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Dermatology > Ear disease > Flashcards

Ear disease Flashcards

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Dermatology Board Prep flashcards
1
Q

Predisposing factors - ear disease

A
  • conformation
  • obstruction
  • excess (moisture, cerum, hair)
  • cornification disorders
  • immuno suppression
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2
Q

Primary factors causing ear inflammtion leading to ear disease

A
  • FB
  • parasites
  • hypersensitivity (AD, cutaneous food hypersensitivity)
  • contact dermatitis (topical ear products)
  • (immune - mediated)
  • (misc)
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3
Q

Secondary factors that contribute to pathology in ear disease

A
  • BACTERIA (S. pseudintermedius, Pseudomonas, Proteus, Klebsiella and E.coli in more chronic cases)
  • YEAST (Malassezia)
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4
Q

Name 3 types of tissue that can lead to ear canal stenosis

A
  • epidermal
  • dermal
  • adnexal1
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5
Q

Define OM/ otitis media

A

middle ear disease (when tympanic membrane is eroded away)

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6
Q

4 management aims - ear disease

A
  • reverse perpetuating factors
  • resolve secondary infection
  • address primary factors
  • (remove predisposing factors)
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7
Q

What are the 2 manifestations of canine otitis

A
  • recurrent/ chronic PRURITIC otitis externa

- chronic/ progressive PURULENT otits

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8
Q

Outline recurrent/ chronic pruritis otitis externa

A
  • allergic skin disease*
  • scondary bacterial/yeast/mixed overgrowth
  • bilateral (not always concurrent or same severity)
  • Pinnae, meatus, canal or all
  • remove discharge and resolve/ prevent microbial complication
  • effective control of allergic inflammation often required
  • not necessarily progress to chronic infectious form
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9
Q

Outline chronic progressive purulent otitis

A
  • long standing unresolved microbial infection
  • multi factorial
  • soft tissue changes and/or OM
  • may become irreversible
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10
Q

How often is the tympanic membrane (TM) intact in OM ears?

A

often - about 73 % cases

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11
Q

T/F: OM is often accompanied by otitis externa (OE)

A

True

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12
Q

What causes the shift from acute to chronic infectious otitis?

A

MICROBIAL SHIFT: Gram + and malassezia to gram -(Pseudomonas), Malassezia alone also seen

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13
Q

Diagnostics - ear infections

A
  • cytology (indespensible) (bacterial culture, interpret, nature of inflammation)
  • culture doesnt replace cytology
  • discordant microbial involvements at different sites
  • poor repeatability of ear swab cultures
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14
Q

Indications - sx tx of ear disease

A
  • tumours, polpys
  • irreversible stenosis
  • aggressive medical tx
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15
Q

Medical approach to tx of otitis

A
  • RESOLVE CURRENT INFECTION:
    1. assess and reverse perpetuating factors (Reverse stenosis, clean and examine, home cleaning)
    2. resolve infections (topical, systemic)
  • PREVENT RECURRENCE OF INFECTION
    3. assess primary factors
    4. remove predisposing factors (if possible)
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16
Q

Common causes of tx failure

A
  • not long enough
  • inadequate ear cleaning
  • fialure to ID and tx OM and soft tissue changes
  • failure to ID and control primary cause of otitis
17
Q

T/F: aural lavage must always be done under GA

A

True

18
Q

Where should you sample in the ear?

A

most proximal site affected

19
Q

T/F systemic ABs often not effective in ear disease

A

True

20
Q

T/F conventional bacterial sensiticity testing is of great value for topical tx

A

False - it is of little value

21
Q

Which products have human reserve ABs?

A

Aurizon and Posatex

22
Q

When should antimicrobial tx be stopped??

A

don’t stop until complete clinical and microbiological cure

23
Q

Systemic adverse effects of ear tx

A
  • GCs
  • basal cortisol
  • ACTH stim
  • T4
  • insulin
24
Q

Adverse effects outer ear

A
  • occlusion
  • maceration
  • epidermal turnover and migration
  • glandular changes
  • micro FB formation
  • atrophic effects
25
Q

Adverse effects - middle ear

A
  • facial nerve (including PS fibres) damage
  • sympathetic neurons for ocular innervation (Horners)
  • OM and cholesteatoma
26
Q

What is cholesteatoma?

A

destructive and expanding growth consisting of keratinising squamous epithelium in middle ear and/or mastoid process

27
Q

Ear specifci AEs of otic medication

A
  • effects on inner ear (hearing and balance) = ototoxicity (due to diffuse from outer and middle ear via round window into inner ear), may occur weeks later
  • seems rare

Dermatology (27 decks)

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