Middle Ear Basic Flashcards

1
Q

Acute Otitis media - ES cause

A

ES too small OR ES inflamed shut

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2
Q

Age range of eustachian tube growing

A

Birth - age 2

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3
Q

OM w/ diffusion fluid type

A

Clear

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4
Q

AOM - common bacteria

<3 months

A

E coli

S aureas

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5
Q

AOM - common bacteria

3 months - 14 years

A

S pneumoniae
H influenzae
M catarrhalis

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6
Q

AOM - common bacteria

>14 yrs

A
  • S pneumoniae
  • GAS (group a hemolytic strep)
  • S aureus
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7
Q

Most frequent dx in sick children + most common antibio administration reason

A

Acute otitis media

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8
Q

Peak incidence AOM

A

6-18 months old

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9
Q

PCV 7 / 13 vaccines treat only

A

Strep pneumo

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10
Q

Risk factors for AOM

A

Smoke, pollution

Day care, family exposure

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11
Q

AOM presentation

A

OTALGIA, +/- OTORRHEA

Headache, apathy

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12
Q

AOM signs

A

fever, irritability, poor feeding

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13
Q

AOM = BC vs. AC?

A

BC>AC

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14
Q

Gold standard for AOM dx

A

pneumatic otoscopy

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15
Q

Good extra support evidence for AOM dx?

A

URI

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16
Q

AAP Dx
AOM , 6-12yo
Guidelines?

A

New otorrhea (w/o AOE)
Mod-Severe TM bulge
Mild TM bulge + otalgia
Mild TM bulge + TM erythema

17
Q

AOM differential

A

AOE, OME, ETD, Cholesteatoma

18
Q

AOM Tx general

A

Reduce pain

Antibio vs. watchful wait

19
Q

AOM Tx

6 months-23 months

A

Severe - ABX
Not severe - ABX bilateral
-decide unilateral

20
Q

AOM Tx

>24 months

A

Severe = ABX

Not severe = decide

21
Q

AOM first line ABX

A
Amoxicillin 80-100mg/kg/day every 12 hrs x 10days
Amoxi clavulanate (augmentin)
22
Q

AOM 2nd line ABX

A

Cefnidir
Cefuroxime
10 days
3RD gen cephalosporins

23
Q

AOM 3rd line ABX

A

Azithromycin Z pack or single (x3)

Ceftriaxone

24
Q

Follow up: when to suspect OME?

A

<2 yrs old + 8-12 weeks

>2yrs old + learning/language problems

25
Q

AOM red flags

A
  • Red swelling behind ear
  • Spread bilateral in infant
  • Persistent high grade (103) fever
26
Q

Mastoiditis TX

A

Ceftriaxone IV

Mastoidectomy

27
Q

Bullous Myringitis Tx

A

ABX

28
Q

Recurrent AOM infxn Tx

A

(W/in 15 days of tx completion)

Change to Ceftriaxone or Levaquine

29
Q

Chronic Otitis Media P.E.

A

TM perf
Polyps
Choesteoma

30
Q

Chronic Otits Media Tx

A

Long term aural ABX

Sometimes oral ABX