RTS - Ear Flashcards

1
Q

What are symptoms of outer ear infections?

A

itch
pain
discharge
deafness

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2
Q

What are symptoms of middle ear infections?

A

discharge
deafness
dizziness

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3
Q

What are symptoms of inner ear infections?

A

deafness
dizziness
tinnitus

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4
Q

What could cause excess cerumen/ear wax?

A

physical structure of the external auditory canal
excess production of cerumen
abnormal secretions - drier or softer
impaction

attempt to clean the ear
- wax becomes trapped, stopping its outward migration

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5
Q

What are symptoms of excess cerumen?

A

wax can be ‘wet and sticky’ or ‘dry’

hearing loss
blocked ears
ear discomfort - should not be pain
itchiness 
water - can cause expansion of the earwax which may result in complete blockage of the ear canal
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6
Q

What are specific questions to ask for excess cerumen?

A
course of symptoms 
associated symptoms 
- pain, dizziness, tinnitus
activities/ trauma to ear
use of previous medicines - refer if they have not worked
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7
Q

What are practical measures for excess cerumen?

A

do not insert foreign objects to clean
- cotton buds
no ear candling

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8
Q

What are treatments for excess cerumen?

A

Oil based - allergy risk

  • cerumol = olive, peanut
  • earex - olive
  • oil softens it as cerumen is hydrophobic so soluble in oil

Water-based cerumenolytics

  • molcer, waxsol - docusate sodium
  • increase water penetration to soften ear wax

Peroxide based

  • sodium bicarbonate
  • otex and exterol = urea hydrogen peroxide, glycerol
  • effervesce with trapped water within wax, causing mechanical removal by ‘popping’
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9
Q

When should excess cerumen be referred?

A

children and elderly - caution

pain in middle ear
mucinous discharge
trauma related deafness/redness/ swelling
dizziness/tinnitus - inner ear
foreign body - cotton buds used
failure in OTC - did they adhere to treatment, recurrent or not,

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10
Q

How to administer ear drops?

A

wash hands before and after use
warm the bottle in your hands for a few minutes before
tilt head to one side and straighten ear canal
adult - pull pinna up and back
children - pull pinna down and back
hold bottle close but do not let the dropper touch the ear
hold head in tilted position for a few minutes

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11
Q

What is otitis externa?

A

inflammation of the external ear - swimmers ear
causes by
- excess water or repeated contact with water =swimmers are more likely to get it
- inadequate cerumen
- dermatological conditions = psoriasis, seborrhoeic dermatitis

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12
Q

What are symptoms of otitis externa?

A
itching and irritation 
scratching may result in trauma and pain
swelling, redness, eczematous 
ear discharge - watery 
temporary deafness
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13
Q

What are specific questions to ask for otitis externa?

A
pain and irritation present?
fever and cold symptoms present? 
- should not have systemic symptoms
- suggest it could be otitis media
discharge
- mucus or watery (should be watery)
recurrent or first time
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14
Q

What are practical measures for otitis externa?

A

avoid cotton buds and scratching
avoid getting water, soap or shampoo into the ear when showering
dry with a hairdryer not a towel

swimmers

  • ear plugs
  • swim caps
  • protective drops = swim seal
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15
Q

When should otitis externa be referred?

A
children
long duration - symptoms persist for more than 7 days after treatment initiation 
significant mucous discharge 
pain in mastoid area
slow growing growth on pinna
systemic symptoms - fever
generalised inflammation on pinna
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16
Q

What are treatment for otitis externa?

A
ear calm spray - primary 
- acetic acid
- treat minor infections = antifungal, antibacterial 
- use in over 12 year olds only
- no longer than 7 day use
for dry skin and eczema on pinna adjacent to ear canal
- emollient - aveeno, epaderm, topical corticosteroid
for dry skin in ear canal 
- olive oil
analgesics 
- paracetamol, ibuprofen 
oral antihistamines 
- for itching and irritation
swimear
- remove water after swimming
swimseal
- coats the ear to prevent trapped water
17
Q

What causes Eustachian tube dysfunction?

A

changes in external pressure
- airplanes
- high altitudes = mountains
upper respiratory infections
allergies
accompanies colds in children, recurrent glue ear
- fluid and bacteria sucked up from the nasopharynx through the tube - results in a swollen tube

18
Q

What are symptoms of Eustachian tube dysfunction?

A

loss of hearing
pain
tinnitus

have they recently had a cold?

19
Q

What are treatment options for Eustachian tube dysfunction?

A
oral decongestants 
- sudafed = pseudoephedrine
spray decongestant 
- sudafed - xylometazoline
children for glue ear
- otovent = balloon
oral antihistamine 
- clarityn = loratadine
- Benadryl = cetirizine hydrochloride 
valsalva's manoeuvre 
swallowing
sucking sweets/gum