Otitis media Flashcards

1
Q

cause of Tympanic membrane perforation?

A

Recurrent otitis media (as the pus in the middle ear bulges on the tympanic membrane)

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2
Q

which part of the tympanic membrane forms most of the TM

A

pars tensa

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3
Q

Otoscopy findings in tympanic membrane perforation

A

Tympanosclerosis

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4
Q

what is Tympanosclerosis

A

Calcium deposition within the tympanic membrane due to healing from previous ear infections

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5
Q

how long will a perforated tympanic membrane usually take to heal?

A

6-8 weeks

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6
Q

what should a patient with tympanic membrane perforation avoid whilst healing

A

getting water in their ear

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7
Q

management of perforated tympanic membrane if it occurs following an episode of acute otitis externa

A

Topical abx + steroids for 7-10 days

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8
Q

surgical management for a perforated tympanic membrane

A

Myringoplasty

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9
Q

3 types of Otitis media?

A

1) Acute suppurative otitis media
2) Chronic suppurative otitis media
3) Otitis media w/ effusion

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10
Q

what is the commonest cause of severe aural pain in children?

A

Acute suppurative otitis media

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11
Q

what is recurrent otitis media defined as?

A

> 4 episodes over a 6 month period

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12
Q

Presentation of otitis media (6)

A
  • mucopurulent discharge (when the tympanic membrane perforates)
  • otaligia
  • irritability
  • sleep disturbance
  • reduced hearing
  • fever
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13
Q

otitis media is a common complication of what?

A

viral respiratory illness

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14
Q

why is otitis media associated with viral resp illness?

A

Upper resp viruses can interfere with nasal passages + eustachian tube

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15
Q

how is otitis media diagnosed?

A

otoscopy

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16
Q

otoscopy findings in otitis media

A
  • bulging, opacified tympanic membrane, with decreased/absent mobility
  • ear effusions
17
Q

3 common causative bacteria of otitis media?

A

Streptococcus pneumoniae
Haemophilus Influenza
Moraxella Catarrhalis

18
Q

Abx should be prescribed immediately for otitis media if:

A
  1. Symptoms last > 4days
  2. Systemically unwell
  3. Immunocompromised or high risk of complications
  4. Younger than 2 years old with bilateral otitis media
  5. Otitis media w/ perforation and/or discharge in the canal
19
Q

1st line management of Otitis media?

A

5 day course Amoxicillin
+
decongestant spray = oltravine

20
Q

1st line management of otitis media if allergic to penicillin?

A
  • erythromycin
    or
  • clarithromycin

+
decongestant spray = oltravine

21
Q

if patient with otitis media is unresponsive to Abx or in severe pain …

A

Tympanocentesis

22
Q

2 types of chronic suppurative otitis media ?

A

Active - w/ discharge

Inactive - w/o/ discharge

23
Q

what is Active Squamous Chronic suppurative otitis media characterised by?

A

Cholesteatoma, due to accumulation of keratin

24
Q

features of Active Squamous Chronic suppurative otitis media? (3)

A
  • cholesteatoma
  • otorrhoea
  • deafness
25
management following perforation?
important to keep the ear dry to prevent infection due to perforation: cotton wool + petroleum jelly
26
simple pars tensa perforation management?
non operative or myringoplasty
27
simple pars flaccida perforation management?
Radical mastoidectomy
28
common causative organisms of chronic suppurative otitis media?
Pseudomonas Aeurginosa Staph aureus Streptoccus Anaerobic - peptostreptococcus
29
4 intra temporal complications of Chronic Otitis Media
- vertigo - hearing loss - acute otitis externa - facial weakness
30
4 extra temporal complications of Chronic Otitis Media
- meningitis - subdural abscess - temporal lobe abscess - sigmoid sinus thrombosis
31
age group for Cholesteatoma?
10-20 year olds
32
presentation of Cholesteatoma?
- intermittent offensive smelling discharge - long history of discharge - hearing loss - occasional vertigo
33
cause of cholesteatoma?
recurrent otitis media