Otitis Media Flashcards
Most common reason for antibiotic therapy?
Otitis media
When is the highest incidence of Otitis media?
6-18 months old
Breastfeeding decreases the likelihood of what?
Otitis media
Why increased risk of Otitis media in winter/spring?
It’s the cold/flu season so respiratory infections
What type of epithelium makes up respiratory epithelium?
Pseudo stratified ciliated columnar epithelium with goblet cells.
What 3 functions does the Eustachian tube perform?
1) Protection
2) Drainage
3) Ventilation
What is the difference in angle between Eustachian tube between adults and infants?
Adults have an angle of 45 degrees while infants have angle of 10 degrees
What causes the inflammation that precedes Otitis media
Allergies and URI
What does inflammation cause in the pathogenesis of OM?
Eustachian tube blocking
What blocks the Eustachian tube?
Masses, smoke, and anatomy
After the Eustachian tube is blocked what happens?
Middle ear effusion/barotrauma from pressure differences
Middle ear effusion leads to what?
Nasopharyngeal contamination
What happens after nasopharyngeal contamination?
Acute otitis media/Otitis media with effusion
Can you catch otitis media?
No, but you can catch the respiratory infection that caused the OM.
3 big bacteria that can cause OM?
1) Strep. Pneumoniae
2) H. Influenzae
3) Moraxella catarhallis
Most clinically significant identifier of AOM?
Pain
Facial paralysis is indicative of what?
Bell’s palsy
What types of post auricular swelling is associated with OM?
Mastoiditis or lymphadenitis
What can cause vertigo, nystagmus, and tinnitus?
Esutachian tube dysfunction, labyrinthitis
What is Ramsay Hunt?
Varicella Zoster (Chicken Pox)
What is the AOM Tympanic Membrane triad?
1) Bulging
2) Immobile
3) Red
Fever and earache should indicate what?
Pneumococcal infection
Otitis conjunctiva syndrome indicates what?
H. influenzae
Tympanic membrane perforation/mastoiditis indicative of what?
Group A Strep
What does scarring look like on TM?
White spot
In what quadrant do we see the light reflex on TM?
Anteroinferior
Where does tuning fork go for Weber test?
Forehead
What does a normal Weber test show?
No lateralization
What happens in unilateral hearing loss during Weber test?
Sound lateralizes toward affected ear
What happens during sensorineural loss in Weber test?
Sound lateralizes to normal hearing ear
Where does tuning fork go for Rinne test?
Mastoid bone
What shows up in an abnormal Rinne test?
Bone conduction > air conduction
How do you treat the symptoms of AOM?
Topical anesthetic, analgesics, and local heat
Antimicrobial of choice for AOM?
Amoxicillin
Time course for AOM treatment?
About 10 days. Shorter if >2 yrs and no risk factors, should see response in 1-2 days
How do you treat for recurrent OM?
Prophylaxis of amoxicillin or sulfisoxamole
What should you keep an eye on during recurrent OM?
Hearing, speech, and language
Purpose of an adenoidectomy?
Remove potential for blockage of eustachian tube
Why is bilateral effusion a real problem?
They can’t hear and it can cause developmental delays
When is an infant’s speech and language at risk?
Infant > 6 months
What should you see with a grommet tube?
Otorrhea
How much AOM resolves spontaneously?
20%
What does the air-fluid level look like on tympanic membrane?
Translucent above and opaque below a line
Retracted tympanic membrane will show as what?
Tympanic membrane will be retracted
What do you need for a diagnosis of AOM?
Acute history
Middle ear effusion
Fever/pain
Most common complication of OM?
Hearing loss
Bullous myringitis characterized by?
Painful vesicles on tympanic membrane
