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ICM Exam 2: Infectious Disease (& CIA) > Otitis Media > Flashcards

Otitis Media Flashcards

1
Q

Hearing loss with OM

A

about 25 dB

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2
Q

OM is the most common reason for ____

A

antibiotic therapy

Most common diagnosis in sick children in the US

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3
Q

Highest incidence age range for OM

A

6-18 months

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4
Q

Increased risk (10)

A
  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
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5
Q

What decreases OM risk

A

Breastfeeding

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6
Q

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

A

4 kids

increases OM risk by 7x

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7
Q

Respirator Epithelium composition

A

Pseudostrat Ciliated columnar

With goblet cells

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8
Q

____ from cigarette smoke paralyzes cilia

A

Cotinine

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9
Q

PTT obstruction in middle ear causes ____

A

negative pressure

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10
Q

Sole active dilator of PTT

A

Tensor veli palatini

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11
Q

Can you catch otitis?

A

generally no

(catch bugs that predispose)

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12
Q

Most significant viruses in OM

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

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

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13
Q

Fever is only present in ____ of OM patients

A

1/3

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14
Q

Causes of Otalgia

A

OE

Ramsay-Hunt

TMJ

Dental problems

Pharyngitis

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15
Q

Ottorhea is a sign of

A

OE

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16
Q

Ramsay Hunt Triad

A

Ipsilat Facial Paralysis

Ear Pain

Vesicles involving auditory canal and auricle

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17
Q

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

A

Bifid uvula

18
Q

AOM TM triad

A

Bulging

immobile

red

19
Q

Erythematous TM is how good at predicting AOM?

A

Only 25%

20
Q

Fevere and earache, suspect…

A

Pneumococcal infctn

21
Q

Otitis conjunctivitis syndrome

or

bilateral otitis

…suspect _____

A

H. influenzae

22
Q

TM perf or mastoiditis, suspect…

A

GAS

23
Q

Light reflex in what quadrant

A

Anteroinferior

24
Q

Gold standard for middle ear effusion (MEE)

A

Tympanocentesis

25
Q

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

A

Retraction

26
Q

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

A
  1. Acute history
  2. Evidence of MEE
  3. Signs or Symptoms
27
Q

Symptomatic Tx of AOM

A

topical anesthetics

analgesics

local heat

28
Q

DOC for AOM

A

Amoxicillin

(augmentin, ceph, macrolides, eryth, bactrim)

29
Q

Time for AB treatment of AOM

A

10 days

Short course if greater than 2 years and no risk factors

30
Q

After AB therapy, recheck in _____

A

10-14 days

31
Q

Antibiotic prophylaxis

A

–amoxicillin or sulfisoxasole at ½ dose

32
Q

Surgery (tubes, adenoidectomy) for… (4)

A
  • Effusion >4-6 mos
  • Bilateral effusion
  • >21 dB hearing loss
  • High risk
33
Q

__% of effusions resolve spontaneously

A

20%

34
Q

__% of MEE remain after 3 months

A

10%

35
Q

__% will have recurrent MEE

A

20%

36
Q

Most common complication of OM

A

Hearing loss

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

37
Q

Serious brain stuff from OM (6)

A
  • Meningitis
  • Extradural abscess
  • Subdural empyema
  • Lateral sinus and carotid artery thrombosis
  • Brain abscess
  • Otitic hydrocephalus
38
Q

Painful vesicles that appear on TM

A

Bullous myringitis

39
Q

a.k.a. myringosclerosis

A

Tympanosclerosis

(wispy, noncalcified changes and dense calcified regions)

40
Q

Other developments in therapy

A

Xylitol sugar

Probiotics

ICM Exam 2: Infectious Disease (& CIA) (10 decks)

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