Acute Otitis Externa Quiz

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Questions and Answers

What is a hallmark sign of acute otitis externa?

Pain with movement of the pinna (correct)

Presence of cerumen

Redness in the tympanic membrane

Itching in the external ear canal

Which of the following is NOT a risk factor for acute otitis externa?

Absence of cerumen

Increased physical activity (correct)

Prolonged exposure to water

Use of hearing aids

What is the most common bacterial cause of acute otitis externa?

Escherichia coli

Staphylococcus

Streptococcus

Pseudomonas (correct)

Which treatment is appropriate for acute otitis externa in cases of a ruptured tympanic membrane?

Ciprofloxacin/dexamethasone Signup and view all the answers

Which statement about cerumen is true?

Cerumen's color can range from yellow to dark brown. Signup and view all the answers

What is a common fungal cause of acute otitis externa?

Candida albicans Signup and view all the answers

Which ear drops can be safely used when the tympanic membrane is NOT intact?

Ciprofloxacin/dexamethasone Signup and view all the answers

What is the purpose of using an ear wick in treatment?

To deliver medication when the canal is extremely edematous Signup and view all the answers

What is a common symptom of acute rheumatic fever?

Painful and tender joints Signup and view all the answers

Which condition is associated with a risk of airway obstruction that may require emergency referral?

Peritonsillar abscess Signup and view all the answers

What virus is responsible for causing mononucleosis?

Epstein-Barr Virus Signup and view all the answers

What is a common laboratory test used to diagnose mononucleosis?

Monospot test Signup and view all the answers

Which finding is indicative of poststreptococcal glomerulonephritis?

Hypertension and edema Signup and view all the answers

What caution should be taken with physical activity in patients with mononucleosis?

Limit physical activity for 4 weeks Signup and view all the answers

Which symptom is NOT typically associated with acute rheumatic fever?

Severe diarrhea Signup and view all the answers

What should be avoided in patients with mononucleosis who present with strep throat?

Amoxicillin Signup and view all the answers

What is the recommended method to dry the ears after exposure to water?

Dry ears with a hair dryer set on low heat at a distance of 1 foot for 1 minute Signup and view all the answers

Which of the following is NOT a recommended prevention method for ear infections?

Seek immediate medical attention for minor ear discomfort Signup and view all the answers

What is the main etiology of Acute Otitis Media (AOM)?

Infections caused primarily by viruses and bacteria such as Strep pneumoniae Signup and view all the answers

What symptom is associated with Otitis Media with Effusion (OME)?

Feeling of fullness in the ear Signup and view all the answers

What is the first-line treatment for Acute Otitis Media (AOM) across all age groups?

Amoxicillin Signup and view all the answers

Which of the following findings is characteristic of Acute Otitis Media (AOM)?

Cloudy and bulging tympanic membrane Signup and view all the answers

Which of the following actions can cause trauma to the external auditory canal?

Inserting cotton swabs to clean the ear Signup and view all the answers

What is a common consequence if fluid remains in the middle ear after an episode of AOM?

Development of further middle ear infections Signup and view all the answers

What is the main presentation symptom of allergic rhinitis?

Nasal congestion with clear mucus rhinorrhea Signup and view all the answers

Which treatment is considered first-line for allergic rhinitis?

Nasal steroid sprays Signup and view all the answers

What complication is commonly associated with allergic rhinitis?

Acute sinusitis Signup and view all the answers

What is the first-line treatment for Streptococcal pharyngitis?

Penicillin V 500 mg BID to TID x 10 days Signup and view all the answers

Which of the following is NOT a symptom of allergic rhinitis?

Fever Signup and view all the answers

Which symptom is characteristic of scarlet fever?

Red, sore tongue Signup and view all the answers

What should be done after 24 hours of starting antibiotics for strep throat?

Return to work or school Signup and view all the answers

What does the presence of 'racoon eyes' indicate in a patient with allergic rhinitis?

Allergy-related inflammation Signup and view all the answers

Which nasal spray would be used if a patient only experiences partial relief from allergic rhinitis?

Azelastine Signup and view all the answers

Which complication is characterized by painful and tender joints that may migrate?

