Earache

Question 1

Referred pain to ear causes

Answer 1

Infection:
- dental abscess 
- tonsillitis 
- herpes / ramsay hunt
Temporo-mandibular arthritis
Cancer: 
- base of tongue carcinoma 
- Larynx carcinoma

Question 2

Nerve responsible for referred earache of dental abscess

Answer 2

trigeminal n

Question 3

Nerve responsible for referred earache of base of tongue carcinoma

Answer 3

glossopharyngeal n

Question 4

Nerve responsible for referred earache of ramsay hunt

Answer 4

facial n

Question 5

Nerve responsible for referred earache of larynx carcinoma

Answer 5

vagus n

Question 6

Signs of otitis media

Answer 6

• bulging of tympanic membrane
• air-fluid level behind membrane
• otorrhoea

Question 7

otorrhoea

Answer 7

ear discharge

Question 8

Middle ear inflammation signs

Answer 8

red TM

otalgia (earache)

Question 9

RFs for OM

Answer 9

1. passive smoking
2. formula milk
3. craniofacial syndrome (cleft palate, downs syndrome)
4. male

Question 10

Bacterial causes of OM

Answer 10

strep pneumonia
Haemophilus influenza
Moraxella catarrhalis

Question 11

Abx for OM

Answer 11

5 days
amoxicillin
or erythromycin

Question 12

NICE guideline on abx for OM

Answer 12

< 3 mo old
systemically unwell
at risk of serious complications

Question 13

Temp measurement for <4 wk old

Answer 13

electronic thermometer in axilla

Question 14

Temp measurement for 4wk - 5 yrs

Answer 14

• electronic thermometer in axilla
• chemical dot thermometer in axilla
• infra-red tympanic thermometer

Question 15

Normal range of resp rate for < 2mo

Answer 15

<60

Question 16

Normal range of resp rate for < 12 mo

Answer 16

<50

Question 17

Normal range of resp rate for < 5 yrs

Answer 17

<40

Question 18

Normal range of resp rate for < 8 yrs

Answer 18

<30

Question 19

Normal range of resp rate for < 14yrs

Answer 19

<20

Question 20

Normal range of heart rate for < 12 mo

Answer 20

<160

Question 21

Normal range of heart rate for < 5 yrs

Answer 21

<120

Question 22

Normal range of heart rate for < 14yrs

Answer 22

<110

Question 23

Otitis externa causes

Answer 23

infection
allergy
iatrogenic (syringing)

Question 24

Risk factors for otitis externa

Answer 24

moisture - swimming
foreign body
trauma
chronic skin disease - eczema/psoriasis

Question 25

Otoscopy findings of OE

Answer 25

dermatitis of ear canal

discharge

Question 26

OE meds

Answer 26

Topical prep for 7 dys:

• aminoglycosides + steroids
• abx drop only

Question 27

Gentamaicin CI for OE

Answer 27

avoid if TM perforation