Otorrhea and Otalgia

Question 1

2 main sources of ear discharge and pain

Answer 1

External auditory canal and middle ear/mastoid area

Question 2

T/F: Cerumen production happens in the cartilaginous outer part of the EAC

Answer 2

T

Question 3

How do you straighten the EAC for examination?

Answer 3

Pull the pinna outward, backward, and upward

Question 4

3 Ossicles comprising the inner ear

Answer 4

Malleus, incus, stapes

Question 5

This part of the middle ear allows ventilation of the tympanic cavity

Answer 5

Eustachian tube

Question 6

T/F: The EAC is the common reason for acute and chronic otitis media

Answer 6

F

Middle ear

Question 7

Otitis externa is usually caused by what pathogen/s?

Answer 7

Staphylococcus aureus and Pseudomonas

Question 8

T/F: Otitis externa aka Swimmer’s ear is due to the removed lipid layer covering the skin of EAC

Answer 8

T

Question 9

This pathogen commonly produces localized/circumscribed otitis externa

Answer 9

Staphylococcus aureus

Question 10

T/F: Pseudomonas causes diffuse otitis media

Answer 10

F: it causes diffuse otitis EXTERNA, where there is circumferential swelling and narrowing

Question 11

Management of External ear infections:

Answer 11

Aural Toilette, otic drops (ear wick)

Question 12

How does otitis media develop?

Answer 12

Usually due to impaired middle ear ventilation brought by eustachian tube dysfunction and mucosal inflammation

Ciliary dysfunction and other causes may lead to eustachian tube function, which impairs ventilation, leading to negative pressure in the middle ear that would further increase mucosal edema and inflammation, that would further damage the eustachain tube

Question 13

T/F: URTI causes acute otitis media

Answer 13

T

S. pneumoniae, H. influenzae, M. catarrhalis, and respiratory viruses ascend and reach the eustachian tube to enter the middle ear

Question 14

What are the stages of acute otitis media?

Answer 14

Hyperemic > exudative > suppurative > complication/resolution

Question 15

Hallmark of chronic otitis media

Answer 15

Non-healing perforation

Question 16

What is cholesteatoma?

Answer 16

result of perforation of the tympanic membrane, where the epithelium seeps from the external to the middle ear, thus disrupting the normal drainage of the middle ear

TX: Myringoplasty or tympanoplasty

Question 17

T/F: Nasal endoscopy is performed if otitis Media with effusion is bilateral or unclear cause

Answer 17

F
unilateral

Question 18

T/F: Intracranial complications are more urgent than extracranial complications

Answer 18

T
Tx of intracranial complications are prioritized over the treatment of ear infection itself

Question 19

Bezold abscess is a complication due to the inferior direction of the spread of ear infection to the SCM

Answer 19

T

Question 20

Thrombophlebitis is a complication due to the lateral direction of the spread of ear infection to the venous sinuses

Answer 20

F - MEDIAL direction

Question 21

Ear infections affecting the parotid gland and subperiosteal spreads in what direction and produce what complications?

Answer 21

• Lateral Direction
  -Complications: Parotid Abscess, Subperiosteal Abscess

Question 22

T/F: Cholesteatoma develops from a developing epithelial pocket

Answer 22

F

Cholesteatoma develops from an ATROPHIC epithelial pocket

Question 23

T/F: Ear infection and inflammation arise when there are factors that interfere with normal defenses

Answer 23

T

Question 24

T/F: Antibiotics can easily permeate the EAC

Answer 24

F: they have poor penetration through the external ear

Question 25

Antibiotics that can be used to manage external ear infection

Answer 25

Polymyxin, Neomycin, Gentamicin, Gramicidin

Question 26

Antifungals that can be used to manage external ear infection

Answer 26

Clotrimazole, Nystatin

Question 27

What are 2 functional disturbances leading to otitis media?

Answer 27

Has 2 functional disturbances:
○ Impaired middle ear ventilation
○ Mucosal inflammation

Question 28

T/F: Chronic otitis media can be diagnosed in the presence of a chronic tympanic membrane perforation

Answer 28

T . it can be wet or dry

Question 29

T/F: Surgery is recommended among children if ear infection is more than 3 months persistence

Answer 29

F: it’s in adults