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Foundations II Exam 1 > Ears 1 > Flashcards

Ears 1 Flashcards

1
Q

Tx for AOM w/ perforated TM

A

Amoxicillin (oral), plus topical abx with low ototoxicity such as ofloxacin or fluoroquinolone and analgesics (pain killers)
–DO NOT USE aminoglycosides

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2
Q
  • Spiking fevers
  • Postauricular pain
  • Postauricular erythema
A

Mastoiditis

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3
Q

Sensorineural loss:

where does sound lateralize to w/ Weber test?

A

AC > BC

-to good ear

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4
Q

The 3 urgent FB of the ear

A
  • button batteries
  • live insects
  • penetrating FB
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5
Q

5 complications of AOM

A
  • Labyrinthitis
  • Hearing loss
  • Mastoiditis
  • Non-responsive to meds
  • Recurrent infections
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6
Q

How soon should AOM improve after starting tx with abx?

A

2 - 3 days

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7
Q

PE findings w/ AOM

A
  • Immobile TM
  • Erythema
  • Bulging
  • can possibly be ruptured
  • Retracted
  • Bullae
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8
Q

Osteomyelitis of temporal bone/skull base, tx?

A

Malignant otitis externa (necrotizing otitis externa) = FATAL, give IV abx (quinolones) for a few months or surgery

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9
Q
  • family hx
  • daycare
  • lack of breastfeeding
  • 2nd hand smoke/air pollution
  • pacifier use
A

risk factors of AOM

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10
Q

1st line tx for AOM

A

high dose Amoxicillin (80 to 90 mg/kg/day twice daily)

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11
Q
  • Foul smelling discharge
  • Granulations in ear canal
  • Deep otalgia
  • CN palsies
  • HA
A

Malignant OE (necrotizing otitis externa)

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12
Q

Ototoxicity is associated with which med?

A

Aminoglycosides (topical ear drop)

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13
Q

Conductive hearing loss, with the Rinne test is AC or BC greater with the good ear?

A

AC > BC

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14
Q
  • Decreased hearing
  • Otalgia
  • Drainage
  • Chronic cough/hiccups
A

Foreign body in ear

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15
Q

Is more common w/ bacterial infections of otitis externa

A

Purulent discharge

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16
Q

2nd line tx for AOM

A

high dose Amoxicillin-clavulanate or 2nd/3rd generation cephalosporin

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17
Q

Epidemiology of AOM. Which age group is most common? Which seasons most common?

A

4 to 24 months old

-fall and winter

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18
Q

What causes AOM?

A

Bacterial infection of middle ear, usually preceeded by URI

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19
Q

What rare ear condition would we tx with antivirals instead of abx?

A

Ramsay Hunt Syndrome (Herpes Zoster Oticus), vesicles on outer ear canal

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20
Q

5 differential diagnosis for OE

A
  • Middle ear disease
  • Contact dermatitis
  • Psoriasis
  • Chronic Suppurative OM
  • Squamous cell carcinoma of external canal
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21
Q

3 main complications of OE

A
  • Periauricular cellulitis
  • Contact dermatitis
  • Malignant otitis externa (necrotizing otitis externa)
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22
Q

Tx for otitis externa if TM is intact

A

Topical ear drops (aminoglycosides or fluoroquinolone with or without corticosteroids)

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23
Q

Is more common w/ fungal infections of otitis externa

A

Pruritis and black discharge

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24
Q

Which ear conditions need referral to ENT?

A
  • persistent otitis externa

- immunocompromised/DM patients

25
Q

1st, 2nd, and 3rd most common bacteria which cause AOM?

A
  1. -Strep pneumoniae
  2. -Haemophilus influenza
  3. -Moraxella catarrhalis
26
Q

3 reasons poor drainage of eustachian tubes?

A
  • age
  • inflammation/edema
  • congenital malformation
27
Q
  • Otalgia
  • Pruritis
  • Purulent discharge
  • hearing loss
  • fullness
  • hx water exposure or trauma
A

Otitis externa

28
Q

Abnormal Rinne test

A

BC > AC

29
Q

Cauliflower ear from hematoma not being drained will lead to the ear being disfigured. What else is impacted?

A

Hearing

30
Q

Why does bacteria build up with AOM?

A

Obstructed eustachian tube, so fluid/mucous accumulate and get secondarily infected

31
Q

3 etiologies of otitis externa. Which is most common?

A
  • Allergic
  • Dermatologic condition (psoriasis)
  • Infection (Pseudomonas (38%)
  • Gram - rod
32
Q

When would immediate abx for AOM be appropriate?

A
    • < 6 months

- -or children < 24 months if sxs are severe (moderate - severe pain, pain over 48 hours, temp 102.2F, bilateral AOM)

33
Q

Most common neoplasm of ear canal (cancer), it mimics chronic infection

A

Squamous cell carcinoma of external canal

34
Q

Pathophysiology of most cerumen impaction

A

Self induced (Q-tips)

35
Q

3 treatments for cerumen impaction

A
  • Detergent ear drops
  • Mechanical removal (curet)
  • Irrigation w/ body temp water and TM intact, then dry it
36
Q

Tx for otitis externa if TM is not intact or if pt has ear tubes

A

Fluoroquinolone

37
Q

How would you remove an organic FB from ear? (beans, peas, insects)

A

DO NOT irrigate (it will expand)

-Use lidocaine to paralyze insect

38
Q

Conductive loss:

where does sound lateralize to w/ Weber test?

A

BC > AC

-to bad ear

39
Q

How do you tell if you’re looking at a right or left TM?

A

Cone of light points anteriorly

40
Q

How many days do you tx otitis externa with meds?

A

7 - 10 days

41
Q

Inflammation of semicircular canals

A

Labyrinthitis

42
Q

Tx for recurrent infections of AOM

A

Tympanostomy tubes or (PE-pressure equalizing tubes)

43
Q

Who is at higher risk for developing malignant otitis externa from an OE?

A
  • DM patients

- immunocompromised

44
Q
  • Occlusive devices
  • trauma
  • debris from psoriasis
  • swimming
  • warm/humid climates
A

Risk factors for otitis externa

45
Q

Normal Rinne test

A

AC > BC

46
Q

Recurrent cases of AOM are associated with which 2 things?

A
  • allergies

- 2nd hand smoke

47
Q

What types of FB are removed with loop, hook, or irrigation

A

Firm objects (not organic)

48
Q

How do you prevent AOM?

A

-Vaccinations

49
Q

Tx for mastoiditis

A

IV abx or mastoidectomy

50
Q

Associated w/ mycoplasma infection

A

Bullae

51
Q

5 differential diagnosis of AOM

A
  • OM w/ effusion
  • OE
  • ETD (eustachian tube dysfunction)
  • Herpes Zoster
  • Head/neck infection
52
Q

Associated w/ wrestlers

A

Traumatic auricular hematoma (can lead to cauliflower ear if not drained)

53
Q
  • Otalgia
  • Pressure
  • fever
  • URI sxs
A

Clinical presentation of AOM

54
Q

How is Malignant OE diagnosed?

A

CT scan showing osseous erosion

55
Q

PE findings w/ otitis externa

A
  • erythema and edema of ear canal skin
  • purulent drainage
  • tenderness w/ tragal or auricle manipulation
  • red TM (maybe)
  • TM is mobile w/ pneumatic otoscopy
  • TM may not be visible due to edema of canal
56
Q

Which ear conditions need oral abx?

A
  • Severe OM w/ cellulitis of periauricular tissue

- Recalcitrant cases

57
Q

When would observation be appropriate for AOM?

A

Observe for 48 to 72 hours in children –6 mo - 2 yrs w/ unilateral and mild sxs
–2 yrs or older w/ unilateral or bilateral if not severe

58
Q

What tx option is used if there is too much swelling of the canal restricting drops from entering ear?

A

Ear wick, keeps canal open. Is replaced every day or 2

59
Q
  • Hearing loss
  • Fullness
  • Itchiness
  • Reflex cough
  • Dizziness
  • Tinnitus
A

Cerumen impaction

Foundations II Exam 1 (25 decks)

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