ears ID

Question 1

what precedes otitis media

Answer 1

URTI

Question 2

bacteria that cause acute otitis media

Answer 2

strep pneumo, H influenza, moraxella

Question 3

symptoms acute otitis media

Answer 3

otalgia (ear tugging) // fever // hearing loss // corzyal

Question 4

symptoms of acute otitis media if tympanic membrane perforates

Answer 4

purulent discharge

Question 5

otoscopy acute otitis media

Answer 5

bulging membrane –> loss of light reflex (middle ear effusion) // red or opaque tympanic membrane //

Question 6

what is required to diagnose acute otitis media

Answer 6

acute onset symptoms + middle ear effusion + inflammation of tympanic membrane

Question 7

when should otitis media be treated

Answer 7

usually self limiting - come back if not better in 3 days

Question 8

indication for abx acute otitis media

Answer 8

last 4 days // systemic unwell // immunocompromised // <2 with bilateral // perforation

Question 9

indication for abx acute otitis media

Answer 9

last 4 days // systemic unwell // immunocompromised // <2 with bilateral // perforation

Question 10

abx for acute otitis media

Answer 10

oral amoxicillin 5-7 days

Question 11

what is chronic suppurative otitis media

Answer 11

perforation and discharge for 6+ weeks

Question 12

complication from spread of infection acute otitis media

Answer 12

labryinthits // mastoiditis // meningitis // brain abscess // CNVII palsy

Question 13

causes otitis externa

Answer 13

infection // seborrhoeic dermatitis // contact dermatitis // diabetes

Question 14

bacteria in otitis externa

Answer 14

staph A, pseudomonas

Question 15

trigger for otitis externa

Answer 15

swimming

Question 16

symptoms otitis externa

Answer 16

ear pain, itch, discharge

Question 17

mx otitis externa

Answer 17

topical antibiotic +/- steroid (gent)

Question 18

when is gentamicin contraindicated in otitis externa

Answer 18

perforation

Question 19

2nd line mx otitis externa

Answer 19

oral fluxclox // swab // maybe antifungal

Question 20

if fungal infection otitis externa what mx

Answer 20

topical clotrimazole

Question 21

when should otitis externa be referred to ENT

Answer 21

no response to topical abx

Question 22

what is malignant otitis externa

Answer 22

extension of otitis externa to temporal bone osteomyelitis

Question 23

who usually gets malignant otitis externa

Answer 23

diabetics

Question 24

organism malignant otitis externa

Answer 24

pseudomonas

Question 25

symptoms malignant otitis externa

Answer 25

diabetes // deep and painful otalgia // temporal headache // purulent discharge // dysphagia, hoarse, facial nerve involvement

Question 26

invx malignant otitis externa

Answer 26

CT

Question 27

mx malignant otitis externa

Answer 27

refer to ENT // IV abx for pseudomonas (cipro)

Question 28

how does mastoiditis occur

Answer 28

infection from middle ear --> mastoid space of temporal bone

Question 29

symptoms mastoiditis

Answer 29

otalgia (behind the ear) // recurrent otitis media // fever // systemic upset // swelling, redness, tenderness // ear discharge

Question 30

invx mastoiditis

Answer 30

usually clinical, in unsure CT

Question 31

mx mastoiditis

Answer 31

IV abx

Question 32

complications mastoiditis

Answer 32

CNVII palsy, hearing loss, meningitis