ear disease

Question 1

What are common symptoms associated with the external ear?

Answer 1

Itch, Pain, Discharge, Hearing Loss

Pain can occur when pulling on the pinna.

Question 2

What symptoms are associated with the middle ear?

Answer 2

Pain, Discharge, Hearing Loss

Pain in the middle ear may not be as common as in the external ear.

Question 3

Which symptoms are linked to the inner ear?

Answer 3

Hearing Loss, Dizziness, Tinnitus

Question 4

What is ear wax also known as?

Answer 4

Cerumen

Question 5

What produces ear wax?

Answer 5

Ceruminous glands

Question 6

What are the two types of ear wax based on composition?

Answer 6

Wet/sticky and Dry

Question 7

What are the important functions of ear wax?

Answer 7

• Protection of tympanic membrane
• Protection from maceration
• Contributing to slightly acidic medium

Question 8

What can cause ear wax impaction?

Answer 8

• Narrowed ear canal
• Drier, harder ear wax in elderly
• Repeated unskilled attempts at removal

Question 9

What are common signs and symptoms of ear wax impaction?

Answer 9

• Feeling of discomfort
• Sensation that ear is blocked
• History of gradual hearing loss

Question 10

What is a common treatment for ear wax impaction?

Answer 10

Cerumenolytics for softening, dislodging and removal of impacted ear wax

Question 11

What is the dosage for Carbamide peroxide (EarClear Ear Wax Remover®)?

Answer 11

5–10 ear drops bd for up to 4 days

Question 12

What is the method of ear candling?

Answer 12

Hollow candles are inserted into the ear and lit to produce a vacuum

Question 13

Is there evidence of efficacy for ear candling?

Answer 13

No evidence of efficacy

Question 14

What are reasons for referral regarding ear issues?

Answer 14

• Trauma to the ear canal
• Obstruction due to foreign bodies
• Dizziness/tinnitus indicating inner ear issues

Question 15

What is Otitis Externa also known as?

Answer 15

Swimmer’s Ear

Question 16

What are precipitating factors for Otitis Externa?

Answer 16

• Moist, humid environment
• Swimming
• Ear trauma/irritation
• Chemicals (hairspray, shampoo)
• Skin conditions (eczema, dermatitis)

Question 17

What are common signs and symptoms of Otitis Externa?

Answer 17

• Pain in 70% of cases
• Discharge initially clear, then foul-smelling
• Itch present in 60% of acute cases

Question 18

How long is the duration for acute Otitis Externa?

Answer 18

Less than 6 weeks

Question 19

How long is the duration for chronic Otitis Externa?

Answer 19

More than 3 months

Question 20

What examination findings are typical for Otitis Externa?

Answer 20

Red, swollen ear canal

Question 21

What is the mode of action of Acetic Acid + Isopropyl Alcohol?

Answer 21

Restores acidic pH of external auditory canal and inhibits microbial growth

Commonly used for swimmer’s ear treatment.

Question 22

What is the dosage for Acetic Acid + Isopropyl Alcohol?

Answer 22

4-6 drops

Administered in the external auditory canal.

Question 23

What is the dosage for Acetic Acid + Benzethonium Chloride + Propylene Glycol?

Answer 23

Px: 2 drops bd, Tx: 5 drops tds-qid

Used for swimmer’s ear treatment.

Question 24

What is the drying action of Ethanol in Spirit Ear Drops?

Answer 24

Inhibits microbial growth

Commonly used in ear drop formulations.

Question 25

What is the recommended dosage for Ethanol (Spirit Ear Drops APF)?

Answer 25

4-6 drops after shaking water out of ears ## Footnote Ensures effective application of the drops.

Question 26

What are common adverse effects of ear drops?

Answer 26

Stinging on instillation; irritation of skin ## Footnote Usually occurs if skin is inflamed or broken.

Question 27

What are the contraindications for using ear drops?

Answer 27

Perforated ear drums ## Footnote Important to avoid potential complications.

Question 28

What are the types of antibiotics available for ear infections?

Answer 28

Topical agents - various combinations of: * Antibacterials (e.g. framycetin, gramicidin, ciprofloxacin, neomycin) * Antifungals (e.g. nystatin, clioquinolol) * Corticosteroids (e.g. hydrocortisone, triamcinolone, dexamethasone) ## Footnote All antibiotics require a prescription.

Question 29

When are systemic agents usually recommended for ear infections?

Answer 29

In severe infections or for immunocompromised patients ## Footnote Examples include patients with diabetes.

Question 30

What are the reasons for referral in children with ear pain?

Answer 30

* Ear pain in children < 6 years * Severe pain not relieved by regular analgesics * Symptoms > 7 days after treatment initiation * Symptoms affecting other areas (e.g. pinna) * Impaired hearing in children * Mucopurulent discharge * Pain on palpation of mastoid area ## Footnote Referral may be necessary for further evaluation.

Question 31

What is Acute Otitis Media?

Answer 31

Infection of the middle ear compartment leading to blockage of Eustachian tube and fluid formation ## Footnote Common in children due to the angle of the Eustachian tube.

Question 32

What are common signs and symptoms of Acute Otitis Media?

Answer 32

* Abrupt onset * Sensation of fullness in ear * Pain * Fever * Temporary deafness * Bulging and reddened ear drum ## Footnote Often associated with a common cold.

Question 33

What is the management for Acute Otitis Media?

Answer 33

* Reassurance of self-limiting condition * Pain management (e.g. paracetamol, ibuprofen) * Antibiotics (e.g. amoxicillin) for certain populations ## Footnote Symptoms usually last 2-3 days.

Question 34

What defines Recurrent Otitis Media?

Answer 34

At least 3 episodes in 6 months or 4 in 12 months ## Footnote Oral antibiotic prophylaxis is not recommended except in high-risk populations.

Question 35

What is Otitis Media with Effusion?

Answer 35

Fluid behind an intact eardrum without acute infection ## Footnote Can lead to hearing loss and speech delay.

Question 36

What is the treatment for persistent Otitis Media with Effusion?

Answer 36

Surgery to remove fluid and insertion of a grommet ## Footnote Grommets allow fluid drainage from the middle ear.

Question 37

What are the steps for administering ear drops?

Answer 37

* Clean and dry external ear canal * Warm bottle to near body temperature * Sit/lie down with affected ear facing upwards * Pull ear backwards then upwards * Put correct number of drops into ear canal ## Footnote Follow these steps for effective application.