Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro Block 3 - KJ > Otitis Media > Flashcards

Otitis Media Flashcards

1
Q

Otitis externa?

A

External otic canal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Otitis media?

A

Middle ear canal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Labrinthitis?

A

Inner ear infection - more rare, but causes more damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mastoiditis?

A

Mastoid bone infection - also more rare, but causes more damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is acute otitis media?

A

Bacterial or Viral cause

Pain, red ear drum, pus and fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is otitis media with effusion?

A

Build up of fluid in Eustachian tube.

  • No infection, associated with URI (upper respiratory infection), cigarette smoke, allergies
  • Resolves on its own
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the pathognesis of Acute otitis media (AOM)?

A
  • URI or allergic conditions may cause congestion of mucosa
  • Narrowing and obstruction Eustachian tubes prevents ventilation and drainage. Anatomic abnormalities or enlarged adenoids increases likelihood of blockage.
  • Accumulation of secretions of middle ear and if pathogen is present AOM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you open you Eustachian tubes?

A

Close mouth and nose and blow.

-Can also open using gum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the epidemiology of acute otitis media?

A
  • About 70% of children experience at least 1 episode of otitis media during childhood probably b/c tubes are more narrow and horizontal and immune system is not at well developed
  • Less common in school age children, adolescence and adults
  • More common: males & Native American/Alaskan Natives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the common etiologic agents of acute otitis media?

A

Strep, pneumoniae - 35-50%
H. influenzae (mostly non-typable) - 15-30%
Moraxella catarrhalis - 3-20%
Viral (especially RSV, rhinovirus) - 5-22%
No pathogen identified - 16-25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are traits of Streptococcus pneumoniae?

A

Gram +, diplococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does Strep pneumoniae spread?

A
  • Secretion contact
  • Asymptomatic colonization of nasa-oropharynx and can be a carrier for weeks to months (esp. WINTER)
  • If spreads to middle ear or terminal airways it leads to RAPID INFLAMMATION
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What makes people more susceptible to Strept, pneumoniae?

A

Chronic diseases, including alcoholism, diabetes mellitus, and chronic renal disease, interfere with normal defense can increase susceptibility.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How many serotypes are there of Strept. pneumoniae?

A

At least 91 bc they have unique surface capsules.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the virulence factors of Streptococcus pneumoniae?

A
  • Resistance
  • Capsule
  • Choline-binding proteins
  • Neuraminidases
  • Pneumolysin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What Resistance does S. pneumoniae have?

A

Resistance due to changes in the penicillin binding protein.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What Capsule does S. pneumoniae have?

A

It’s capsule blocks phagocytosis by interfering with the deposition of complement on surface of organsim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What Choline-binding proteins does S. pneumoniae have?

A

The choline-binding proteins bind carbohydrates present on surface of epithelial cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What Neuraminidases does S. pneumoniae have?

A

They cleave host mucins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What pneumolysin does S. pneumoniae have?

A

It is a pore forming toxin that is released disrupts cilia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What iron acquisition does S. pneumoniae have?

A

Iron acquisition A (PiaA) and uptake A (PiuA)

-This helps bc bacteria needs iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the traits of Haemophilus influenzae?

A

Small, pleomorphic, gram -, coccobacillus, nonmotile, biofilms, facultative anaerobe
-Expresses Beta-lactamases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do Haemophilus influenzae infect?

A

Humans are only known host

  • Nontypeable- nonencapsulated (NTHi) colonize nasopharynx in 80% of people and if spreads to eustachian tubes causes otitis media
  • Other mucosal sites of infection include genital tract and conjunctivitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How to grow H. influenzae?

A

Fastidious requires additional blood factors for growth: hematin (X) and NAD (V) both present in chocolate agar

25
Q

Does current Hib vaccine offer protection against NTHi?

A

NO - vaccine is specific to capsulated form

-Lately there has been inc. in cases cause by non-typable H flu and by pneumococcal strains not covered by vaccine

26
Q

What are the traits of Moraxella catarrhalis?

A

Gram negative, aerobic, diplococcus, oxidase +, nonmotile, fastidious-chocolate agar, pili

27
Q

What does Moraxella catarrhalis usually colonize?

A

Upper resp. tract of infants.

28
Q

What is unique about Moraxella catarrhalis?

A
  • 95% of M. catarrhalis produces Beta-lactamases

- Hockey puck test - easily slide across agar - not well attached to agar as other strains

29
Q

How do you diagnose Otitis Media?

A
  • Pneumatic otoscopy to asses TM
  • Tympanometry - detect fluid in middle ear
  • If not responding to therapy, collect aspirate for gram stain & culture bc recurrent infections can lead to hearing loss
30
Q

How can you prevent Acute Otitis Media?

