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#Phase 2.2: Special Senses > Otitis Media > Flashcards

Otitis Media Flashcards

1
Q

What is Otitis Media?

A

Infection of Middle Ear

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2
Q

What age group is Otitis Media most commonly found in?

A

Kids under 4

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3
Q

What proportion of kids will have at least 1 episode of OM by age 3?

A

Over 2/3

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4
Q

What is the Pathophysiology of OM? (3 points)

A
  1. Nasopharyngeal organisms migrating via Eustachian tube
  2. Eustachian tube of kids = immature (aka short, straight, wide)
  3. So infection more likely
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5
Q

What are the common causative BAC of OM? (4 things)

A
  1. Strep pneumonia (most common)
  2. H influenzae
  3. M catarrhalis
  4. Staph aureus
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6
Q

What other infections does Strep pneumonia also commonly cause? (2 things)

A
  1. Rhino-sinusitis
  2. Tonsillitis
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7
Q

What are the RF for OM? (6 things)

A
  1. Age (peak between 6-15 months)
  2. Male
  3. Passive smoking
  4. Bottle feeding
  5. Pacifiers (sakaata)
  6. Craniofacial abn
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8
Q

Which of the RF of OM is a RF for RECURRENT OM?

A

Pacifiers (sakaata)

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9
Q

What season is OM most common in?

A

Winter

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10
Q

What are the CF of OM? (5 things)

A
  1. Fever (50%)
  2. Coryzal symptoms
  3. Ear pain
  4. Reduced hearing in affected ear
  5. Discharge (if tympanic memb perforates)
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11
Q

Since pain is hard to interpret in kids, what signs will you see that could suggest they’re in pain? (4 things)

A
  1. Tugging / rubbing their ear
  2. Appear irritable
  3. Disinterested in food
  4. Vomiting
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12
Q

What investigations should you do for sus OM?

A

Otoscopy

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13
Q

What might will you see @ Otoscopy of OM? (3 things)

A
  1. Bulging Tympanic membrane (loss of light reflex)
  2. Erythema (redness) of Tympanic membrane
  3. Perforation w Purulent Otorrhoea (ear ishaal)
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14
Q

What investigations should you do for sus SEVERE OM?

A

Bloods (FBC / UnE / CRP)

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15
Q

How should you investigate discharge from the ear in sus OM?

A

Send for fluid MC&S (microscopy, culture, and sensitivity)

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16
Q

What complications should you investigate for in OM? (4 things)

A
  1. Check for Intracranial complications
  2. Facial Nerve examination
  3. Signs of inf in throat / oral cavity
  4. Cervical lymphadenopathy
17
Q

Why should you test the function of Facial Nerve in sus OM?

A

Due to its anatomical course thru Middle ear

18
Q

What DDx present similarly to OM? (3 things)

A
  1. Chronic Suppurative Otitis Media (CSOM)
  2. Otitis Media w Effusion (OME)
  3. Otitis Externa (OE)
19
Q

How do you differentiate between OM and OE?

A

OE will have:
* Erythematous ear CANAL (+/- exudate)

20
Q

What are the Mx options for OM? (2 things)

A
  1. Nothing (can resolve w/o abx within 1-3 days)
  2. Simple analgesics (paracetamol / ibuprofen)
21
Q

What do Simple analgesics (paracetamol / ibuprofen) treat in OM? (2 things)

A
  1. Pain
  2. Fever
22
Q

What are the Abx prescribing options for OM? (3 things)

A
  1. No abx
  2. Delayed prescription
  3. Immediate abx
23
Q

When should you give Immediate Abx for OM? (3 things)

A
  1. Significant Co-morbs
  2. Systemically unwell
  3. Immunocompromised
24
Q

When should you give a Delayed Prescription of Abx for OM? (2 things)

A
  1. Pt demanding abx
  2. Sus CF might worsen
25
Q

What is the FIRST LINE NICE recommended Abx for OM?

A

Amoxicillin (5-7 days)

26
Q

What are the SECOND LINE NICE recommended Abx for OM? (2 things)

A
  1. Clarithromycin (@ penicillin allergy)
  2. Erythromycin (@ penicillin allergy + pregnant)
27
Q

What is the Mx option for RECURRENT OM?

A

Grommets

28
Q

What are the COMMON complications of OM? (4 things)

A
  1. OM w Effusion
  2. Hearing loss (temporary)
  3. Perforated Tympanic memb (w pain + reduced hearing + discharge)
  4. Labyrinthitis (causes dizziness / vertigo)
29
Q

What are the RARE complications of OM? (4 things)

A
  1. Mastoiditis
  2. Abscess
  3. Facial nerve palsy
  4. Meningitis

#Phase 2.2: Special Senses (11 decks)

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