Outer ear

Question 1

chronic, acute, malignant/nectrotizing, serpes zoster or ramset-hunt syndrome are all types of what

Answer 1

otitis externa

Question 2

overcleaning, trauma, warm moist environments and bacterial infections are all causes of what

Answer 2

swimmers ear

Question 3

conductive hearing loss with itching, severe pain and sense of fullness/pressure

Answer 3

swimmers ear

Question 4

A patient presents with complaints of itching and severe pain. The PE shows otorhhea, moist discharge in the canal and you have difficulty visualizing the TM. You perform the webers test to find sound lateralizing to the affected ear. lastly, you palpate the tragus and retract the auricle and the patient reports its very painful.

1. What is this?
2. What causes it?
3. what diagnostic tests do you need?
4. How do you treat it?

Answer 4

1. acute otitis externa (swimmers ear)
2. bacteria (pseudomonas), swimming, trauma, moist environments, changes in pH, loss of cerumen protection
3. none, clinical dx
4. depending on cause:
   * clean to remove debris
   * topical abx such as cipro
   *pain relief
   * ear wick

Question 5

a patient presents with conductive hearing loss and feeling of something in her right ear. on evaluation she tells you that she is a competitive swimmer. you find that she has pain with palpation of tragus and with retraction of auricle.

1. what is the likely diagnosis
2. what is the LIKELY CAUSE of the diagnosis (just one)
3. why does this occur?

Answer 5

1. acute otitis externa
2. Swimming
3. exposure to water can cause skin maceration and can wash away protective cerumin. Also, increased moisture exposure promotes bacterial growth.

Question 6

A patient presents with symptoms of ear pain right inside of the ear canal. upon exam you see what appears to be infection of a hair follicle.
1. What is the diagnosis for this patient?
2. What causes this specific type?
3. what is the treatment of this diagnosis

Answer 6

1. acute otitis externa - furunculosis
2. staph aureus
3. oral dicloxacillin or keflex (I&D if needed)

Question 7

a patient presents with ear itching, discomfort and white discharge. Upon exam you find that he has edema of the canal and growth inside his ears that is soft and white sebaceous-like material.

1. what is a historical finding that would have been significant in this patient

Answer 7

1. previous antibiotics use
2. hot/humid climates