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My Ear Hurts!
516 Intro to Med, Module 2
48
Medical
Graduate
05/21/2009

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Term
What are some organisms responsible for otitis externa
Definition
pseudomonas aeruginosa
staph aureus
fungi
-aspergillus
-candida
Term
What are some txs for otitis externa?
Definition
containing aminoglycoside, additional Ab adn anti-inflammatory corticosteroid
(neomycin sulfate, polymyxin B sulfate, and hydrocortisone)
Flluoroquinolone
(floxin otic (ofloxacin), ciprofloxin otic)
fungal
cleanse, acidifying otic drops (VoSol)
Term
How can otitis externa be prevented?
Definition
-acidifying drops after exposure to H2O
(OH-/vinegar mix: 50% rubbing OH-, 25% white vinegar, 25% distilled H2O)
-ear plugs while swimming
-no soap to clean ears
Term
malignant otitis externa:
Of what is it a result?
In whom is it common?
It involves an extension of external otitis into where?
Definition
-result of persistent otitis externa
-common in diabetics and immunocompromised pts
-extension of external otitis into mastoid or temporal bone
Term
What organism is responsible for malignant otitis externa?
Definition
pseudomonas aeruginosa
Term
What are some symptoms of malignant otitis externa?
Definition
headache out of proportion to clinical findings
deep pain
persistent foul discharge
Term
What are some physical findings of malignant otitis externa?
Definition
granulations in ear canal
progressive cranial nerve palsies
Term
What is a test for malignant otitis externa?
Definition
ct-osseous erosions
Term
What are some tx options for malignant otitis externa?
Definition
surgical debridement
fluoroquinolones
IV tx may be required
Term
Age, prematurity, allergies, craniofacial abnormalities,
GERD, genetic predisposition, M>F, URI, season, daycare attendance, passive smoke, family size, bottle feeding, socioeconomic level, and pacifier use
are all risk factors for what condition?
Definition
risk factors for otitis media
Term
Tugging/pulling @ ears (feeling of fullness)
hearing difficulties
loss of balance
delayed speech (in children)
are all symptoms of what condition?
Definition
symptoms of serous otitis media
Term
What condition involves a collection of fluid in md ear from blocked eustachian tube?
Definition
serous otitis media
Term
Dull TM
hypomobile on pneumatic otoscopy
air bubbles
conductive hearing loss
physical findings of what?
Definition
serous otitis media
Term
What are tx options of serous otitis media?
Definition
Controversial
AAP recommendations:
-watchful waiting
-referral to otolaryngologist
-surgery: tympanostomy tubes
-antimicrobial therapy
AAP does not reccomend antihistamines, decongestants, antimicrobials, or corticosteroids
Term
What condition involves inflammation of the middle ear, most commonly as a complication of URI?
Definition
acute otitis media
Term
What are responsible organisms for acute otitis media?
Definition
strep pneumoniae
Haemophilius influenzae
moraxella catarrhalis
strep pyogenes
Term
Irritability
pulling on ear or hair
fever
are s/s of what condition?
Definition
s/s acute otitis media in infants
Term
Otalgia
pressure
decreased hearing
headache
lethargy
fever
are s/s of what condition?
Definition
s/s older children and adults acute otitis media
Term
Erythema of TM,
Bulging TM,
Decreased visibility of landmarks, and
Hypomobile TM,
are all physical exam findings of what condition?
Definition
acute otitis media physical exam findings
Term
What are some tx options of acute otitis media?
Definition
pain control
-acetaminophen, ibuprofen
PO antibiotics
-amoxicillin
-augmentin (amoxicillin-clavulanate)
-allergic azithromycin or clarithromycin
Term
When is acute otitis media considered recurrent?
Definition
3 episodes of Acute Otitis Media within 6 mos or 4 or more episodes w/in a year
Term
What are 4 complications of acute otitis media?
Definition
serous otitis media
chronic otitis media
mastoiditis
perf TM
Term
How can acute otitis media be prevented?
Definition
prevention:
-alter attendance at day care centers
-breastfeeding for at least 6 mos
-avoid supine bottle feeding
-reduce/eliminate use of pacifier after 6 mos of age
-eliminate exposure to tobacco smoke
Term
What are some responsible organisms for chronic otitis media?
Definition
pseudomonas aeruginosa
proteus sp.
staphylococcus aureus
mixed anaerobes
Term
Under what conditions is otitis media considered chronic?
Definition
chronic inflammation of middle ear
persists at least 6 weeks
otorrhea *hallmark sign
Term
Purulent drainage with little to no pain ares/s of what condition?
Definition
chronic otitis media
Term
Dull TM
erythema
perf w/drainage
conductive hearing loss are
physical findings of what condition?
Definition
chronic otitis media
Term
What are some tx options for chronic otitis media?
Definition
antibiotics
surgical
Term
What are some complications of chronic otitis media?
Definition
mastoiditis
cholesteatoma
epidural abscess
hearing loss
Term
What develops when md ear inflammation spreads to mastoid air cells?
Definition
mastoiditis
Term
In what does mastoiditis result?
Definition
results in infection and destruction of mastoid bone
Term
What age group is mainly affected by mastoiditis?
Definition
mainly affects young children
Term
What age group is mainly affected by mastoiditis?
Definition
mainly affects young children
Term
The following s/s are indicative of what condition?
otalgia and pain behind ear
fever
Definition
mastoiditis s/s
Term
Bulging, red TM
eryghema, tenderness, edema over mastoid area
psotauricular fluctuance
protrusion of auricle and
are physical findings of what condition?
Definition
mastoiditis
Term
CBC s/ differential may show leukocytosis in what condition?
Definition
mastoiditis test/study
Term
Elevated ESR, myringotomy with fluid that should be sent for culture, x-rays that show coalescence of mastoid cells, and CT adn/or MRI becoming used more frequently in what condition?
Definition
mastoiditis tests/studies
Term
What are some tx options for mastoiditis?
Definition
iv antibiotics
myringotomy
mastoidectomy
Term
Inability to equalize pressure on middle ear indicates what condition?
Definition
barotrauma
Term
What are 3 causes of barotrauma?
Definition
diving, air travel, hyperbaric oxygen chambers
Term
What is a superficial infection of external auditory canal?
Definition
otitis externa
Term
What are common initiating events of otitis externa?
Definition
moisture, trauma
Term
The following s/s indicate what condition?
progressive ear pain
-mild to severe
itching
purulent dischage
hearing loss
feeling of fullness or pressure
occasional fever
Definition
otitis externa
Term
The following physical findings indicate what condition?
pain upon palpation of tragus or when applying gentle traction to pinna
conductive hearing loss
edema and erythema of external canal
purulent discharge
scaling
Definition
otitis externa physical findings
Term
The following s/s are indicative of what condition?
clogging of the ear
ear pain/discomfort
hearing loss
dizziness
tinnitus
hemorrhage from ear
Definition
barotrauma s/s
Term
The following physical findings are indicative of what condition?
retracted TM
erythema and injected TM
hemotympanum
Definition
barotrauma physical findings
Term
What is a complication of barotrauma?
Definition
perf
Term
How can barotrauma be prevented/tx?
Definition
swallow, yawn, chew gum during descent
PO decongestants prior to flight
for persistent- myringotomy
AVOID DIVING WHEN HAVE URI OR EXACERBATION OF ALLERGIES
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