Otitis Media tutorial

Question 1

aetiology of the inflammation in otitis externa?

Answer 1

bacterial
fungal
exczematous

Question 2

most common pathogenic bacteria in otitis externa?

Answer 2

pseudomonas
proteus
staph aureus

Question 3

Tx of bacterial otitis externa?

Answer 3

drops containing steroid and:
neomycin
gentamycin

Question 4

most common pathogenic fungi in otitis externa?

Answer 4

aspergillus niger

candida albicans

Question 5

Tx of fungal otitis media?

Answer 5

clotrimazole

nystatin

Question 6

Tx of eczematous otitis externa?

Answer 6

steroid without antibiotic

Question 7

how to generally care for otitis externa without medication?

Answer 7

keep water away
don’t put anything in the ear
keep hearing aids out

Question 8

how to treat cellulitis in otitis externa?

Answer 8

systemic + topical Abs

Question 9

name some preparatons used as wax solvents?

Answer 9

sodium bicarbonate
olive oil
almond oil

Question 10

when would a wick be helpful?

Answer 10

if the canal skin is oedematous

Question 11

when could drops cause dizziness?

Answer 11

drops are not close to body temperature

Question 12

describe the centor criteria

Answer 12

history of fever
tonsillar exudates
tender anterior cervical lymphadenopathy
no cough

> 3 = antibiotics

Question 13

difference between glandular fever and tonsillitis

Answer 13

GF:
lasts longer
get hepatosplenomegaly
get jaundice
LNs are bigger and multiple

Question 14

what bacteria causes epiglottitis?

Answer 14

haemophilus influenzae type B

Question 15

treatment of mild epiglottitis?

Answer 15

supportive
Abs
nebulisers eg adrenaline

Question 16

treatment of severe epiglottitis?

Answer 16

steroids
antibiotics
intubation
tracheostomy

Question 17

drugs that can cause nosebleeds?

Answer 17

anticoagulants

blood thinners eg warfarin

Question 18

what blood disorders can cause epistaxis?

Answer 18

haemophilia
leukaemia
thrombocytopaenia
clotting abnormalities

Question 19

define glue ear

Answer 19

otitis media with effusion

bilateral fluid in the middle ear causing hearing loss that lasts for 3 months

Question 20

Tx of glue ear?

Answer 20

nothing for 3 months

after consider hearing aids, grommet or adenoidectomy

Question 21

why is an adenoidectomy beneficial in otitis media?

Answer 21

the adenoids (nose tonsils) can block the opening to the eustachian tube further exacerbating glue ear

Question 22

difference in symptoms of acute otitis media and glue ear?

Answer 22

glue = will not have otalgia, otorrhea, or signs of systemic infection, but may experience mild-to-moderate hearing impairment

Question 23

cause of fluid in the middle ear?

Answer 23

eustachian tube dysfunction

Question 24

common causes of glue ear?

Answer 24

URTI

acute otitis media

Question 25

how is diagnosis of glue ear confirmed?

Answer 25

tympanometry

Question 26

how can acute otitis media become glue ear?

Answer 26

if any discharge is left behind in the middle ear

Question 27

how can glue ear become acute otitis media?

Answer 27

if the fluid in the middle ear becomes infected

Question 28

why are children more likely to get ear infections?

Answer 28

have shorter eustachian tubes that are more likely to be closed

Question 29

risk factors for glue ear

Answer 29

``` 2-6 yrs old boy poor income background bottle fed pre-term downs syndrome cleft palate ```

Question 30

how does the middle ear normally control its pressure?

Answer 30

eustachian tube opens during swallowing to bring a certain amount of gas into the middle ear cleft

Question 31

what does reduced ventilation of the middle ear cause?

Answer 31

reduction in pressure and effusion | effusion will become viscous if prolonged -> glue ear

Question 32

why are ear infections common in children with facial abnormalities?

Answer 32

usually have short eustachian tubes and small ear canals

Question 33

where is the middle ear in relation to the cochlea?

Answer 33

lateral to it

Question 34

you get fluid discharge in AOM: T or F

Answer 34

Fish, only really in OME

Question 35

a bulging TM is found in what ear condition?

Answer 35

AOM

Question 36

risk factors for OME?

Answer 36

``` recurrent URTI recurrent AOM premature craniofacial abnormality immunodeficiency smoking in household allergy day care bottle feeding ```

Question 37

symptoms of OME in a child?

Answer 37

deaf poor school performance speech delay behaviour problems

Question 38

how is OME diagnosed?

Answer 38

``` Hx otoscopy tuning fork test audiometry tympanometry ```

Question 39

what does the TM look like in OME?

Answer 39

retracted less mobile colour change can see bubbles

Question 40

what ear condition presents with bubbles on the TM?

Answer 40

OME

Question 41

what does tympanometry look like when fluid is in it and why?

Answer 41

FLAT, fluid doesnt move

Question 42

Tx of OME?

Answer 42

wait for 3 months grommet do adenoidectomy if recurrent