Otitis Media

Question 1

Hearing loss with OM

Answer 1

about 25 dB

Question 2

OM is the most common reason for ____

Answer 2

antibiotic therapy

Most common diagnosis in sick children in the US

Question 3

Highest incidence age range for OM

Answer 3

6-18 months

Question 4

Increased risk (10)

Answer 4

1. Age less than 6
2. Males
3. Family Hx
4. Low SES
5. Alaskan, American, Australian
6. Craniofacial Abnormalities/nasopharyngeal masses
7. Winter or Early Spring
8. Smoke
9. Day Care
10. Pacifier

Question 5

What decreases OM risk

Answer 5

Breastfeeding

Question 6

Number of kids in daycare that increases OM risk (and by what amount)

Answer 6

4 kids

increases OM risk by 7x

Question 7

Respirator Epithelium composition

Answer 7

Pseudostrat Ciliated columnar

With goblet cells

Question 8

____ from cigarette smoke paralyzes cilia

Answer 8

Cotinine

Question 9

PTT obstruction in middle ear causes ____

Answer 9

negative pressure

Question 10

Sole active dilator of PTT

Answer 10

Tensor veli palatini

Question 11

Can you catch otitis?

Answer 11

generally no

(catch bugs that predispose)

Question 12

Most significant viruses in OM

Answer 12

1. Strep pneumo
2. H.influenzae
3. Moraxella Catarhallis

(GAS, S.aureus, Anaerobes, mycoplasma, Chlamydia)

Question 13

Fever is only present in ____ of OM patients

Answer 13

1/3

Question 14

Causes of Otalgia

Answer 14

OE

Ramsay-Hunt

TMJ

Dental problems

Pharyngitis

Question 15

Ottorhea is a sign of

Answer 15

OE

Question 16

Ramsay Hunt Triad

Answer 16

Ipsilat Facial Paralysis

Ear Pain

Vesicles involving auditory canal and auricle

Question 17

___ is a congenital indication that there may be predisposition to OM

Answer 17

Bifid uvula

Question 18

AOM TM triad

Answer 18

Bulging

immobile

red

Question 19

Erythematous TM is how good at predicting AOM?

Answer 19

Only 25%

Question 20

Fevere and earache, suspect…

Answer 20

Pneumococcal infctn

Question 21

Otitis conjunctivitis syndrome

or

bilateral otitis

…suspect _____

Answer 21

H. influenzae

Question 22

TM perf or mastoiditis, suspect…

Answer 22

GAS

Question 23

Light reflex in what quadrant

Answer 23

Anteroinferior

Question 24

Gold standard for middle ear effusion (MEE)

Answer 24

Tympanocentesis

Question 25

When there is negative pressure in Middle ear cavity, what happens to the TM

Answer 25

Retraction

Question 26

AAP guidelines for Dx of AOM: You must have what 3 things?

Answer 26

1. Acute history 2. Evidence of MEE 3. Signs or Symptoms

Question 27

Symptomatic Tx of AOM

Answer 27

topical anesthetics analgesics local heat

Question 28

DOC for AOM

Answer 28

Amoxicillin (augmentin, ceph, macrolides, eryth, bactrim)

Question 29

Time for AB treatment of AOM

Answer 29

10 days Short course if greater than 2 years and no risk factors

Question 30

After AB therapy, recheck in \_\_\_\_\_

Answer 30

10-14 days

Question 31

Antibiotic prophylaxis

Answer 31

–amoxicillin or sulfisoxasole at ½ dose

Question 32

Surgery (tubes, adenoidectomy) for... (4)

Answer 32

* Effusion \>4-6 mos * Bilateral effusion * \>21 dB hearing loss * High risk

Question 33

\_\_% of effusions resolve spontaneously

Answer 33

20%

Question 34

\_\_% of MEE remain after 3 months

Answer 34

10%

Question 35

\_\_% will have recurrent MEE

Answer 35

20%

Question 36

Most common complication of OM

Answer 36

Hearing loss (also mastoiditis, Perf, Chronic, CHOLESTEATOMA, facial paralysis)

Question 37

Serious brain stuff from OM (6)

Answer 37

* Meningitis * Extradural abscess * Subdural empyema * Lateral sinus and carotid artery thrombosis * Brain abscess * Otitic hydrocephalus

Question 38

Painful vesicles that appear on TM

Answer 38

Bullous myringitis

Question 39

a.k.a. myringosclerosis

Answer 39

Tympanosclerosis (wispy, noncalcified changes and dense calcified regions)

Question 40

Other developments in therapy

Answer 40

Xylitol sugar Probiotics