Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Medicine I > Ear Infections > Flashcards

Ear Infections Flashcards

1
Q

Most common cause of OE

A
  1. Pseudomonas aeruginose (38%)

2. Staph epidermidis/staph aureus (9%, 8%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

during physical exam, otalgia in OE can be felt where?

A

during palpation of the tragus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Discharge color for OE bacteria

A

Green = pseudomonas

yellow = staph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

EAC in OE is found to be…

A

erythematous, edematous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of hearing loss is present in OE?

A

conductive if marked swelling or significant discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

1st line txs for bacterial OE?

A

if no TM perf: cortisporin otic - 2 abx and CS

If TM perf: floxin otic

Ciprodex suspension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Solution vs suspension for OE

A

suspension is less acidic. Rx when possible (i.e. cortisporin suspension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tx options for fungal OE

A
  1. clean EAC, apply clotramazole 1% BID x 10-14 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can you tell pts to prevent OE?

A
  1. acidify EAC with 2% acetic acid solution, or 50:50 mix of water and white vinegar
  2. dry ear w/ isopropyl alcohol or hair dryer after wetting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Who is most at risk for malignant OE?

A
  1. elderly diabetic pts.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Classic findings of malignant OE?

A
  1. red granulation tissue in EAC

2. nocturnal pain and with chewing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What to watch for in malignant OE?

A
  1. involvement of CN 7, which would indicate progressive osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you diagnose malignant OE?

A
  1. CT to show bone erosion–distinguishing factor of malignant OE from normal OE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how should a PA treat a pt after diagnosing w/ malignant OE?

A
  1. admit to hospital, C&S of ear discharge

2. IV ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 types of OM?

A
  1. Otitis media w/ effusion
  2. acute otitis media
  3. chronic otitis media
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A pt. enters the clinic w/ recent hx of AOM compaining of decreased hearing and a feeling of ear fullness. Pt. denies pain, appears well, and is afebrile. What is your suspected diagnosis?

A

Otitis media w/ effusion.

-these patients typically have recent AOM and no acute sxs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What would you expect to find on inspection of TM in a patient with OME

A
  1. amber colored fluid behind TM
  2. air-fluid levels and bubbles
  3. retracted TM
  4. Type B tympanogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What should you do for a patient w/ persistant unilateral OME?

A
  1. Refer to ENT to rule out nasopharyngeal carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When to refer to ENT w/ OME?

A
  1. fluid or hearing loss > 3 mo

2. children at risk for speech/language/learning problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you manage OME?

A
  1. watchful waiting or ENT referral for T tube placement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What distinguishes eustachian tube dysfunction from OME?

A
  1. ET dysfunciton has type C tympanogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Etiology of ET dysfunction

A
  1. inflammation or blockage resulting in negative middle ear pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical findings of ET dysfunction?

A

retracted TM, prominent bony landmarks.

24
Q

ET dysfunction Tx

A
  1. steroid nasal spray, allergy management, nasal decongestant, T-tube placement.
  2. afrin may help prevent barotrauma
25
Q

What is the peak incidence of AOM?

A

6-18 mo old.

26
Q

What usually precedes AOM?

A

viral URI (RSV)

27
Q

3 most common pathogens for AOM

A
  1. strep. pneumoniae (50%)
  2. haemophilus influenzae (40%)
  3. moraxella catarrhalis (10%)
28
Q

Peds pt. w/ suspected AOM will present w/…

A
  1. ear pain and tugging on ear
  2. anorexia and irritability
  3. hearing loss/er fullness
  4. conjunctivitis due to H. Flu
29
Q

Physical exam findings w/ AOM

A
  1. bulging TM
  2. TM erythema
  3. Poor mobility of TM
30
Q

criteria for AOM diagnosis in children 6 mo-12 years

A

Any of the following:

  1. moderate/severe TM bulging
  2. new otorrhea not due to OE
  3. mild TM bulging and either 48 hr ear pain or intense TM erythema
31
Q

When do you treat AOM w/ antibiotics?

A
  1. < 6 mo
  2. children with:
    moderate-severe otalgia
    otalgia > 48 hrs
    temp > 102.2
  3. < 24 months w/ bilateral AOM
32
Q

1st line Tx for AOM

A
  1. Amoxicillin 90mg/kg/day Q12 hrs x 7-10 days
33
Q

When do you resort to second line treatment for AOM?

A
  1. pt. had amoxicillin w/in 30 days
  2. concurrent purulent conjungtivitis
  3. recurrent AOM hx
  4. penicillin allergy
34
Q

2nd line for AOM

A
  1. Augmentin 90mg/kg (amoxicillin) & 6.4mg/kg clavulanate
35
Q

AOM tx if PCN allergy

A
  1. mild: oral or IM cephalosporins

2. Serious: macrolides (mycins)

36
Q

Precaution regarding sx treatment of AOM

A

avoid OTC cough and cold prep in children < 4 yrs

37
Q

What should you tell pts about AOM?

A

pain and fever should resolve w/ in 3 days

hearing loss may take a month to resolve

38
Q

What happens if tx for AOM fails?

A

after 48-72 hours:

initiate or change abx to augmentin PO or ceftriaxone 50mg/kg IM (QD x 2-3 days)

39
Q

What constitutes recurrent AOM?

A
  1. development of s/s w/in 30 days of successful treatment.
40
Q

How to treat recurrent AOM?

A
  1. < 15 days use ceftriaxone

2. > 15 days use augmentin

41
Q

When to consider T-Tubes to treat recurrent AOM

A

3 or more episodes of AOM in 6 months

4 or more episodes of AOM in 12 months

42
Q

common complications of AOM

A
  1. conductive hearing loss
  2. TM perf
  3. COM
  4. tympanosclerosis
  5. cholesteatoma
  6. mastoiditis
  7. acute labrynthitis
43
Q

Type B tympanogram means…

A

little or no mobility

fluid or TM perf

44
Q

Type C tympanogram means…

A

retracted TM, usually ET dysfunction

45
Q

Pt. complains of hearing loss, fluid draining from ears and vertigo w/ hx of COM. What do you suspect?

A
  1. TM perforation
46
Q

What constitutes COM?

A
  1. drainage from ME for 2 or more weeks and painlessTM perforation
47
Q

Etiology of COM?

A

recurrent AOM, trauma, cholesteatoma, pseudomonas, MRSA.

48
Q

Tx for COM?

A

ENT referral

49
Q

On inspection of TM, you notice white plaques on the TM absent any other pathologic features. What is this?

A

tympanosclerosis due to frequent ME infection

50
Q

What is a cholesteatoma?

A

abnormal growth of squamous epithelium in middle ear and mastoid.

progressively enlarge and destroy ossicles

51
Q

A patient presents w/ post-auricular pain, edema and erythema. There is a mass which appears to be protruding the pinna and fever. what do you suspect?

A

mastoiditis

52
Q

How do you treat mastoiditis

A
  1. IV abx and mastoidectomy
53
Q

What distinguishes vestibular neuritis from labyrinthitis?

A

labyrinthitis there is unilateral hearing loss.

54
Q

what is the hypothesized etiology of labyrinthitis?

A

viral or postviral inflammation of vestibule

55
Q

What sxs do you expect w/ labyrinthitis?

A
  1. acute onset of severe vertigo
  2. N/V
  3. Unilateral hearing loss
  4. no CNS deficits
56
Q

What test confirms labyrinthitis

A

+ Head Thrust:

cannon maintain visual fixation when head turned to affected side.

Clinical Medicine I (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions