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CPD > Ears- Middle > Flashcards

Ears- Middle Flashcards

1
Q

what causes AOM?

A
  • organisms
  • position of eustachian tube
  • strep, h. flu, moraxella (common)
  • GAS, staph, gram neg bacilli, mycoplasma (less common)
  • sterile effusions
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2
Q

what are risk factors for AOM?

A
  • day cares
  • bottle feeding (positioning)
  • smokers in house
  • AOM in first year of life predisposes to more down the road
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3
Q

SSxs of AOM?

A
  • throbbing pain (or maybe NO pain)
  • fever
  • decreased hearing
  • n/v
  • moodiness, irritability
  • child tugs on ear
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4
Q

PE findings of AOM?

A
  • bulging, red or cloudy TM
  • possible fluid line on TM
  • decreased mobility on pneumatic otoscopy
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5
Q

complications of AOM?

A
  • OM w/effusion most common
  • if bilateral= hearing loss and may be speech delay
  • mastoiditis used to be common
  • perforation of TM is common but not serious unless peripheral
  • may persist during abx tx or relapse w/in 1 mo
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6
Q

if TM perforates what will the pt experience? if perforation is peripheral what should you check for?

A
  • perforation= discharge & sudden loss of pain

- peripheral= check regularly for cholesteatoma

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7
Q

what does chronic otitis media include?

A
  • otitis media with effusion

- chronic supprative otitis media

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8
Q

what is chronic otitis media with effusion (OME)? what causes it?

A
  • effusion in middle ear

- incomplete resolution of acute OM or due to inflammation

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9
Q

risk factors for OME?

A
  • prior t-tube placement
  • allergy
  • adenoid hypertrophy
  • summer or fall
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10
Q

SSxs for OME?

A
  • hearing impairment
  • mild otalgia, tends to be worse at night
  • may have overlapping of common cold
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11
Q

PE findings for OME?

A
  • amber or gray intact TM but usu retracted or in neutral position
  • impaired mobility of TM
  • bubbles or air/fluid level may be seen
  • chronic cervical LA
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12
Q

what is the course of OME?

A
  • if persists becomes COME
  • fluid behind intact TM
  • risk of infxn
  • recurrent AOM and/or perforation
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13
Q

what is chronic supprative otitis media? what causes it?

A

-chronic inflammation of middle ear for at least 6 weeks w/TM perforation & otorrhea

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14
Q

what are causes of CSOM?

A
  • acute OM resulting in performation

- trauma

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15
Q

SSxs of CSOM?

A
  • hearing loss
  • chronic purulent d/c
  • painless
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16
Q

PE findings of CSOM?

A
  • perforation of TM

- may see retraction pocket in posteriorsuperior quadrant, cholesteatoma, granuloma, polyps

17
Q

what is the course of CSOM?

A
  • may have perforation w/o sxs, but sometimes chronic bac infxn develops
  • chronic persistent infxns can destroy parts of ossicles leading to conductive hearing loss-child= delayed intellectual development
18
Q

what is the diagnostic criteria for AOM?

A
  • acute onset
  • middle ear effusion
  • limited or absent TM mobility
  • air-fluid level behind membrane
  • SSx of middle ear inflammation
19
Q

diagnostic criteria for persistent AOM?

A

-persistent SSxs during abx tx or relapse w/in 1 mo of tx completion

20
Q

diagnostic criteria for OME?

A

-fluid behind intact TM in absence of features of acute infxn

21
Q

diagnostic criteria for COME?

A

-persistent fluid behind intact TM in absence of acute infxn

22
Q

diagnostic criteria for CSOM?

A
  • persistent inflammation of middle ear or mastoid cavity

- recurrent or persistent otorrhea through perforated TM

23
Q

what is myringitis? what causes it?

A
  • inflam or infection of TM, primary/secondary, acute/chronic forms
  • primary causes: mycoplasma pneu, TM trauma, acute bullous or hemorrhagic myringitis, fungal, eczema, granulosa
  • secondary causes: AOM, AOE, COM, COE
24
Q

SSxs of myringitis?

A
  • serosanguinous otorrhea, otalgia, hearing impairment

- if acute: sudden ear pain 24-48 hrs, fever

25
Q

PE findings of myringitis?

A
  • vesicles develop on TM in bullous form

- granulomatous tissue in granulosa form

26
Q

what is a cholesteatoma? causes?

A
  • growth of keratinizing squamous epi in middle ear and pars tensa, can englarge
  • congenital, primary/secondary acquired
27
Q

SSxs of cholesteatoma?

A
  • painless otorrhea, unremitting or frequently recurring
  • conducting hearing loss then grow into inner ear and cause sensorineural hearing loss
  • dizziness uncommon
28
Q

PE findings of cholesteatoma?

A
  • canal filled with muco-pus & granulation tissue
  • TM perforation in >90% of cases
  • may require surgical removal
29
Q

what is acute mastoiditis? causes?

A
  • suppurative infxn in mastoid air cells
  • complication of severe AOM
  • strep pneu (most common), strep pyo, stap spp., h. flu, pseudomonas
30
Q

SSxs of mastoiditis?

A

-redness, swelling, tenderness behind ear, fever, hearing loss, profuse creamy d/c, throbbing pain

31
Q

PE findings for mastoiditis?

A
  • bulging erythematous TM
  • tenderness, redness, swelling over mastoid
  • postauricular fluctulance
  • protrusion of auricle, downward displacement of auricle
32
Q

complications of mastoiditis?

A
  • subperiosteal abscess
  • CN 7 palsy
  • hearing loss
  • osteomyelitis
  • meniningitis
  • venous sinus thrombosis
  • ALWAYS REFER
33
Q

what is otosclerosis?

A
  • genetic (autosomal dominant) metabolic bone dz affecting optic capsule & ossicles
  • overgrowth of footplate in stapes/dysfunction
34
Q

SSxs of otosclerosis?

A

-progressive bilateral conductive hearing loss, tinnitus & occasionally vertigo

35
Q

what is tympanosclerosis? causes?

A
  • sclerosis of TM, stiffening of TM= impaired conductive hearing
  • from chronic OM, post t-tube
36
Q

SSxs of tympanosclerosis?

A

-early asx, hearing loss progressive

37
Q

PE findings of tympanosclerosis?

A

-whitish plaques on TM

CPD (7 decks)

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