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ears1 Flashcards

1
Q

acute otitis media definition

A

inflammation of middle ear

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2
Q

acute otitis media bacterial pathogens

A

 Streptococcus pneumoniae (most common)
 Haemophilus influenzae
 Moraxella catarrhalis
 Occasional streptococcus or staphylococcus aureus

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3
Q

what is going on with the ear in otitis media

viral

A

 Eustachian tube dysfunction or obstruction secondary to viral nasal pharyngitis – ineffective drainage of middle ear

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4
Q

what age group is most prone to otitis media

A

kids < 7 yrs

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5
Q

otitis media risk factors

A 
	Recent URI
	Congenital disorders – cleft palate, Down Syndrome
	Smoke
	Native American or Eskimo
	Family hx of otitis media
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6
Q

acute otitis media- history

A 
	Earache
	Fever 
	Conductive hearing loss
	Otorrhea (if eardrum perforation)
	Perforated TM – intense pain followed by popping sound with acute relief
	Vertigo
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7
Q

acute otitis media PE

A 
	Bulging TM
	Distorted light reflex
	Obscured landmarks
	Decreased TM mobility 
	Pneumonic otoscope
	Preauricular or cervical adenopathy
	Bullae on TM indicative of Mycoplasma Pneumoniae
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8
Q

acute otitis media Ddx

A
  1. Otitis Externa
  2. Referred pain from jaw, teeth
  3. Dental abscess
  4. Mastoiditis
  5. Ear canal furuncle
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9
Q

acute otitis media management/tx

A
  1. ATB

2. pain management

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10
Q

ATB for acute otitis media

A
  1. Amoxicillin 875 mg po q 12hours x 5-7 days
  2. Amoxicillin clavulanate for recurrence or No response to treatment after 48-72 hours
     Combination oral antibiotics and topical otic suspension –for perforation (Ciprodex, Ofloxacin)
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11
Q

what med class to avoid with TM perforation

A

aminoglycosides

ex- gentamycin, streptomycin, tobramycin, neomycin

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12
Q

what pain meds for otitis media

A

acetaminophen
ibuprofen
topical local anesthetic- otitic solution

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13
Q

when to refer to ENT or consult MD for otitis media

A
  1. hearing loss after tx
  2. mastoiditis
  3. facial nerve palsy
  4. chronic perforation
  5. recurrent infection
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14
Q

perforated TM management

A
  • often heals spontaneously

keep dry
ATB drops or systemic ATB

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15
Q

definition of serous otitis media

A

effusion in middle ear or chronic otitis media with effusion

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16
Q

what is happening with serous otitis media

A

patency of eustachian tube impaired preventing equalizing of pressure

17
Q

serous otitis media is associated with

A
  1. Subacute infection
  2. Allergic manifestation
  3. Barotrauma
  4. Deviated septum
  5. Hypertrophic adenoids
  6. Benign or malignant neoplasms
18
Q

serous otitis media - history

A

 Diminished hearing
 Popping sensation
 Fullness in ear
 Occasional dizziness

 Often asymptomatic

19
Q

serous otitis media- PE

A

 Serous middle ear fluid (translucent membrane with diminished mobility)
 Extensive inflammation and purulent middle ear effusion should not be evident
 Air fluid level present (bubbles)
 Decreased membrane mobility with insufflation
 Conductive hearing loss

20
Q

what will be seen with conductive hearing loss in serous otitis media

A

 Weber – lateralize to affected side

 Rinne BC>AC

21
Q

dx testing / findings for serous otitis media

A

 Audiometry – decreased hearing

 Tympanometry – middle ear effusion

22
Q

serous otitis media diff dx

A
  1. Acute Otitis Media
  2. Conductive hearing loss
  3. Meniere’s disease
23
Q

serous otitis media management/tx

A

 Topical decongestants – phenylephrine 1-2 sprays each nostril q8-12h for 3 days
 Oral decongestants

24
Q

can serous otitis media resolve sponatenously

A

yes, 2-3 weeks

25
Q

patient education for serous otitis media

A

Valsalva or gum to relieve tube blockage

26
Q

f/u for serous otitis media

A

in 4-6 wks

27
Q

when to refer to MD with serous otitis media

A

persistent hearing loss

NR 636 (8 decks)

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