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Dermatology > SA Otitis > Flashcards

SA Otitis Flashcards

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Dermatology Board Prep flashcards
1
Q

Label this schematic of the ear.

A

THINK!

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2
Q

Describe the characteristics of the different parts of the tympanic membrane.

A

Pars flaccida

Stria mallearis - Insertion of auditory ossicles

Pars tensa - Translucent

Thick hairs lie proximal to membrane

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3
Q

Why is it difficult to flush a cats eat when compared with a dog?

A

A bony shelf separates two parts of the inner ear (little communication between each compartment) making flushing difficult

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4
Q

What cleaning mechanisms exist within the external and middle ear?

A

External canal - cerumen - antimicrobials, barrier, IgA. Epithelium carry cerumen out of the canal

Middle ear - Eustachian tube - drains fluid from the middle ear

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5
Q

3 P’s of otitis pathogenesis

A

Primary factor - initiates

Predisposing factor - continues

Perpetuating factor - makes worse

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6
Q

PAIN FREE

Primary factors mneumonic.

A
  • P - parasitic
  • A - allergic
  • I - inflammatory
  • N - neoplastic/ polyps
  • F - foreign body
  • R - rare/ misc
  • E - epithelialisation
  • E - endocrinopathies
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7
Q

Parasitic causes of otitis.

A

Otodectes cyanotis

Demodex - cornei, canis

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8
Q
A

Otodectes cynotis - hypersensitivity reactions cause otitis

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9
Q
A

Demodex canis - long tail

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10
Q
A

Demodex cornei/ gatoi - short tail

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11
Q

What types of hypersensitivity cause allergic skin disease?

A

Type 1 - IgE

Type 4 - delayed

Due to food or environmental allergens

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12
Q

What type of hypersensitivities cause immune-mediated otitis?

A

Generalised disease

Type 2 - Cell mediated antibody production

Type 3 - immune-complexes

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13
Q

Why do neoplastic or polypoid growths lead to otitis?

A

They disrupt the cleaning process/ expulsion of cerumen

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14
Q

Differentials for unilateral otitis..

A

Neoplasia

Foreign body - grass seed

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15
Q

Primary secretory otitis media

A

Plug of mucus within the middle ear - causes progrssive hearing loss, air scratching

Eustachian tube dysfunction

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16
Q

How do endocrinopathies lead to otitis?

A

Changes in epithelial turnover

17
Q

Outline some predisposing factors which can lead to otitis.

A
  1. Conformation - large, pendulous ears, narrow ear canals, waxy ears
  2. Environment/ behaviour - lots of swimming, high humidity
  3. Iatrogenic - overcleaning/ inappropriate cleaning agents
18
Q

Outline some perpetuating factors which lead to progressive otitis.

A
  1. Secondary bacterial infection - overgrowth of commensal bacteria
    1. Malassezia, Pseudomonas, staph pseudointermedius
  2. Progressive pathological change - calcification, stenosis, osteomyelitis
  3. Otitis media - ascending infection/ rupture of tympanic membrane
19
Q
A

Peanut shaped malassezia found on cytology

20
Q
A

Cocci - staphs/ streps

21
Q

You perform an otic exam and find reduced flexibility on palpation. What could this be suggestive of?

A

Calcification of the ear canal

22
Q

Differentials for pruritis on otic palpation

A
  1. Acute otitis
  2. Otodectes
  3. Malassezia
23
Q

Differentials for pain on otic palpation

A

Chronic otitis

Epithelial ulceration/ hyperplasia (inflammatory)

Gram -ve bacterial infection (Pseudomonas/ proteus)

24
Q

Modified wright-giemsa stain

A

Diff-quik

25
Q

Gram -ve rod implicated in otitis

A

Pseudomonas

26
Q

Gram +ve cocci implicated in otitis

A

Staphylococcus and streptococcus

27
Q

Treatment options for PPC

A

Topical corticosteroids at anti-inflammatory doses

28
Q

What indicators would be suggestive of ear canal ablation and bulla osteotomy?

A

Severe stenosis and fibrosis

Calcification of ear canals

Osteomyelitis

Para-aural abscessation

29
Q

Topical antimicrobials should possess what properties for use in the ear?

A

Ceruminolytic

antibact

antifungal

anti-inflammatory

Dermatology (7 decks)

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