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Peds > Ears > Flashcards

Ears Flashcards

1
Q

The AAP guidelines requirements for diagnosing AOM include

A

recent, abrupt onset of ME inflammation and effusion. MEE confirmed by bulging TM. ME inflammation by distinct erythema of TM or onset of ear pain

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2
Q

Acute onset of bleeding from the ear is usually associated with

A

Acute onset of bleeding from the ear is usually associated with

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3
Q

Altered mobility of a TM in pneumatic otoscopy may suggest

A

MEE or possible perforation

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4
Q

AOM treated initially with Amoxicillin with treatment failure and without pcn allergy would next be treated with

A

AOM treated initially with Amoxicillin with treatment failure and without pcn allergy would next be treated with

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5
Q

The Auditory brainstem response is useful in identifying hearing loss in young infants or children who are

A

unable to cooperate with EOAE, occasionally sedation is required

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6
Q

The Auditory brainstem response measures signals in the cochlea and

A

the functioning of the peripheral auditory system and neurological pathways related to hearing, requires audiologist

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7
Q

Azithromycin dose for AOM is:

A

10mg/kg/day on day 1 then 5mg/kg/day on day 2-5 given daily

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8
Q

A child has been treated with amoxicillin in the previous 30 days for AOM already. The child returns with AOM and concurrent conjunctivitis. The provider will prescribe next

A

amoxicillin/clavulunate or third-generation cephalosporin

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9
Q

A child returns with AOM, has failed amoxicillin/clavulanate and is now vomiting. The prescriber will prescribe next

A

ceftriaxone IM

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10
Q

Clinical findings of chronic OM, malodorous purulent discharge, vertigo, a pearly white lesion on or behind TM are findings of

A

cholesteatoma, and immediate referral for surgical excision is in order

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11
Q

The definition of AOM include

A

rapid onset otalgia, MEE confirmed and middle ear inflammation

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12
Q

The diagnosis of OME is made when there is evidence of

A

MEE without s/sx of acute ear infection

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13
Q

Education to parents on installation of ear drops include

A

the drops should be warmed, the tragus should be pumped a few times after instillation, affected ear should remain up for at least 2-3 minutes

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14
Q

The evoked otoacoustic emissioin (EOAE) testing is the method of hearing screening used for universal newborn screening. The exam provides evidence that hearing is intact however may not identify

A

auditory nerve dysfunction

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15
Q

The first-line antibiotic for AOM remains

A

amoxicillin 80-90mg/kg/day BID unless allergy

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16
Q

The following findings are seen with OE examination

A

pain, often severe with movement of the tragus or pinna, swollen EAC with debris, red crusty or pustular lesions, puritis with thick otorrhea

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17
Q

pain, often severe with movement of the tragus or pinna, swollen EAC with debris, red crusty or pustular lesions, puritis with thick otorrhea

A

recurrent AOM three times in 6 months or four times in 1 year with at least 1 episode in the last 6 months

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18
Q

Initial treatment for AOM with pcn allergy was treated with Cefdinir, after failure of treatment the next approach would be

A

ceftriaxone

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19
Q

A Macrolide such as Azithromycin or Cefdinir may be used for AOM if

A

patient has a PCN allergy.

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20
Q

The major tenants of the guideline for appropriate diagnosis and treatment of AOM are

A

accurate dx, pain management and initial observation

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21
Q

Mom asks if the patient with a TM perforation if surgery will be necessary

A

the provider advises that the goal of therapy is management of drainage and watchful waiting. most ruptures complete heal within one month

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22
Q

Mom asks the provider if the patient with pressure-equalizing tubes needs to wear ear plugs while bathing, showering or surface swimming. The providers response is

A

earplugs should be worn if the child is diving or dunking the head below water level

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23
Q

Mom brings in a 6 y/o patient who previously had AOM, mom states patient no longer experiencing pain however is having profuse drainage. Next the provider would

A

examine the ear for poss TM rupture

24
Q

Observation of “watchful waiting” is done for

A

48-72hrs with phone call f/u, scheduled f/u and poss provide rx

25
Q

On physical examination of AOM, presence of MEE is confirmed by the physical presence of

A

bulging TM, decreased translucency of TM, decreased or absent mobility TM, air fluid, otorrhea

26
Q

On pneumatic otoscopy reveals decreased TM mobility with OME. What are some other physical exam findings

