Otitis Media tutorial Flashcards
aetiology of the inflammation in otitis externa?
bacterial
fungal
exczematous
most common pathogenic bacteria in otitis externa?
pseudomonas
proteus
staph aureus
Tx of bacterial otitis externa?
drops containing steroid and:
neomycin
gentamycin
most common pathogenic fungi in otitis externa?
aspergillus niger
candida albicans
Tx of fungal otitis media?
clotrimazole
nystatin
Tx of eczematous otitis externa?
steroid without antibiotic
how to generally care for otitis externa without medication?
keep water away
don’t put anything in the ear
keep hearing aids out
how to treat cellulitis in otitis externa?
systemic + topical Abs
name some preparatons used as wax solvents?
sodium bicarbonate
olive oil
almond oil
when would a wick be helpful?
if the canal skin is oedematous
when could drops cause dizziness?
drops are not close to body temperature
describe the centor criteria
history of fever
tonsillar exudates
tender anterior cervical lymphadenopathy
no cough
> 3 = antibiotics
difference between glandular fever and tonsillitis
GF: lasts longer get hepatosplenomegaly get jaundice LNs are bigger and multiple
what bacteria causes epiglottitis?
haemophilus influenzae type B
treatment of mild epiglottitis?
supportive
Abs
nebulisers eg adrenaline
treatment of severe epiglottitis?
steroids
antibiotics
intubation
tracheostomy
drugs that can cause nosebleeds?
anticoagulants
blood thinners eg warfarin
what blood disorders can cause epistaxis?
haemophilia
leukaemia
thrombocytopaenia
clotting abnormalities
define glue ear
otitis media with effusion
bilateral fluid in the middle ear causing hearing loss that lasts for 3 months
Tx of glue ear?
nothing for 3 months
after consider hearing aids, grommet or adenoidectomy
why is an adenoidectomy beneficial in otitis media?
the adenoids (nose tonsils) can block the opening to the eustachian tube further exacerbating glue ear
difference in symptoms of acute otitis media and glue ear?
glue = will not have otalgia, otorrhea, or signs of systemic infection, but may experience mild-to-moderate hearing impairment
cause of fluid in the middle ear?
eustachian tube dysfunction
common causes of glue ear?
URTI
acute otitis media
how is diagnosis of glue ear confirmed?
tympanometry
how can acute otitis media become glue ear?
if any discharge is left behind in the middle ear
how can glue ear become acute otitis media?
if the fluid in the middle ear becomes infected
why are children more likely to get ear infections?
have shorter eustachian tubes that are more likely to be closed
risk factors for glue ear
2-6 yrs old boy poor income background bottle fed pre-term downs syndrome cleft palate
how does the middle ear normally control its pressure?
eustachian tube opens during swallowing to bring a certain amount of gas into the middle ear cleft
what does reduced ventilation of the middle ear cause?
reduction in pressure and effusion
effusion will become viscous if prolonged -> glue ear
why are ear infections common in children with facial abnormalities?
usually have short eustachian tubes and small ear canals
where is the middle ear in relation to the cochlea?
lateral to it
you get fluid discharge in AOM: T or F
Fish, only really in OME
a bulging TM is found in what ear condition?
AOM
risk factors for OME?
recurrent URTI recurrent AOM premature craniofacial abnormality immunodeficiency smoking in household allergy day care bottle feeding
symptoms of OME in a child?
deaf
poor school performance
speech delay
behaviour problems
how is OME diagnosed?
Hx otoscopy tuning fork test audiometry tympanometry
what does the TM look like in OME?
retracted
less mobile
colour change
can see bubbles
what ear condition presents with bubbles on the TM?
OME
what does tympanometry look like when fluid is in it and why?
FLAT, fluid doesnt move
Tx of OME?
wait for 3 months
grommet
do adenoidectomy if recurrent
