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Otitis Externa > Importnat Details To Know > Flashcards

Importnat Details To Know Flashcards

1
Q

What are the two bacteria that contribute to the development of otitis externa?

A

Pseudomonas aeruginosa and staphylococcus aureus

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2
Q

Pseudomonas aeruginosa is gram….?

A

Negative rod

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3
Q

Staphylococcus aureus is a gram what?

A

Positive cocci

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4
Q

Pseudomonas aeruginosa can be found on?

A

Water reservoirs

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5
Q

Pseudomonas aeruginosa can be transmitted via?

A

Aerosol transmission

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6
Q

Does pseudomonas aeruginosa have motility?

A

Yes, it has a polar flagella

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7
Q

Does pseudomonas aeruginosa have a capsule?

A

Yes

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8
Q

What substances does pseudomonas aeruginosa produce?

A

Endotoxin and exotoxin A and elastase which is an enzyme that targets and destroys the blood vessels

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9
Q

Pseudomonas aeruginosa is oxidase…?

A

Positive

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10
Q

Pseudomonas aeruginosa is an obligate…?

A

aerobe

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11
Q

Pseudomonas aeruginosa is a non…

A

Fermenter

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12
Q

Pseudomonas has two pigments which are…?

A

Blue-green due to pyocyanin and fluorescent due to fluorescein

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13
Q

What type of odor does pseudomonas aeruginosa expel?

A

A fruity “grape-like” odor

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14
Q

Staphylococcus appears are…?

A

Grape-like clusters

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15
Q

Is staphylococcus aureus non motile?

A

Yes

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16
Q

Does staphylococcus aureus form spores?

A

No! It is non spore forming

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17
Q

What features does staphylococcus aureus have?

A
  1. Capsule
  2. Protein A
  3. Slime layer
  4. Peptidoglycan
  5. Teichoic acid
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18
Q

Is staphylococcus aureus an opportunistic bacteria?

A

Yes

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19
Q

Where can we find staphylococcus aureus in the body normally?

A

In the nose and skin

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20
Q

How is staphylococcus aureus transmitted?

A

Via the hands, sneezing, surgical wounds, and contaminated foods

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21
Q

What toxins does staphylococcus aureus produce?

A
  1. Cytotoxins
  2. Exfoliative toxins A/B
  3. Enterotoxins
  4. TSST-1
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22
Q

What enzymes does staphylococcus aureus produce?

A
  1. Coagulase
  2. Hyaluronidase
  3. Fibrinolysin
  4. Li pases
  5. Nucleases
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23
Q

Staph aureus is catalase what?

A

Positive

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24
Q

Staph aureus is coagulase what?

A

Positive

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25
Q

Staph aureus is oxidase what?

A

Negative

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26
Q

Staph aureus is a facultative

A

Anaerobe

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27
Q

Staph aureus will show what color when grown in blood agar?

A

Golden

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28
Q

Staph aureus is Beta what?

A

Hemolytic

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29
Q

Is staph aureus a mannitol fermenter?

A

Yes

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30
Q

What are the manifestations of otitis externa?

A

Pain, pruritus, discharge
The pinna is tender but with no lymphadenopathy
There is pain exacerbation with movement
There is erythema
There is edema in the external ear canal
Fever ( more than 37.3 degrees Celsius )

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31
Q

What other manifestations are associated with otitis externa?

A 
Fullness feeling 
Vértigo 
Nystagmus 
Tinnitus 
Viral respiratory infection symptoms 
Allergic reaction symptoms
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32
Q

What are some otitis externa manifestations in children?

A

Fever, ear pain, irritability, vomiting, diarrhea

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33
Q

Which patients are at risk of developing malignant otitis externa?

A

Those with poorly controlled diabetes and those with a compromised immune system

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34
Q

What are some symptoms of malignant otitis externa?

A

Fever, severe pain, regional lymphadenopathy in the preauricular and cervical lymph nodes,

The fever is high grade btw

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35
Q

Malignant otitis externa is a…

A

Necrotizing infection affecting the cartilage, blood vessels, bone

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36
Q

Which other structures can malignant otitis externa affect?

A

skull base, brain meninges, brain cranial nerves 7, 9, 10, 12

37
Q

What other pathologies can be seen in conjunction with otitis externa?

A

Purulent conjunctivitis, rhinitis, sinusitis

38
Q

What is the most common cause of otitis externa in adults?

A

swimmers and divers

39
Q

What are some predisposing factors for developing otitis externa?

A
  1. High environmental temperature
  2. Mechanical removal of cerumen
  3. Trauma (foreign object insertion)
  4. Chronic dermatologic disease (eczema, psorias, seborrheic dermatitis, acne
40
Q

Which groups or individuals are vulnerable for developing otitis externa?

