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Clin Med 1 > Ear Infections/Allergic Rhinitis > Flashcards

Ear Infections/Allergic Rhinitis Flashcards

0
Q

Otitis externa etiology

A

psuedomonas, staph epi, staph aureus, fungal

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1
Q

ear pain, tender tragus. Pruritis, discharge, erythematous and edematous EAC. Conductive hearing loss

A

Otitis externa

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2
Q

Otitis externa treatments for bacterial infection (2)

A

Bacterial: Corticosporin otic suspension (Polymyxin, neomycin, and hydrocortisone)- not for perforated TM

Otic solution for perforated TM, Ciprodex

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3
Q

Otitis externa lifestyle changes

A

No swimming for 7-10 days

Prophylaxis: vinegar solution or commercial product

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4
Q

intense ear pain and discharge. Red, granulation tissue in the EAC. Possible periauricular lymphadenopathy, trismus
Seen in diabetics and immunocompromised patients

A

Malignant otitis externa

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5
Q

Malignant otitis externa involves?

A

Osteomyelitis

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6
Q

Malignant otitis externa treatment

A

IV antibiotics, wound debridement

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7
Q

Malignant otitis externa etiology

A

primarily psuedomonas

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8
Q

otalgia, reddened TM w/ decreased mobility, signs of effusion, loss of visible landmarks.
Can be preceded by URI. Ear may feel “full,” may have conductive hearing loss
(adults)

A

Acute otitis media

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9
Q

otalgia, reddened TM, reduced TM mobility, etc
PLUS fever, irritability, tugging on the ear

(peds)

A

Acute otitis media in peds

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10
Q

Otitis media etiology

A

Strep pneumo, mostly

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11
Q

Acute Otitis Media treatment schedule

A

Age 24 mo w/ severe symptoms and certain AOM diagnosis- Antibiotics
Antibiotics and/or observation for others
Symptomatic care

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12
Q

severe clinical signs of AOM

A

moderate-severe otalgia, otalgia for at least 48h, or temp of 39 (102.2 F) or higher

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13
Q

Antibiotic dosage for AOM (2)

A

Amoxicillin 90 mg/kg BID for 7-10 days

Augmentin 90 mg/kg 6.4 mg/kg BID 7-10 days

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14
Q

drainage from the middle ear > 2 weeks & associated TM perforation that is usually painless. Conductive hearing loss

A

Chronic otitis media

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15
Q

Chronic otitis media etiology

A

recurrent otitis media, trauma, cholesteatoma

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16
Q

Chronic otitis media tx

A

refer to ENT

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17
Q

+/- pain, +/- otorrhea, conductive hearing loss, associated with acute/chronic OM, immobile TM

A

TM perforations

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18
Q

TM perforation tx

A

heals spontaneously- resulting in tympanosclerosis (scarring)

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19
Q

extension of otitis externa or acute otitis media into mastoid air cells.
Postauricular pain and erythema, fever, deep temporal pain

A

Mastoiditis

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20
Q

Mastoiditis treatment

A

IV antibiotics, ENT consult, mastoidectomy

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21
Q

ear fullness, hearing loss. Middle ear effusion secondary to inflammation, URI, Eustachian tube issues

A

Serous otitis media

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22
Q

Pt. afebrile, amber-colored fluid behind TM, may see bubbles, retraction of TM produces prominent landmarks, immobile TM, possible conductive hearing loss

A

Serous Otitis Media

23
Q

Serous otitis media treatment

A

most resolve spontaneously; topical nasal decongestants may help- No Antibiotics

24
Q

Serous otitis media referral conditions

A

refer to ENT for persistent (>3 mo.) cases or for kids

25
Q

discomfort or damage to ear due to pressure differences between middle ear and external ear
Associated w/ altitude changes, URIs, allergies

A

Ear barotrauma

26
Q

Ear barotrauma treatment

A

prevention- nasal decongestants, antihistamines, Valsalva manuever, chewing gum

27
Q

benign, acute inflammation or infection of the vestibular system
Most commonly associated with URI, AOM, meningitis

A

Labyrinthitis

28
Q

Acute onset of severe vertigo, nausea & vomiting, balance issues, tinnitus, unilateral hearing loss

A

Labyrinthitis

29
Q

positive head thrust indicates?

