Outer Ear

Question 1

what is cerumen made up of?

Answer 1

skin oils and dead cells

Question 2

what creates cerumen?

Answer 2

sebaceous glands

Question 3

how does cerumen inhibit bacterial and fungal growth?

Answer 3

makes the canal acidic

Question 4

what could a patient that presents with decreased hearing and intra-aural fullness or pressure be experiencing?

Answer 4

cerumen impaction

Question 5

what color would a cerumen impaction look like?

Answer 5

light to dark yellow, brown, red, or black

Question 6

what are 3 cerumen impaction differentials?

Answer 6

1. foreign body
2. tumor
3. blood clot

Question 7

what is the first-line treatment for cerumen impaction?

Answer 7

cerumenolytics

Question 8

what are 2 OTC cerumenolytics?

Answer 8

1. hydrogen peroxide urea
2. clear canal

Question 9

if cerumenolytics do not work on a patient with a cerumen impaction, what are 2 treatments options?

Answer 9

1. lavage
2. otomicroscopic debridement

Question 10

what is a possible complication from a lavage or otomicroscopic debridement?

Answer 10

infection from provider treatment

Question 11

infection of the external auditory canal caused by an infectious, allergic. or derm etiology

Answer 11

otitis externa

Question 12

what are 5 risk factors for otitis externa?

Answer 12

1. swimming
2. trauma
3. earphones
4. allergic contact dermatitis
5. psoriasis

Question 13

a patient that presents with excessive otalgia, pain with traction of tragus or helix, pruritus, erythema, +/- hearing loss, and sometimes fever is experiencing …

Answer 13

otitis externa

Question 14

upon physical exam, a patient that has colorful, purulent or watery discharge most likely has …

Answer 14

otitis externa

Question 15

what is the most common etiology of otitis externa?

Answer 15

pseudomonas

Question 16

green discharge from otitis externa indicates what bacteria?

Answer 16

pseudomonas

Question 17

yellow discharge from otitis externa indicated what bacteria?

Answer 17

staph aureus

Question 18

cheesy discharge from otitis externa indicates what etiology?

Answer 18

candida

Question 19

fluffy discharge from otitis externa indicates what etiology?

Answer 19

aspergillus

Question 20

what medication can be used for otitis externa caused by candida or aspergillus?

Answer 20

clotrimazole

Question 21

if there is no improvement with initial treatment of otitis externa, what 2 things can we do?

Answer 21

1. culture and sensitivities
2. KOH prep

Question 22

a KOH prep will show what etiology?

Answer 22

fungus

Question 23

what is the treatment for mild otitis externa?

Answer 23

OTC acetic acid/hydrocortisone drops

Question 24

what are the 2 treatments for moderate otitis externa?

Answer 24

1. cipro ear drops
2. neosporin ear drops

Question 25

what are the 4 treatments for severe otitis externa?

Answer 25

1. cipro ear drops
2. neosporin ear drops
3. pope otowick
4. NSAID

Question 26

when should we see symptom improvement in a patient with otitis externa after treatment?

Answer 26

36-48 hrs

Question 27

what are 4 complications of otitis externa?

Answer 27

1. myringitis
2. conductive hearing loss
3. cellulitis
4. osteomyelitis of skull base