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Flashcards in 2- Midle Ear Deck (43)
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1

What is acute otitis media

bacterial infection of middle ear

2

What are potential reasons for bacteria getting caught in the middle ear

Eustachian tube obstructed by mucus s/p URI
Poor eustachian tube drainage (young age, inflammation, congenital defect)

3

What bacteria cause acute otitis media

Strep Pneumo and H. Influenza!!
(if recurrent, probs due to allergies or secondhand smoke

4

How does acute otitis media present clinically

otalgia
pressure
hearing loss
fever
URI Sx

5

What does a TM look like in acute otitis media

immobile, bulging

6

What organism are bullae associated with

Mycoplasma infection

7

What are signs of a perforated TM

Previous pain, now resolved but with drainage

8

How do you treat acute otitis media

Amoxicillin first (2-3 days for improvement)
-Cephalosporin if PCN allergy)

9

What is amoxicillin doesn't work after 2-3 days

high dose amoxicillin-clavulanate or cephalosporin

10

What antibiotic would you give with a perforated TM

Ofloxacin, it is not ototoxic

11

What are important patent education pieces to give your patient

don't bottle feed laying down
Pneumo vaccine

12

What are potential complications of acute otitis media

labrynthitis
hearing loss
mastoiditis

13

When and who is acute otitis media most common in

kids 4-24, esp. those sucking on pacifier
fall and winter

14

What did Feirstein say abx tx should be for acute otitis media

Observation (abx if same or worse in 2-3 days): 6mo-2yo with unilateral, mild sx, OR, 2+yo if uni/bilateral and not severe
Immediate abx: <6 mo, OR, <24 mo and severe (pain 2+ days, Temp >102.2, bilateral)

15

What causes chronic otitis media

recurrent acute otitis media

16

What will you see on chronic seborrheic otitis media exam

chronic otorrhea
perforated TM
conductive hearing loss

17

What is treatment for chronic seborrheic otitis media

remove infected debris, use earplugs, topical/oral and
TM repair surgically

18

What is serous otitis media in ADULTS

Eustachian tube blocked for long time fluid to go into the middle ear
More common in kids because they have shorter eustachian tubes

19

What is the cause of serous otitis media

S/p URI, barotrauma, chronic allergies

20

How does serous otitis media present clinically

conductive hearing loss
fullness
NO acute illness/edema

21

What will you see on serous otitis media physical exam

HYPOmobile TM, bubbles behind TM
TM bulging or retracted
conductive hearing loss

22

How can you treat serous otitis media

decongestants
anti-histamine
nasal steroids
vent tubes if resistant

23

What is a cholesteatoma

a type of chronic otitis media characterized by prolonged eustachian tube dysfunction creating a keratin sac in the middle ear

24

What is a secondary cause of cholesteatoma

pseudomonas or proteus

25

How does cholesteatoma present clinically

hearing loss and ear drainage

26

What will you see on cholesteatoma PE

TM pocket/TM perforation exuding debris

27

How do you treat a cholesteatoma

abx drops
surgical removal

28

What are complications of cholesteatoma

erosion into inner ear, facial nerve, or brain abscess

29

What is Eustachian tube dysfunction

When the normally closed tube connecting ear to nasopharynx develops negative pressure (edema, or air trapped inside)

30

What causes eustachian tube dysfunction

Viral URI, allergies