A

Labyrinthitis

30
Q

head thrust sign

A

can’t fix vision as head is moved

horizontal nystagmus

31
Q

Labyrinthitis treatments (4)

A

Symptomatic- bed rest, hydration
Benzos
Anticholinergics (as an anti-emetic)- Prochlorperazine/Compazine
Antihistamines (as a vestibular suppressant similar to dramamine)- Neclizine/Antivert

32
Q

amoxicillin dose

A

900 mg/kg BID

33
Q

rhinorrhea, sneezing, itchy eyes, itchy nose, nasal congestion, PND, ~cough

A

Allergic rhinitis

34
Q

What histories should be considered for allergic rhinitis? (4)

A

hx of hay fever, asthma, eczema, and allergies

35
Q

On physical diagnosis: pale, “blue” mucosa, clear discharge; pale, swollen conjunctiva with some injection

A

Allergic rhinitis

36
Q

External eye characteristics of allergic rhinitis

A

“allergic shiners” & Denie Morgan Lines

37
Q

skin folds under eye consistent w/ allergic conjunctivitis

A

Denie Morgan Lines

38
Q

First line drug treatment for allergic rhinitis

A

2nd gen topical intranasal corticosteroids

Fluticasone (Flonase), Triamcinolone (Nasacort)

39
Q

1st gen topical intranasal steroids

and what they’re used for?

A

Beclomethasone (Beconase), Flunisolide (Nasolide)

alternative to 2nd gen for treatment of allergic rhinitis

40
Q

Antihistamines for 2nd line allergic rhinitis (5)

A

Chlorpheniramine (Chlor-trimeton) or Diphenhydramine (Benadryl)
Loratadine (Claritin), Fexofedadine (Allegre), Cetirizine (Zyrtec)

41
Q

Which symptoms of allergic rhinitis can be alleviated by antihistamines?

A

sneezing, rhinorrhea, itching

No congestion relief

42
Q

allergic rhinitis treatment that vasoconstricts to decrease edema and secretions

A

Sympathomimetics (Decongestants)

Psuedoephedrine (Sudafed)

43
Q

Psuedoephedrine (Sudafed) contraindications

A

HTN, heart disease

44
Q

Last line, most intense allergic rhinitis treatment

A

Immunotherapy- “allergy shots”

45
Q

allergy shot mechanism of treatment

A

increased production of specific IgG antibodies

46
Q

nasal congestion, rhinorrhea
no itching, sneezing
normal nasal mucosa
normal IgE antibodies

A

Perennial Non-Allergic (Vasomotor) Rhinitis

47
Q

Perennial Non-Allergic (Vasomotor) Rhinitis sxs

A

nasal congestion, rhinorrhea

no itching, sneezing

48
Q

abnormal autonomic responsiveness triggered by stress, sexual arousal, perfumes, smoke, temperature change

A

Perennial Non-Allergic (Vasomotor) Rhinitis

49
Q

Perennial Non-Allergic (Vasomotor) Rhinitis treatments (5)

A

Trigger avoidance, topical steroids***, topical antihistamines, topical anticholinergics, 1st gen oral antihistamined

50
Q

Pedunculated, non-tender, grey, soft tissue growths

Nasal congestion/obstruction

A

Nasal polyps

51
Q

Nasal polyp treatment

A

refer to ENT

52
Q

rebound congestion following overuse of topical decongestants (afrin)

A

Rhinitis medicamentosa

53
Q

Rhinitis medicamentosa physical exam findings

A

Erythematous nasal mucosa

54
Q

Rhinitis medicamentosa treatment

A

discontinue medication (taper) and supplement with intranasal glucocorticoid

55
Q

Tx for fungal otitis media?

A

Fungal: Clotrimazole (3 drops BID for 14 days), acetic acid irritation

56
Q

Anticholinergics for labrynthitis

A

Anticholinergics (as an anti-emetic)- Prochlorperazine/Compazine

Clin Med 1 (18 decks)

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