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ENT - RIA > Otitis media > Flashcards

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
Q

management following perforation?

A

important to keep the ear dry to prevent infection due to perforation: cotton wool + petroleum jelly

26
Q

simple pars tensa perforation management?

A

non operative or myringoplasty

27
Q

simple pars flaccida perforation management?

A

Radical mastoidectomy

28
Q

common causative organisms of chronic suppurative otitis media?

A

Pseudomonas Aeurginosa
Staph aureus
Streptoccus
Anaerobic - peptostreptococcus

29
Q

4 intra temporal complications of Chronic Otitis Media

A
  • vertigo
  • hearing loss
  • acute otitis externa
  • facial weakness
30
Q

4 extra temporal complications of Chronic Otitis Media

A
  • meningitis
  • subdural abscess
  • temporal lobe abscess
  • sigmoid sinus thrombosis
31
Q

age group for Cholesteatoma?

A

10-20 year olds

32
Q

presentation of Cholesteatoma?

A
  • intermittent offensive smelling discharge
  • long history of discharge
  • hearing loss
  • occasional vertigo
33
Q

cause of cholesteatoma?

A

recurrent otitis media

ENT - RIA (10 decks)

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