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Foundations of Clinical Practice II > Ear Disorders 1 > Flashcards

Ear Disorders 1 Flashcards

1
Q

What is the physiology behind cerumen

A

Helps protect external ear from foreign bodies and water

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2
Q

What are clinical presentations of Cerumen Impactions

Hints: Think Q-tips

A 
Hearing loss
Earache
Reflex cough (CN X)
Dizziness
Tinnitus
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3
Q

What are the treatments for Cerumen impactions?

A
  1. Detergent ear drops
  2. Mechanical removal
  3. Water (body temperature) irrigation
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4
Q

When should you only irrigate an ear canal?

A

Only when tympanic membrane is intact

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5
Q

How do you remove a firm object from the ear?

How about organic foreign bodies

A
  1. Remove using a loop or hook or irrigation

2. Do not irrigate and immobilize insects with lidocaine

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6
Q

What is the bacteria that causes Otitis Externa “swimmers ear”

A

Pseudomonas proteas

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7
Q

During an Pneumatic Otoscope exam, what would you find in someone with Otitis Externa

A

TM will move normally

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8
Q

What medications are prescribed to treat Otitis Externa?

A
  1. 7-10 days with topical Aminoglycoside or Fluoroquinolone with or w/o corticosteroids
  2. Keep ear canal dry and away from moisture
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9
Q

What is the treatment for Hamatoma of External Ears

A

Drainage to prevent ear deformities/blockage and to prevent Cauliflower ear via cartilage discharge

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10
Q

What are the most common organisms that cause Acute Otitis Media

A
  1. Streptococcus pneumonia

2. Haemophilus influenza

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11
Q

How does a TM present during Acute Otitis Media

A

Immobile with erythema and bulging

May also rupture

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12
Q

What is the 1st line treatment for Acute Otitis Media?

What is the 2nd line?

A

Amoxicillin

Amoxicillin-clavulanate

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13
Q

What is a good prevention measure for acute otitis media

A

Pneumococcal vaccinations

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14
Q

Complications of Acute Otitis Media?

A
  1. Mastoiditis
  2. Non-responsive to meds (resistant organisms)
  3. Reoccurring infections (might indicate the need for ear tubes
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15
Q

What is the etiology behind Serous Otitis Media aka Otitis media with Effusion?

A
  • Eustachian tube stays blocked for prolonged period of time.
  • Negative pressure causes transudation of fluid into the middle ear
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16
Q

When does a foreign body in the ear become urgent?

A
  1. If its is a button battery (children)
  2. Live insects
  3. Penetrating FB
17
Q

How is Otitis Externa characterized?

A

Inflammation of the external auditory canal

18
Q

How does Otitis Externa present?

A
  • Otaligia (earache)
  • Pruritis (itching)
  • Purulent discharge
  • Hearing
  • Fullness
19
Q

How does Otitis Externa present during a Physical Exam

A
  1. Erythema and edema of ear canal
  2. Tenderness while pulling the auricle
  3. TM is erythematous but moves normally during pneumatic otoscopy
20
Q

Differential diagnosis with Otitis External

A
  1. Contact dermatitis
  2. Psoriasis
  3. Squamous cell carcinoma of the external canal
  4. Ramsy Hunt syndrome- HSV causing vesicles on th out ear canal
21
Q

What is a complication of Otitis Externa

A
  1. Periauricular cellulitis
  2. Contact dermatitis from antimicrobials (neomycin)
  3. Malignant Otitis externa- osteomielitis of temporal bone/skull
22
Q

How is Otitis media with a perforated TM treated?

A
  • Topical antibiotic with low ototoxicity- Oflaxacin
  • Analgesics
  • Prevention- Pnneumoccocal vaccinations
23
Q

Guidelines for Observation of Acute otitis Media, NOT antibiotics

A
  1. Children 6 months - 2 y.o. with unilateral AOM and mild symptoms
  2. Greater than or equal 2, unilateral or bilateral AOM but not severe
    * Give antibiotics if condition gets worse and doesn’t improve in 48-72 hrs
24
Q

Guidelines to give Antibiotics for Acute Otitis Media

A
  1. Children < 6 months
  2. Children < 24 months if:
    • Moderate to severe pain
    • Pain for 48hrs or more
    • Fever of 102.2 or greater
    • Bilateral Acute Otitis Media
25
Q

How is Serous Otitis Media clinically presented?

A
  1. Conductive hearing loss
  2. TM is dull and hypo mobile
  3. Bubbles are visible (fluid)
26
Q

Treatment for Serous Otitis media

A
  • Decongestants
  • Antihistamines
  • Nasal steroids if underlying allergies
  • Ventilating tubes if this is a resistant case
27
Q

Etiology of Cholesteatoma

A

Chronic negative pressure draws in a part of TM (retraction)

Creates a sac that produces keratin

*Prone to secondary infection: Pseudomonas or Proteus

28
Q

Clinical presentation of Cholesteatoma?

A
  1. Asymptomatic hearing loss

2. Chronic infection

29
Q

How is Cholesteatoma seen on a Physical Exam?

A

Tympanic Membrane Pocket

TM discharging debris

30
Q

Treatment for Cholesteatoma?

A

Antibiotic drops
OR
Surgical removal

31
Q

Causes/Etiology behind Eustachian Tube Dysfunction?

A
  1. Edema of tubal lining, this traps air in the middle ear and causes neg. pressure
  2. Viral upper respiratory infection
  3. Allergies
32
Q

How is Eustachian Tube Clinically presented?

A
  • Fullness
  • Fluctuating hearing
  • Popping or cracking sound
  • Pain with pressure changes
33
Q

How is a Eustachian Tube dysfunction seen on a Physical Exam

A
  1. Retracted TM

2. Decreased mobility of TM during pneumatic otoscopy

34
Q

Treatment for Eustachian Tube Dysfunction?

A
  1. Decongestants
  2. Autoinflation
  3. Desensitization therapy (for allergies)
  4. Intranasal corticosteroids
  5. Avoid air travel/underwater diving during symptoms
35
Q

What Otic Barotrauma?

A

Inability to equalize pressure during:

  • air travel/altitude changes
  • underwater diving
36
Q

How is Otic Barotrauma clinically presented?

A
  1. Otalgia- more likely during airplane descent than ascent
37
Q

Treatment for Otic Barotrauma?

A
  1. Work to enhance Eustachian tube dysfunction (precursor)

2. Take Decongestants a few hours before air travel and one hour before descent

38
Q

How do you treat persistent Otic Barotrauma even after landing?

A
  1. Decongestants
  2. Autoinflation
  3. Myringotomy
  4. Ventilating tubes

Foundations of Clinical Practice II (23 decks)

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