URTIs EARACHE

Question 1

Inflammation of the external ear may be one of which?

Answer 1

Diffuse
Furuncular
May be precipated by trauma caused by scratching

Question 2

Explain what is Diffuse externa ear infection

Answer 2

Diffuse: an infection of the ear canal, often due to gram negative bacilli (especially P. aeruginosa). Pain is increased when chewing and the lining of the canal may be eaither inflammed or swollen with dry or moist debris or even a white or clear discharge
Swimmers ear

Question 3

explain what is causes Furuncular and what is it?

Answer 3

Usually caused by staphylococcus aureus. A painful localised swelling present at the entrace to th ear canal.

Question 4

The general meausures exclude which part of ear infection

Answer 4

Suppurative otitis media (middle ear infection)

Question 5

General meausures for otitis externa

Answer 5

Most cases recover after thorough cleansing and drying of the ear
Keep the ear clean and dry
Do not leave pieces of cotton wool
Do not instil anything into the ear unless prescribed

Question 6

Does Otitis externa (diffuse) require antibiotics

Answer 6

Does not usually require an antibiotic

Question 7

Medicine treatment of diffuse otitis externa in details

Answer 7

Make a wick where possible, using ribbon gauze or other suitable absorbent cloth, e.g. paper towel to clean and dry the ear
Acetic acid 2% in alcohol, topical, instikked into the ear every 6 hours for 5 days
Instil 3-4 drops after cleaning and drying the ear.

Question 8

List the Medicine treatment for Furuncular otitis externa

Answer 8

Cefalexin, oral, 6 hourly for 5 days
OR
Flucloxacillin, oral, 6 hourly for days
Sever penicillin allergy:
Azithromycin, oral daily for 3 days

Question 9

what is otitis media, acute

Answer 9

Inflammation of the middle ear

Question 10

The otitis media is characterised by what?

Answer 10

Pain
Drum perforation
Loss of hearing
Fever in about half of the cases
Red bulging eardrum
Loss of normal light reflex of the eardrum
Mild redness of the eardrum and rubbing the ear are not reliable signs

Question 11

General measure of otitis media
List them

Answer 11

Do not instil anything into the ear
Avoid getting the inside of the ear wet
Dry mop ear if discharge is present
Do not plug the ear with cotton wool
Exclude HIV infection as contributing factor for recurrent ear infection

Question 12

List medicine of acute otitis media

Answer 12

Amoxicillin, po, 12 hourly for 5 days
For those who have taken antibiotics treatment in the last 30 days
1. Co-amoxiclav 12 hourly for 5 to 10 days
Severe penicillin allergy
Azithromycin, po, daily for 3 days

Question 13

Medicine treatment for pain- otitis media

Answer 13

Paracetamol, po, 4-6 hourly prn for pain and fever
For patient with URT congestion secondary to allergy
Cetirizine, po, daily for 10 days

Question 14

List four otitis media that results to refer

Answer 14

1. Suspected meningitis
2. Reccurent otitis media
3. Painful swelling behind the ear or tenderness on percussion of the mastoid
4. Sever pain, fever or vomiting, not responding to treatment after 72 hours (If otoscopy confirmed) or after 24 hours (if otoscopy unconfirmed)

Question 15

if the oral antibiotics treatment is generally infective the patient is suffering from what kind of ear infection

Answer 15

Otitis media, chronic, suppurative

Question 16

A —————- from the ear
with perforation for > ————-. If
the eardrum has been ruptured for
———–, a secondary infection
with multiple organisms usually
occurs.

Answer 16

a. purulent discharge
b. 2 weeks
c. ≥ 2 weeks

Question 17

Is TB associated with otitis media, chronic, suppurative

Answer 17

TB may present with a chronically discharging ear. Consider the diagnosis of TB if other clinical features suggestive of TB present (Cough, weight loss, failure to thrive)

Question 18

List general measure of Otitis media, chronic, suppurative

Answer 18

Do not send pus swabs collected from the external ear canal for routine bacterial and
fungal MC+S (microscopy, culture and sensitivity) or for microscopy and culture for
tuberculosis.
* Explain to patients and caregivers that a chronically draining ear can only heal if it is dry.
* Dry mopping is the most important part of the treatment. It should be demonstrated to
the child’s caregiver or patient if old enough. Roll a piece of clean absorbent cloth into a
wick.
* Carefully insert the wick into the ear with twisting action.
* Remove the wick and replace with a clean dry wick.
* Repeat this until the wick is dry when removed.
* Do not leave anything in the ear.
* Do not instil anything else in the ear.
* Avoid getting the inside of the ear wet while swimming and bathing.
* Check HIV status if unknown.