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