A
  • Avoid cigarette smoke and sick children
  • Brestfeed children & avoid bottles before bed (bottles build up pressure in ears)
  • Wash hands often
  • Stay up to date on vaccines - influenza and 13-valent pneumococcal conjugate vaccine
31
Q

How should you treat Acute Otitis Media in 6-24 month year old?

A

Oral amoxicillin provides coverage against Streptococcus pneumoniae, Haemophilus influenzae with limited side effects.

32
Q

What if baby’s ear infection doesn’t improve in 48 hours after amoxicillin?

A

Switch to amoxicillin - Clavulanate [since the bacteria may be resistant and have a beta-lactamase]

33
Q

What if baby has a penicillin allergy?

A

Treat ear infection with azithromycin.

34
Q

How should you treat an older kid/adult with acute otitis media?

A
  • Pain management (acetaminophen and ibuprofen) and decongestants
  • If multiple infections, prophylaxis may be considered
  • Resistance is associated with previous infection and may be related to compliance - try to reduce doses per day and have shorter treatment course
35
Q

What amount of antibiotic prescriptions does acute otitis media account for in the US?

A

30%

36
Q

What organisms would you expect clavulanate to potentially expand coverage?

A

Moraxella catarrhalis & Haemophilus influenzae

37
Q

What is used to treat recurrent ear infections?

A

Ear tubes - TM is cut, tube inserted and fluid is drained

-Tubes fall out and incision heals on own

38
Q

What can cause conductive hearing loss and/or delayed speech?

A

Perforation of the TM and erosion of ossicles

39
Q

Where can infection spread in otitis media?

A

Mastoid, Inner ear, Temporal bone, Meninges & Brain

40
Q

What is a cholesteatoma? What happens to the TM?

A
  • Cyst of epithelial cells

- It is sucked inwards

41
Q

What does an ear infection that has spread to the mastoid bone look like?

A

There is a red, swollen area behind the ear and the outer ear is turned forward.

42
Q

What is otitis externa?

A

Swimmer’s ear - unilateral inflammation of ear canal, pain, itching and purulent ear drainage.

43
Q

What is Cerumen and why is it helpful?

A

Earwax. It contains lysozyme and is slightly acidic deterring microbial growth.

44
Q

What are risk factors for Otitis externa?

A

Maceration - trauma, foreign bodies, excessive moisture (dry ears after swimming), extension of middle ear infection, diabetes

45
Q

What are four main types of otitis externa (etiologies)?

A
  1. Acute localized
  2. Acute diffuse
  3. Malignant
  4. Fungal
46
Q

What causes Fungal Otitis externa?

A

Aspergillus and candida albicans

47
Q

What causes malignant otitis externa?

A

Pseudomonas aeruginosa
-Invasion of adjacent bone & cartilage which can progess to cranial nerve palsy and death.
More common: elderly, poorly controlled diabetes, immunocompromised

48
Q

What causes acute diffuse otitis externa?

A

Pseudomonas aeruginosa

-Itches, red canal and painful

49
Q

What causes acute localized otitis externa?

A

Most often Staphylococcus pustule or furuncle associated with hair follicles

50
Q

How do you diagnose otitis externa?

A

It can be complicated due to contamination from surface bacteria.

51
Q

How do you treat cellulitis or fungal otitis externa?

A

You could use a topical antibiotic:

Neomycin + polymyxin + hydrocortisone

52
Q

How to treat/manage otitis externa?

A
  • Avoid flushing unless TM is intact
  • Cleans with topical solutions often of low pH (acetic acid) to deter bacterial and yeast growth
  • Treat with analgesics (NSAIDs, acetaminophen)
53
Q

What causes red eye, mild cold and clear drainage?

A

Adenovirus

54
Q

What causes visual field deficit and is most common in HIV infected individuals?

A

Cytomegalovirus

55
Q

What releases pneumolysin pore forming toxin?

A

Streptococcus pneumoniae

56
Q

What causes green-yellow discharge from the eyes?

A

Neisseria gonorrhea (but it doesn’t infect ears)

57
Q

What can recurrent otitis media cause?

A

Conductive hearing loss, meningitis and mastoiditis

58
Q

Why do patients need to be monitored after given amoxicillin for otitis media treatment?

A

Treatment failure could occur due to drug resistant strains of bacteria.

59
Q

What are the links between bacterial conjunctivitis, otitis media and sinusitis?

A

They are common, often occur together and are caused by similar agents.

Neuro Block 3 - KJ (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions