OM Flashcards
What is AOM?
Acute inflammatory disease of the middle ear and TM with or without purulent middle ear fluid
What is the definition of OME (OM with effusion)?
Presence of middle-ear effusion without any local or systemic signs of inflammation
What are the physical exam findings of AOM? (3)
- Bulging
- Erythema
- Perforation w/ drainage
What are the symptoms of AOM? (4)
- Otalgia
- Irritability
- Fever
- Ear tugging
What percent of children are diagnosed with OM by 9 months of age?
40%
What percent of children are diagnosed with OM by 2 years of age?
60%
What is the peak age for recurrence of OM?
6-12 months of age
True or false: The incidence of OM is increasing in the developed world
False–decreasing
True or false: the heavy burden of OM is still in the developing world
true
What are the two ethnicities that have an increased incidence of OM in the US?
native american
Eskimo
Children with an atypical course of OM should be worked up for what?
Immune workup looking for common variance of immunosuppression, such as IgG subclasses deficiency
Why are kids with T21 more susceptible to OM?
Craniofacial abnormality predisposes them
What is the effect of an untreated cleft palate and the incidence of OM?
Increased significantly
What is the chromosome that may play a role in predisposition to OM?
19q
What are the environmental risk factors for the development of OM? (3)
- Smoking
- daycare
- Season
What is the role of breastfeeding and the incidence of OM?
Increased risk for 3 or more OM in children who are breastfed less than 6 months
What is the role of pacifiers and the incidence of OM?
Unknown
True or false: for the most part, kids with OME are asymptomatic
True
What is the main concern with OME?
Long term consequences of hearing loss
What is the usual precipitating event for OME?
Viral illness
What is the suspected pathophysiology of OME?
Eustachian tube dysfunction
What are the three most common pathogens that cause OM?
- Strep pneumo
- H. influenza
- Moraxella catarrhalis
What is the trend in the causes of OM?
-Increase in H. influ, decrease in Strep
What is the role of antihistamines in the treatment of OM?
Do not use
What is the role of corticosteroids in the treatment of OM?
Do not use
What is the role of decongestant in the treatment of OM?
Do not use
What is the role of allergies in the development of AOM?
Thought to play a role, but unsure
What is the relation between kids with gastroesophageal reflux and AOM?
Positive correlation, with treatment of GERD leading to decreased rates
What GI protein has been identified within the middle ear of pts undergoing placement of myringotomy for OME?
Pepsin and pepsinogen