Lecture 17 Otitis Media

Question 1

What is the most common diagnosis made in sick children in the US?

Answer 1

otitis media (OM)

Question 2

What time of year is OM most prevalent?

Answer 2

winter/early spring

Question 3

what kind of epithelium is seen in the eustachian tube and middle ear?

Answer 3

respiratory epithelium

ie pseudostratified ciliated columnar epithelium with goblet cells

Question 4

Is the eustachian tube at a steeper or shallower angle in kids relative to adults? Why does this matter?

Answer 4

shallower –> less drainage, so more risk of infection

Question 5

What is OME?

Answer 5

otitis media effusion;

chronic, non-infectious form of OM

Question 6

Besides virsuses, what are the 3 most common causes of OM?

Answer 6

strep pneumo, H-flu, moraxella catarhallis

Question 7

“popping ears” pulls on the ____ muscle, opening the eustachian tube

Answer 7

tensor veli palatini

Question 8

what sort of infection is OM often a sequelae of ?

Answer 8

upper respiratory infection

Question 9

what should you save for the last part of the physical exam in patients with OM?

Answer 9

throat (kids aren’t fans of tongue depressors)

Question 10

Acute OM tympanic membrane (TM) triad of symptoms:

Answer 10

bulging, immobile, red

Question 11

what should you suspect if a patient presents with fever and ear ache?

Answer 11

strep pneumo

Question 12

what should you suspect if a patient presents with TM perforation or mastoiditis?

Answer 12

group A strep

Question 13

What should you suspect if a patient presents with OM and conjunctivitis or bilateral OM?

Answer 13

H-flu

Question 14

normal TM is described as having what color?

Answer 14

pearly gray

Question 15

a swollen external auditory meatus is indicative of what?

Answer 15

acute otitis externa (eg swimmer’s ear)

Question 16

when there is ____ pressure in the middle ear cavity, the TM is retracted (ie chronic OME)

Answer 16

negative

Question 17

drug of choice for treating Acute OM?

Answer 17

amoxicillin

Question 18

most common complication of OM

Answer 18

hearing loss

Question 19

_____ is characterized by dense calcification and excessive scarring and fibrosis of the TM

Answer 19

Tympanosclerosis

Question 20

chronic purulent drainage, white mass behind the ear drum –> indicative of _____

Answer 20

cholesteatoma

Question 21

what do tympanograms measure?

Answer 21

middle-ear pressure

Question 22

Deep tymanograms are characteristic of _____ compliance, such as in ossicular chain discontinuity

Answer 22

increased

Question 23

shallow tympanograms show decreased compliance, suggesting a stiff middle ear system. What might cause this finding?

Answer 23

tympanosclerosis