Otitis Media

Question 1

fluid inside middle ear without acute signs of infection

Answer 1

SOM/OME

Question 2

a patient with hearing loss, blocked/plugged feeling and has a retracted and immobile TM is experiencing …

Answer 2

serous otitis media/otitis media with effusion

Question 3

what are 3 things I can find in a physical exam to diagnose SOM/OME?

Answer 3

1. retracted TM
2. immobile TM
3. air bubbles

Question 4

what test can be performed to find conductive hearing loss in a patient with SOM/OME?

Answer 4

audiogram

Question 5

what happens in a patient with SOM/OME when they valsalva?

Answer 5

air bubbles move

Question 6

What should I worry about if an adult has chronic or unilateral SOM/OME?

Answer 6

nasopharyngeal tumor

Question 7

what are 3 treatments for SOM/OME?

Answer 7

1. time
2. decongestants
3. valsalva

Question 8

what are 2 complications of SOM/OME?

Answer 8

1. poor school performance
2. adhesive otitis media

Question 9

infection in the middle ear that is most common in childhood

Answer 9

acute otitis media

Question 10

incidence for acute otitis media has a sharp decline after age ___

Answer 10

7

Question 11

a patient with history of viral URI symptoms, ear pain, hearing loss, and an irritable/clingy infant who pulls at ears and won’t eat or sleep is experiencing …

Answer 11

acute otitis media

Question 12

what is the etiology of most cases of acute otitis media?

Answer 12

viral infection

Question 13

what will be seen in a patient’s otoscopy exam who has acute otitis media?

Answer 13

red, bulging TM with decreased mobility

Question 14

what are the drugs of choice to treat acute otitis media? (2)

Answer 14

amoxicillin and augmentin

Question 15

what is the overall treatment goal for acute otitis media?

Answer 15

antipyretics and analgesics
- reduce fever and pain

Question 16

what is the treatment for a patient that is younger than 2 years old with acute otitis media?

Answer 16

antibiotics

Question 17

what are the treatment options for a patient that is older than 2 years old with acute otitis media?

Answer 17

1. optional observation
2. antibiotics initially or after 48 hours

Question 18

what is required on any neonate with AOM?

Answer 18

work-up for sepsis

Question 19

who is chronic/recurrent otitis media most common in?

Answer 19

young children/infants

Question 20

what should I do for a patient with chronic/recurrent otitis media?

Answer 20

refer to ENT

Question 21

what are 3 devices that can be given to a patient with chronic/recurrent otitis media?

Answer 21

1. tympanostomy tube
2. ventilating tube
3. pressure equalizing tube

Question 22

a prominence that is part of the temporal bone, contains numerous air cells, and communicates with the middle ear space

Answer 22

mastoid process

Question 23

what is the most common serious complication of middle ear infections?

Answer 23

mastoiditis

Question 24

a patient with a history of otitis media, malaise, fever, otalgia, mastoid TTP, retro-auricular edema, erythema, heat, protruding auricle, and a loss of postauricular crease is experiencing …

Answer 24

mastoiditis

Question 25

how would ENT confirm a case of mastoiditis?

Answer 25

mastoid air cell CT

Question 26

what would a CT look like of mastoiditis?

Answer 26

mastoid filled with tissue (opacification)

Question 27

How would ENT treat mastoiditis? (2)

Answer 27

1. hospitalization
2. IV vancomycin

Question 28

what would be done in serious mastoiditis?

Answer 28

mastoidectomy