ENT Part 1 Flashcards
What causes an ear infection and how fast is the onset of symptoms?
When someone is exposed to an environment that inhibits or removes cerumen. Typically onset is within 48 hours.
Which two bacteria make up roughly 90% of ear infections?
Pseudomonas aeruginosa (20-60%) Staphylococcus aureus (10-70%)
A patient presents with complaints of otalgia and erythema to his ear. He mentions that he was swimming at lake mead yesterday but had felt great the rest of the day but woke up with the pain today. Upon examination you notice that when you move his ear to look in it makes the pain worse. What is the cause of his pain?
Firstly the patient has Acute Otitis Externa and the pain is most likely due to Pseudomonas Aeruginosa.
Your patient is complaining about otalgia and some drainage to her right ear. She had noticed that she had some hair growing in her ear and wanted to remove the hair. Shortly after her ear started hurting and gradually got worse. What would you expect to see in her ear and what is causing the infection?
I would expect to see a Furuncle where she pulled the hair out due to an infected hair follicle. And this is most likely cause by Staphylococcus Aureus.
Your patient is a DM patient who recently got done with an extended period of time on Abx and is complaining about ear pain. When obtaining a Hx from the patient you find out that they recently moved to Las Vegas from Florida to get out of the humid air and hurricanes. upon ear examination you find hardened cerumen with specks of green in it. What would you expect to be the cause of the pain?
They most likely have a fungal infection caused by either Aspergillus (60-90%) or Candida spp. (10-40%) called Otomycosis.
What are the main treatment for AOE?
A 10 day course of Abx drops BID or TID. However you need to be aware of if they have a ear tube in or are immune compromised
How can you differentiate between AOE and AOM?
You use a otoscope that puffs air and if the TM moves then it is AOE but if there is no movement then there is fluid on the inside and you have AOM.
What are the four main bacterial causes of AOM?
Streptococcus pneumoniae
non-typable Haemophilus influenzae
Streptococcus pyogenes
Moraxella catarrhalis (becoming more common)
What are the best treatments for AOM?
Abx Treatment and or Nasal Decongestants. If these do not work you make have to do a tympanocentesis. In rare cases you may even have to do Myringotomy which is a surgical drainage of the ear.
Describe the difference in OME and AOM.
In OME the eustation tube is clogged and there is a build up of clear fluid in the middle ear with no symptoms of pain. AOM usually has red bulging TM and is associated with Otalgia and fever.
What is the cause for CSOM?
It is due to a lack of effective treatment to AOM which allows the bacteria to continue to grow in the middle ear. Same infections as AOE are most common cause of chronic infections.
Why do most people experience Labrythitis?
The cause is actually unknown but it has been associated with recent respiratory tract infections.
What is the main difference with nasal infections as compared to Ear infections?
Nasal infections are mainly due to Viruses and bacterial infections are very rare.
What are some complications to worry about with a nasal infection?
Middle ear effusion if the eustachian tube is clogged. other worries would be a secondary bacterial infection.
What types of treatments can you use for nasal infections?
Most common would be nasal decongestants or a nasal spray but there is no real treatment for rhinitis at this time.