A

People who have antibody, complement, and phagocytic cell deficiencies, cleft palate, kids at day care, babies being bottle fed, second hand smokers, family history

41
Q

A cerumen insufficiency may predispose someone to ?

A

Acute otitis externa

42
Q

What fungi may also be involved in the development of otitis externa?

A

Cándida ir aspergillus species

43
Q

In acute otitis externa what is the color of the discharge?

A

Thick white mucus

44
Q

In chronic otitis externa what is the composition of the discharge?

A

Bloody

45
Q

In malignant otitis externa, what is the composition of the discharge?

A

Foul smelling (otorrhea that smells bad)

46
Q

What are some therapeutic and preventative strategies for otitis externa?

A

Cleansing, debris removal, topical anti microbial like acetic acid, oxfloxacin, neomycin plus polymin B

47
Q

What is the therapeutic approach when it comes to malignant otitis externa?

A

IV use of imipenem

48
Q

What is otitis media?

A

Inflammatory disease of the mucosa of the inner ear with exudative production

49
Q

There is a loss of what in otitis media?

A

Transient loss of hearing

50
Q

What common bacterial micoorganisms are responsible for otitis media?

A

Strep pneumoniae , haemophilus influenza, moraxella catarrhalis

51
Q

What bacteria are mostly responsible for otitis media in infants?

A

E.Coli, Klebsiella, Pseudomonas

52
Q

Strep pneumoniae is gram what?

A

Positive

53
Q

Strep pneumoniae appears as?

A

Cocci in chains

54
Q

Does strep pneumoniae have a capsule?

A

Yes ( C polysaccharide )

55
Q

Does strep pneumoniae have a IGA protease?

A

Yes

56
Q

Does strep pneumoniae have teichoic acid?

A

Yes

57
Q

Does strep pneumoniae have pneumolysin O

A

Yes

58
Q

Does strep pneumoniae have surface protein adhesins?

A

Yes

59
Q

Strep pneumoniae is catalase what?

A

Negative

60
Q

Strep pneumoniae is optochin what?

A

Sensitive

61
Q

Strep pneumoniae is lysed with what?

A

Bile

62
Q

Strep pneumoniae is alpha what?

A

Hemolytic

63
Q

How is strep pneumoniae transmitted?

A

Respiratory droplets

64
Q

Haemophilus influenzae bacteria is gram what?

A

Negative

65
Q

Haemophilus influenzae is of what shape?

A

Cocco bacilli (short rod)

66
Q

What type of capsule does the Haemophilus influenzae have?

A

Polyribitol phosphate capsule

67
Q

Does Haemophilus influenzae have an IGA protease?

A

Yes

68
Q

Which type of Haemophilus influenzae bacteria is 90% invasive?

A

The type one that had type B capsule

69
Q

What is the reservoir for Haemophilus influenzae?

A

Humans

70
Q

How is Haemophilus influenzae transmitted?

A

Respiratory droplets

71
Q

What growth factors does Haemophilus influenzae require?

A

X (hemin) and V (nad)

72
Q

In which type of agar does Haemophilus influenzae grow?

A

Chocolate agar

73
Q

When Haemophilus influenzae is cultured with Staph aureus, what phenomenon can be observed?

A

Satélite phenomenon

74
Q

Moraxella catarrhalis is gram what?

A

Negative

75
Q

What shape is moraxella catarrhalis?

A

Cocci (diplococci)

76
Q

Is moraxella catarrhalis aerobic or anaerobic?

A

Aerobic

77
Q

Moraxella catarrhalis is a…

A

Non fermenter (maltose)

78
Q

Moraxella catarrhalis is oxidase…

A

Positive

79
Q

Moraxella catarrhalis is a producer of?

A

Beta-lactamase

80
Q

Otitis media is common in which population?

A

Children due to their ear anatomy. They have a short, flexible, and horizontal Eustachian tube

They will have. A viral respiratory infection first

81
Q

In otitis media we have …

A

Swelling, Eustachian tube obstruction, exudate accumulation, inner ear pressure increase, timpánica membrane bulge and rupture

82
Q

In otitis media we see a bulging what?

A

Tympanic membrane

83
Q

Otitis media requires what?

A

Antibiotic treatment

84
Q

What is the treatment for otitis media if the symptoms last for three days?

A

initiate antibiotic (amoxicillin)

85
Q

What is the treatment for otitis media if you have been administering an antibiotic for three days and there is no response?

A

Amoxicillin + clavulanate or 3rd generation cephalosporin

86
Q

For allergic patients with otitis media, what is the treatment?

A

Trimethropin-sulfamethoxazole

87
Q

For people with recurrent otitis media what is the treatment?

A

Tumpanostomy tubes

88
Q

What is the vaccine for patients older than 2 years old specifically against strep pneumo?

What is the vaccine for patients less than two years old?

A

Pneumovax (older than two years old)

Less than two years old is Prevnar

Otitis Externa (5 decks)

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