A

TM can be dull and vary from bulging and opaque with no visible landmarks or even retracted and translucent with visible landmarks and air/bubble

27
Q

Otitis Externa is commony called

A

swimmer’s ear and can involve the pinna or TM

28
Q

Otitis Externa is most commonly caused by

A

retained moisture in the EAC

29
Q

Postauricular swelling, displacing of the pinna inferiorly or laterally in infants lead to suspected

A

mastoiditis. in older children the pinna may push superior and laterally

30
Q

The preferred treatment for TTO with drainage is

A

combination antibiotic and corticosteroid otic drops

31
Q

Prophylactic antibiotics are never recommended in the treatment of

A

chronic or recurrent AOM

32
Q

Provider educates the parent that viral myringitis or early AOM without drainage in a child with ear tubes will

A

most likely resolve spontaneously due to the increased middle ear ventilation

33
Q

most likely resolve spontaneously due to the increased middle ear ventilation

A

3 month watchful waiting, hearing checks, ID for risks for speech/language/learning problems and referral

34
Q

Risk factors for SNHL include all of the following except; BW <1500g, low apgar, long QT, TORCH, pathways to the brain are either damaged or impaired

A

pathways to the brain are either damaged or impaired

35
Q

Signs and symptoms of middle ear inflammation are indicated by

A

erythema of TM, obscured or absent landmarks, red/yellow or purple TM, thin-walled sagging bullae filled with straw colored fluid

36
Q

his abx would not be used for AOM of C&S is not confirmed

A

clindamycin

37
Q

This hearing exam is useful in older children for assessing hearing loss and measures the hearing threshold via b

A

bone or air conduction in decibals

38
Q

This medication is a non ototoxic combination antibiotic and steroid and should not be used in children less than 6 months of age

A

Ciprodex (ciprofloxacin and dexamethasone)

39
Q

This medication is ototoxic, contains antibiotic, steroid and acid and can not be used in children less than 1 years old

A

Cortisporin (polymyxcin B/hydrocortisone/glacial acetic acid)

40
Q

This third-generation cephalosporin may be used for amoxicillin allergy in treatment of AOM and may cause red stool

A

This third-generation cephalosporin may be used for amoxicillin allergy in treatment of AOM and may cause red stool

41
Q

Thorough education for instillation of drops for OE is important and includes educating the parent that

A

drops should run into the EAC until it is filled, move the pinna or pump tragus to remove trapped air, child should remain lying down for 3-5 mins leaving the ear open to air

42
Q

Treatment for AOM using Ceftriaxone is dosed at

A

50mg/kg/day IM; 1-3 doses over 5 days

43
Q

The treatment outline for OE management is

A

eardrops containing acetic acid or abx with and without steroid drops

44
Q

True/False: Any child 6-23 months old with acute OM, without severe sx, without fever, sick <48hrs would receive treatment

A

true (tbl 30-5, Burns)

45
Q

True/False: Conductive hearing loss implies a problem with the outer or middle ear

A

true. cochlea and bone conduction are normal with decreased air conduction

46
Q

True/False: EOAE and Audiometry is the preferred diagnostic test for newborn hearing screening

A

False

47
Q
  1. True/False: Evidence shows that decongestants and nasal steroids help shorten the time of recovery for OME
A

False

48
Q
  1. True/False: If a TM perf was caused by AOM, treat the ear with otic drops and ear infection as you normally treat AOM
A

True

49
Q
  1. True/False: Observation or watchful waiting for 48-72hrs is the first principle of treatment for AOM
A

False - pain management is first

50
Q
  1. True/False: Persistant cough or hiccups can be a clinical finding of a foreign body in the ear canal
A

True

51
Q
  1. True/False: Persistent AOM should be referred to Otolaryngology
A

False

52
Q
  1. True/False: Persistent MEE is common after resolution of acute sx and should not be seen as a need or continuing abx
A

True

53
Q
  1. True/False: Risk factors for hearing loss includes kidney malformation
A

True

54
Q
  1. True/False: S. pneumoniae continues to be the most common bacteria responsible for AOM
A

True

55
Q
  1. True/False: Swimming is an absolute contraindication with TM perf ——-as well as getting shampoo in the ears
A

True

56
Q
  1. True/False: Swimming is prohibited during acute infection of OE
A

True

57
Q
  1. The tympanic membrane is at the proximal end of the EAC and separates the external ear from the middle ear 55.
A

.

Peds (13 decks)

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