module 2 otitis media

Question 1

Referral for OM needed if

Answer 1

cochlear implants
tympanostomy tubes
anatomic or craniofacial abnormalities
< 6 mo: lethargic or toxic

Question 2

Otitis media

Answer 2

dysfunction/fluid in the middle ear and middle ear mucosa
- varied inflammatory or infective processes
- bacterial
- fungal
- viral
- often assoc. with URI or allergies

Question 3

peak incidence of OM

Answer 3

6-15mo
- narrow eustachian tubes

Question 4

Bacterial or viral OM

Answer 4

rapid onset and short duration
- Viral: -> edema of the eustachian tube and nasopharynx

Question 5

Otitis media with effusion

Answer 5

accumulation of serous fluid in the middle ear without acute inflammation
- can precede or follow AOM
- barotrauma or allergy can trigger

Question 6

middle ear effusion

Answer 6

accumulation of serous fluid in the middle ear
- can be assoc. with AOM
- often persists for weeks or months after AOM

Question 7

chronic effusion

Answer 7

serous OM or glue ear
- hearing impairment (conductive)
- persist for several months with or without s/s

Question 8

Recurrent OM

Answer 8

3 or more episodes in 6 months
OR
4 or more episodes in 12 months, at least one in last 6 months

Question 9

common bacterial agents for OM

Answer 9

streptococcus pneumoniae
HIB
Group A b-hemolytic Strep
Staphylococcus auresus
Moraxella catarrhalis

Question 10

AAP considers these with OM dx

Answer 10

age
severity of symptoms
otorrhea
laterality

Question 11

OM s/s

Answer 11

rapid onset otalgia
-worse in prone position
ASSOCIATED:
- headache
- eye drainage
- nasal congestion
- sore throat
- mouth pain
CHILDREN:
- ear rubbing
- rhinorrhea
- vomiting/diarrhea
- fever

Question 12

PMH with OM

Answer 12

Ear infections
URI
allergies
smoke exposure
barometric pressure activities: scuba diving, flying

Question 13

OM physical exam

Answer 13

frontal and maxillary sinus: tender, no transillumination
lymphadenopathy
- posterior auricular, cervical
fluid behind TM
discharge in canal suggests perforation
bulging TM

Question 14

AOM-SOS

Answer 14

Acute Otitis Media Severity of Symptoms Scale
- parent-reported symptoms score for pediatric pt
- ear tugging, rubbing, holding
- excessive crying
- irritability
- difficulty sleeping
- dec. activity
- dec. appetite
- fever

Question 15

OME physical exam

Answer 15

fluid present in middle ear
no s/s of acute infection
TM dull gray, could be injected, could be retracted
ear fullness/popping
balance problems or hearing loss
school performance affected

Question 16

chronic serous otitis physical exam

Answer 16

TM may appear retracted and amber or bluish
diffuse light reflex

Question 17

complications of OM

Answer 17

Short-term: dec. conductive hearing
TM perforation
hearing loss
cholesteatoma
acute mastoiditis
meningitis
epidermal abscess