

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

A

medetomidine- hearing will still be present

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14
Q

List the 3 aims of treating otitis

A

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

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15
Q

List 2 ear drusg that are not affective against rods

A

neptra
osurnia

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16
Q

Describe Erythroceruminous otitis

A

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

17
Q

Describe how to treat Erythroceruminous otitis

A

Cleaner appropriate for the level of discharge
Corticosteroid alone

18
Q

Describe what is seen with Purulent otitis – acute

A

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

19
Q

Describe how to treat Purulent otitis – acute

A

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

20
Q

Describe Chronic allergic otitis

A

Long term Malassezia and S. pseudintermedius dysbiosis and overgrowth

21
Q

Describe how to treat Chronic allergic otitis

A

treat prophylactically with steroids and cleaner to prevent flares

22
Q

Describe exudate in staphylococcus or Malassezia infections

A

moist brown exudate

23
Q

Describe exudate in otodectes cynotis infections

A

dry coffee grounds

24
Q

Describe exudate in Pseudomonas infections

A

Purulent yellow/green exudates

25
Q

Describe exudate in allergy or endocrine diseases

A

ceruminous discharge

26
Q

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

A

dysbiosis will have no inflammatory cells

27
Q

what will we see on pseudomonas ear infection cytology

A

lots of nuclear streaming from damaged cells

28
Q

what is the issue with biofilms

A

it makes antibiotic penetration difficult and it makes cleaning difficult

29
Q

does bacteria in the ear mean that this is the disease

A

no

30
Q

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

A

dissolve and mobilise waxy/greasy discharge
not antimicrobial

31
Q

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

A

disrupts biofilm
antimicrobial activity
otosafe

32
Q

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

A

immunosuppression
swimming or prior use of antibacterials

33
Q

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

A

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

34
Q

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

A

because the topical antibiotics usually have steroids in

35
Q

what can we do to treat an end stage ear

A

total ear canal ablation

20- SA- Dermatology (21 decks)

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