Otitis media Flashcards

1
Q

What is otitis media?

A

An infection of the middle ear

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2
Q

What often preceeds a bacterial infection of the middle ear?

A

A viral upper respiratory tract infection

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3
Q

What is the most common bacterial cause of otitis media?

A

Streptococcus pneumoniae

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4
Q

What are the symptoms of otitis media?

A

Ear pain
Fever
Irritability
Vomiting
Follows a viral upper respiratory infection

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5
Q

What is glue ear?

A

Otitis media with effusion

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6
Q

What is the first line management of otitis media?

A

Otitis media is often self-limiting - first line management is simple analgesia

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7
Q

What antibiotic strategies are there for otitis media?

A

No antibiotics
Delayed antibiotics
Immediate antibiotics

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8
Q

When should immediate antibiotics be given for otitis media?

A

When the patient is systemically unwell, immunocompromised or has significant co-morbidities

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9
Q

What are the extra-cranial complications of otitis media?

A

Facial nerve palsy
Mastoiditis
Labyrnthitis

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10
Q

What are the intra-cranial complications of otitis media?

A

Meningitis
Sigmoid sinus thrombosis
Brain abscess

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11
Q

What type of hearing loss does glue ear cause?

A

Conductive hearing loss

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12
Q

What would be seen on examination in a child with unilateral glue ear?

A

A negative Rinne’s test on the affected side

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13
Q

What are the symptoms of glue ear?

A

Ear pain
Hearing loss
Tinnitus

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14
Q

What is the treatment of glue ear?

A

Watchful waiting - first line
Autoinflation - second line

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15
Q

What is autoinflation?

A

Opening up the eustachain tubes by increasing intranasal pressure - this is done by a special device or by holding nose and breathing out through it

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16
Q

What is seen on otoscopy in glue ear?

A

A dull tympanic membrane with either air bubbles or a visible fluid level
Can look normal

17
Q

What are grommets?

A

Tiny tubes placed in the tympanic membrane that drain fluid from the middle ear into the ear canal

18
Q

How long do grommets last?

A

Grommets typically last a year, until they fall out

19
Q

When should antibiotics be given for otitis media?

A

If no improvement after 3 days
Younger than 2 years old with exudate
Perforation or discharge in canal

20
Q

What hearing test do newborns have?

A

Otoacoustic emission

21
Q

What hearing test is carried out for children under 4?

A

Distraction test

22
Q

What hearing test is carried out in children over 4?

A

Pure tone audiometry

23
Q

What hearing test is used if a newborn fails a hearing test?

A

Automated auditory brainstem response test

24
Q

What is mastoiditis?

A

Mastoiditis is an infection of the mastoid bone, behind the ear

25
Q

What is the presentation of mastoiditis?

A

Tenderness behind the ear
One ear sticking out more
Ear pain
Irritability
Hearing loss
Fever

26
Q

What are the common causes of otitis media?

A

RSV
Rhinovirus
Adenovirus
Influenza virus

Steptococcus pneumoniae
Streptococcus pyogenes
Haemophilus influenzae

27
Q

What is the first line antibiotic for otitis media?

A

Amoxicillin

28
Q

What is the second line antibiotic for otitis media?

A

Clarithromycin