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Ear, Nose and Throat > Ear Infections > Flashcards

Ear Infections Flashcards

1
Q

What is otitis externa

A

Infection of the outer ear

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2
Q

Symptoms of otitis externa

A

Itchy, moist, dull, blocked, otorrhoea, tender pinna and tragus, discharge clumpy

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3
Q

Precipitating factors for otitis externa

A

Swimming, tropic, cotton buds, syringing.

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4
Q

Causes of otitis externa

A

Eczema, bacterial, fungal, malignant

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5
Q

Management of otitis externa

A

Ear drops, microsuction, analgesia, aural toilet, pope wick, BIPP gauze, pack ear is canal oedematous

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6
Q

Ear cannal problems in otitis externa

A

Swelling and becomes very painful and tender

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7
Q

Tympanic membrane in otitis externa

A

Difficult to visualise due to canal debris

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8
Q

What is otitis media

A

Infection of the middle ear

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9
Q

Bacterial causes of otitis externa

A

Pseudomonas Aeruginosa, Staph. Aureus, Staph. epidermidis

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10
Q

When does fungal otitis externa occur

A

Suspect if discharge resistent to Abx. Fluffy cotton wool type debris or black spots (aspergillus niger).

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11
Q

Symptoms of otitis media

A

Otalgia, fever, pain, watery discharge, pyrexia, malaise, hearing impaired

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12
Q

View of tympanic membrane in otitis media

A

Red, bulging, oedematous, perforated with mucopus pulsating through

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13
Q

What often preceeds otitis media

A

Upper RTI, often viral

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14
Q

Common causes of otitis media

A

step pneumoniae, H influenza B, M catarrhalis

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15
Q

What age does otitis media usually occur

A

2 - 5 years of age

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16
Q

Management of otitis media

A

Abx or conservative management. Nasal decongestants.

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17
Q

What to do if the tympanic membrane perforates

A

Keep dry and review in 6-8 weeks, often heal

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18
Q

Complications of otitis media

A

Mastoiditis, petrositis, labyrinthitis, facial paralysis, subdural abscesses, extradural abscesses, lateral sinus thromboplebitis, meningitis, brain abscesses

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19
Q

Red flags of otitis media

A

drowsiness, meningism, severe headache, vomiting, retroorbital pain, squnit or diplopia, vision problems, limb weakness, gait or coordination issues, pain beyond ear, extensive headache or facial pain.

20
Q

What is glue ear

A

Inflammation of middle ear mucosa with middle ear effusion for 3 months without infection.

21
Q

When are the peak ages for glue ear

A

ages 2 and 5 years

22
Q

Association with glue ear

A

Cleft palate, Downs, cilairy dyskinesia, craniofacial syndromes, winter>summer

23
Q

Management of glue ear

A

Watchful waiting for 3 months, hearing aids, grommets. Hearing needs to be better in ear by 25-30dB

24
Q

What is mastoiditis

A

Infection of the mastoid air cells behind the ear, medical emergency

25
Q

Symptoms of mastoiditis

A

Subperiosteal abscess, pain around the ear, red, protrusion of pinna, bulging canal wall, unwell

26
Q

Treatment of mastoiditis

A

IV Abx, IV fluids, CT with mastoid surgery, requiring surgical drainage and mastoidectomy.

27
Q

How does mastoiditis occur

A

Complication of otitis media

28
Q

Complications of mastoiditis

A

Can spread to inner ear or intracranial space

29
Q

What is labyrinthitis

A

Inflammation of the bony labyrinth of the inner ear including the semicicular canals, vestibule and cochlea.

30
Q

Symptoms of labyrinthitis

A

Acute onset vertigo, hearing loss nad tinnitus. Associated symptoms with causative virus

31
Q

Diagnosis of labyrinthitis

A

Clinical diagnosis based on history and examination findings. Exclude central casues of vertigo. Head impulse test

32
Q

Management of labyrinthitis

A

Supportive care and short term use of medication to suppress symptoms such as prochlorperazine and antihistamines.
Abx for bacterial causes

33
Q

Cause of labyrinthitis

A

Viral upper RTI. Can be caused by bacterial infection. Usually secondary to otitis media or meningitis

34
Q

Symptoms of necrotising external otitis

A

Progressive pain and drainage from the EAC. Granulation tissue often present. Some facial nerve palsy

35
Q

What is necrotising external otitis

A

Malignant external otitis from pseudomonas infection of soft tissue, cartilage and bone

36
Q

Treatment of necrotising external otitis

A

Radical surgical debridement with combination semi-synthetic penicillin and aminoglycoside for 4-6 weeks.

37
Q

Symptoms of perichondritis

A

Pain and warmth to the pinna following trauma or infection, erythema, induration.

38
Q

Treatment of perichondritis

A

Betadine or boric acid wet to dry dressings to open wound.

39
Q

What is the most common organism for perichondritis

A

pseudomonas aeruginosa

40
Q

What is a complication of perichondritis and how to resolve it

A

Chondritis with abscess, then incision, drainage and debridement of non-viable cartilage

41
Q

Symptoms of otomycosis

A

Itching or mild otalgia, secondary bacterial infection may produce intense pain

42
Q

Signs of otomycosis if from apergilla nigrans

A

Grayish membrane with hyphae visible under microscope. Erythema of underlying epithelium

43
Q

Treatment of otomycosis

A

Clean external ear canal, topical cresyl acetate or 1% gentian violet and/or boric or aceteic acid and alcohol drops

44
Q

Symptoms of bullous myringitis

A

Otalgia, haemorrhagic blebs on TM and adjacent canal.

45
Q

Treatment of bullous myringitis

A

Incision of blebs if severe pain, prophylactic oral abx to prevent otitis media, anesthetic otic drops

Ear, Nose and Throat (24 decks)

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