Middle Ear Disorders

Question 1

Acute OM- Eti

Answer 1

In children due to eustachian anatomy, following resp. infection. Exposure to pollutants, day care increase risk. Caused by wide variety of orgs.

Question 2

Acute OM- Sx

Answer 2

middle ear pain, drainage, fluid, erythema, pulling on ear

Question 3

Acute OM- Dx

Answer 3

No movement on pneumatic otoscopy, loss of landmarks, bulging

Question 4

Acute OM- Tx

Answer 4

Spontaneous resolution. Abx if symptoms very severe or < 6 mo old. Topical analgesics & moist cloth for sx.

Question 5

Chronic OM- Eti

Answer 5

Chronic otorrhea. Due to different organisms than acute- pseudomonas, protus, S. aureus.. Trauma and recurrent OM

Question 6

Chronic OM- Sx

Answer 6

purulent discharge, pain during flares, reactivated in h2o or URI

Question 7

Chronic OM- Dx

Answer 7

conductive hearing loss, perforation of tympanic membrane with osteitis, scleritis

Question 8

Chronic OM- Tx

Answer 8

Ciprofloxacin- oral and topical, surgery

Question 9

Serous OM- Eti

Answer 9

Prolonged fluid in middle ear following AOM- blockage of eustachian tube

Question 10

Serous OM- Sx

Answer 10

dull, hypomobile TM, airbubbles, conductive hearing loss

Question 11

Serous OM- Dx

Answer 11

Otoscopy- if fluid present for >3 mo consider additional tx

Question 12

Serous OM- Tx

Answer 12

Often resolves on own, >3mo take abx & corticosteroid or surgery

Question 13

Serous OM- PE

Answer 13

If patient is flying prompt to yawn, use decongestants 1 hr prior to landing

Question 14

Mastoiditis- Eti

Answer 14

Fluid collection in mastoid air cells- often purulent and in children

Question 15

Mastoiditis- Sx

Answer 15

Pain, erythema, swelling of mastoid process

Question 16

Mastoiditis- Dx

Answer 16

purulent fluid culture from mastoid

Question 17

Mastoiditis- Tx

Answer 17

Abx corresponding to organism