Ear problems Flashcards
Acute Otitis Media ( purulent or supportive otitis media)
signs ? PE ? pathogen? tx?
complains of unilateral ear pain follow by “ cold”, ear fullness or decreased hearing
PE: TM= red bulging, abnormal cone of light
Pathogen : strep pneumonia or homophiles influenza
TX:
If no previous antibitic in the last month : Amoxicillin TID 5-7 days
History of antibiotics: Augmentin BID 10 days
adjuncts ( not a cure)
- NSAIDS
- Oral decongestants ( no to people with HTN)
- Nasal Saline Spray
- Afrin ( watch for rebound )
Otitis Media with effusion ( serous otitis media)
Due to trapped sterile fluid in middle ear, may follow an AOM
PE: TM may look translucent but filled with clear serous fluid
TX: can give decongestant
What are the complications of an Otitis Media
Acute Mastoiditis
Cholesteatoma
Otitis Externa
Cholesteatoma
cauliflower-like white growth draining purulent foul smelling discharge with hearing loss.
Refer to ENT
Otitis Externa ( swimmers ear)
caused by pseudomonas aeruginosa ( gram -). Pain with manipulation of tragus and pinna
tx: topical steroid and antibiotics ( cortisporin) don’t go in water
Acute Bacterial Rhiniosinusitis
persistent URI, for 10 or more days or a cold that has returned and worsened.
complains of unilateral facial pain/pressure, toothache. will have frontal headache, or behind on eye,
PE: transilluniation on effected side will be duller
most caused by step pneumonia and h. influenza
TX: either observe or antibiotics
1. Augmentin 5-7 days
PCN Allergy: Doxy 5-7 days
infectious mono
caused by epstein barr virus
EBV can cause cancer
presentation: onset of malaise, low grade fever, headache, tonsils may have white exudate, may have a maculopapular rash. lasting 4 weeks but may be longer
testing: monospot but have false results
EBV titer is gold standard
suspect spenomegaly; order a US
avoid contact sports for 4-6 weeks
