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Y4 Special Senses > Otitis Externa > Flashcards

Otitis Externa Flashcards

1
Q

What is Otitis externa?

A

Inf of external ear

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2
Q

What groups of people is Otitis externa more prevalent in? (2 things)

A
  1. Young age
  2. Females
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3
Q

What is the pathophysiology of Otitis Externa? (5 steps)

A
  1. Disruption to EAC protective mechanisms
  2. Pathogen overgrowth / inflamm
  3. Skin –> erythematous / swollen / tender / warm
  4. Debris + discharge accum –> canal narrowing
  5. Further entrapment of pathogens
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4
Q

What can lead to Disruption to EAC protective mechanisms? (3 steps)

A
  1. Repeated water exposure (interrupts wax formation)
  2. Trauma to canal (cotton buds)
  3. Blockage (debris)
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5
Q

What are the most common causative pathogens of OE? (3 things)

A
  1. Pseudomonas aeruginosa (40%)
  2. S. epidermidis
  3. S. aureus
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6
Q

What are the RF for OE? (7 things)

A
  1. Freq water contact (e.g swimmers / freq hair washers)
  2. Humid environments
  3. Ear polyps / foreign bodies
  4. Narrow ear canals
  5. Ear eczema / Psoriasis
  6. Trauma (hearing aids / cotton buds)
  7. Immunocompromised / DM (inf risk)
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7
Q

What are the RF for OE? (7 things)

A
  1. Freq water contact (e.g swimmers / freq hair washers)
  2. Humid environments
  3. Ear polyps / foreign bodies
  4. Narrow ear canals
  5. Ear eczema / Psoriasis
  6. Trauma (hearing aids / cotton buds)
  7. Immunocompromised / DM (inf risk)
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8
Q

What is the classical clinical picture of OE?

A

Progressive ear pain + purulent discharge

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9
Q

What are the CF of OE? (4 things)

A
  1. Pain
  2. Discharge
  3. Itchiness
  4. Conductive Hearing Loss (if ear blocked)
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10
Q

What are the CF of OE? (4 things)

A
  1. Pain
  2. Discharge
  3. Itchiness
  4. Conductive Hearing Loss (if ear blocked)
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11
Q

What will you see @ exam of OE? (4 things)

A
  1. Erythema / swelling
  2. Pus / discharge
  3. Tenderness
  4. Lymphadenopathy in neck / around ear
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12
Q

What does White / yellow Pus indicate?

A

Bac inf

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13
Q

What does Thick white grey w spores Pus indicate?

A

Fungal inf

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14
Q

What does Clear grey Pus indicate?

A

Otitis media

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15
Q

What are some DDx that present similarly to OE? (3 things)

A
  1. Otitis media w Perforation
  2. Ramsay Hunt syndrome
  3. Furuncle
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16
Q

How is OM w Perforation different to OE? (3 things)

A
  1. Clear / bloody discharge
  2. Pain relieved after discharge
  3. Tympanic memb inflamm + Perforated
17
Q

How is Ramsay Hunt syndrome different to OE?

A

Vesicular rash within 2 days of first onset of pain

18
Q

How is Furuncle different to OE?

A

Visible bulge present @ otoscope exam

19
Q

How is the Dx of OE made?

A

Clinical Dx (based on thorough Hx + otoscopy)

20
Q

When should you do further investigations for OE? (4 things)

A
  1. Not responding to Abx
  2. Signs of fungal disease @ otoscopy
  3. Recurrent disease
  4. Complicated disease
21
Q

What further investigations can you do for OE? (3 things)

A
  1. Swabs of discharge –> send for culture
  2. Glucose levels for DM (in recurrent disease)
  3. High Res CT scan (HRCT) (for complicated disease)
22
Q

What is the main things in Mx of OE? (4 things)

A
  1. Prevention
  2. Aural toileting
  3. Topical abx
  4. Simple analgesia
23
Q

What Topical abx is sued for OE?

A

No single regime has been found to be the best

24
Q

Therefore what does Abx choice depend on for OE? (3 things)

A
  1. Pt / doctor preference
  2. Local sensitivities
  3. Side fx
25
Q

What can you give to decrease swelling of Canal + reduce pain?

A

Steroid drops

26
Q

What are the Prevention options for OE? (4 things)

A
  1. Remove debris by Microsuction
  2. Avoid swimming + cotton buds
  3. Use Bone-achored hearing aid (BAHA) (if dey need a hearing aid)
  4. TUC (eczema / polyps)
27
Q

What are the complications of OE? (4 things)

A
  1. Malignant OE
  2. Mastoiditis
  3. Osteomyelitis
  4. Intracranial spread
28
Q

What is Malignant OE?

A

Spread of OE into Mastoid + Temporal bones

29
Q

Who does Malignant OE typically occur in? (2 things)

A
  1. Elderly DM pt
  2. Immunocompromised pt
30
Q

What are the CF of Malignant OE? (2 things)

A
  1. Severe pain
  2. Headaches
31
Q

What investigation should you do for sus Malignant OE?

A

Urgent CT scan

32
Q

What neurological involvement could Malignant OE cause?

A

CN 7 involvement

33
Q

What is the Mx for Malignant OE?

A

IV abx (for debridement)

Y4 Special Senses (11 decks)

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