External Ear Infections - Blake

Question 1

How far distally and proximally can otitis media extend?

Answer 1

Distally to the pinna and proximally to the tympanic membrane

Question 2

What is malignant necrotizing otitis externa?

Answer 2

rare complication where it invades the surrounding soft tissue and bone

Question 3

What are the predisposing factors to chronic otitis media that lasts three months or longer?

Answer 3

allergies, chronic derm conditions, or badly treated acute otitis externa

Question 4

What are the two most common bacterial causes of otitis externa?

Answer 4

S. aureus and Pseudomonas aeruginosa

Question 5

What percent of cases are polymicrobial?

Answer 5

one third

Question 6

(Viral/fungal) otitis externa happens in pts that were previously treated with abx

Answer 6

fungal

Question 7

What is the mechanism that the common risk factors such as swimming and cleaning your ears uses to give you otitis externa?

Answer 7

loss of cerumin barrier and disruption of the epithelium leading to inoculation with bacteria and increase in canal pH

Question 8

T/F: don’t use Q tips

Answer 8

DO YOU REALLY NEED THIS ONE COLT?

Question 9

When do you use acetic acid drops for the ear?

Answer 9

after water exposure

Question 10

What symptom best correlates with the severity of the ear infection?

Answer 10

pain

Question 11

Fevers beyond 101F suggest what?

Answer 11

extension beyond the ear canal

Question 12

T/F: acute otitis externa is a form of cellulitis

Answer 12

true

Question 13

What are the two most common fungal causes of otitis externa?

Answer 13

Aspergillus and candida

Question 14

T/F: you may give topical antimicrobials without having to give topical corticosteroids alongside them

Answer 14

true

Question 15

which causes symptom relief faster: topical antimicrobials or oral antibiotics?

Answer 15

topical antimicrobials

Question 16

What is the first line therapy if the TM is intact?

Answer 16

neomycin/polymyxin B/hydrocortisone preparation

Question 17

What should be used for a middle ear infection or if the TM is not intact?

Answer 17

Cipro and dexamethasone

Question 18

What is firstline pain management for otitis externa?

Answer 18

NSAIDS

Question 19

How soon do pts normally get symptom relief?

Answer 19

within 24 hours, definitely by 48-72

Question 20

How long do you prescribe topical abx?

Answer 20

10 days

Question 21

What is the preferred mix when prescribing acetic acid drops?

Answer 21

give it with hydrocortisone

Question 22

What are the cardinal symptoms of otitis externa?

Answer 22

ear pain, itching, or fullness WITH signs of ear canal inflammation

Question 23

T/F: otitis externa can present as jaw pain or hearing loss

Answer 23

true

Question 24

What is this?

chronic otorrhea, blown TM

Answer 24

chronic suppurative otitis media

Question 25

What is this? High fever, granulation tissue or necrotic tissue in canal, potential for cranial nerve involvement, seen in pts with DM, elevated ESR

Answer 25

malignant otitis externa; MEDICAL EMERGENCY, IV ABX

Question 26

What is this? | TM inflammation, potential vesicles, severe pain, NO CANAL EDEMA

Answer 26

myringitis

Question 27

What is this? | baaaaad itching, thick material in canal, less edema

Answer 27

otomycosis

Question 28

What is the secondary disease from acute otitis MEDIA or viral infection?

Answer 28

myringitis

Question 29

T/F: otomycosis can be polymicrobial with bacteria

Answer 29

true

Question 30

What is this? | Herpetic ulcers in canal, facial numbness, sever pain, loss of taste

Answer 30

Ramsay Hunt syndrome

Question 31

How do you treat Ramsay Hunt syndrome?

Answer 31

antivirals and systemic corticosteroids

Question 32

What is this? | Normal ear exam but pain nonetheless

Answer 32

referred pain

Question 33

What is this? | itching rash on hairline, face, and scalp

Answer 33

Seborrhea

Question 34

What is the Tx for seborrhea?

Answer 34

lubricating or moisturizing external canal

Question 35

What is this? | Severe itching, maculopapular or erythematous rash on conchal bowl and canal, streak on pinna, vesicels

Answer 35

hypersensitization to otic meds