Acute rheumatic fever Signup and view all the answers

What is a typical presentation of a peritonsillar abscess?

Displaced uvula and dysphagia Signup and view all the answers

What is a risk factor that can lead to anterior nasal bleeds?

Severe hypertension Signup and view all the answers

What is an effective first step in treating an anterior nasal bleed?

Apply direct pressure on the front of the nose Signup and view all the answers

What is the proper alternative treatment for patients with a penicillin allergy?

Azithromycin (Zpak) x 5 days Signup and view all the answers

Which of the following is a symptom of poststreptococcal glomerulonephritis?

Dark-colored urine Signup and view all the answers

Which symptom would likely not be associated with streptococcal pharyngitis?

Severe vomiting Signup and view all the answers

What is the recommended dosage of Amoxicillin for children diagnosed with an acute bacterial infection?

90 mg/kg/day Signup and view all the answers

Which medication should not be used in children under 10 years of age?

Benzonatate Signup and view all the answers

What is the maximum duration for which topical decongestants such as Afrin should be used?

3 days Signup and view all the answers

What is a common side effect of Amoxicillin-clavulanate (Augmentin)?

GI side effects Signup and view all the answers

What alarming symptom might indicate the need to refer a patient to the emergency department for meningitis?

Acute headache and stiff neck Signup and view all the answers

Which of the following is a treatment indicated for pain or fever in both adults and children?

Acetaminophen Signup and view all the answers

What is the primary concern associated with prescribing levofloxacin?

Tendon rupture Signup and view all the answers

Which nasal spray is advised for using as a mucolytic agent as well as a treatment for nasal congestion?

Guaifenesin Signup and view all the answers

Study Notes

Ear Conditions

Ear conditions are covered in NUR 7575, a primary care course
The external ear structure includes the helix, scaphoid fossa, crura of the antihelix, antihelix, antitragus, and lobule of the auricle.
The tympanic membrane (TM) appears translucent off-white to gray, with a cone of light.
The pinna has significant cartilage.
The tragus is a small cartilage flap on the front of the ear.
Cartilage does not regenerate; injuries should be referred to a plastic surgeon.
Cerumen (ear wax) ranges from yellow to dark brown.

Ear Pathophysiology

Ear ossicles (malleus, incus, and stapes) are essential components
Acute otitis externa (Swimmer's ear) involves inflammation or infection of the external ear canal, auricle and/or both.
Causes of otitis externa include excessive moisture, and bacteria (Pseudomonas, Staphylococcus, Streptococcus), and fungal infections (Aspergillus, Candida albicans)

OE Assessment Findings

Ear pain with movement (traction of the pinna) is a hallmark
Edema and redness in the external ear canal.
Discharge of flaky debris is common
Itching is observed
Tympanic membrane is typically normal

OE Treatment

Otic antibiotics combined with steroids are effective in treating OE.
Cortisporin (hydrocortisone, neomycin, polymyxin B)
Ciprodex (ciprofloxacin/dexamethasone)
TobraDex (tobramycin/dexamethasone)
Ofloxacin (Floxin) may be used in patients over 12 years with a ruptured TM and over 6 months with an intact TM
Antifungals are used as necessary
Oral antibiotics are reserved for severe cases
Ear wick insertion may be necessary for extremely edematous canals.

Otitis Media (OM)

Acute OM (AOM): middle ear inflammation causing tympanic membrane bulging or fullness, and middle ear effusion.
Etiology can include viruses/bacteria such as Strep pneumoniae.
OM with effusion (OME): fluid buildup in the middle ear without an infection.
OM causes include eustachian tube dysfunction.

Otitis Media Assessment

Rapid onset of ear pain
Fever
Distorted TM landmarks; displaced light reflex; decreased TM mobility
Cloudy, dull, opaque, or erythematous TM
Moderate to severe bulging TM of Otitis Media
Feeling of fullness in ear
Diminished hearing
Dull TM
Decreased mobility of TM, retracted
Visible air bubbles

Otitis Media Treatment

Amoxicillin is initial treatment for any age
Second-line agents include Augmentin, Cefdinir, effective against beta-lactamase-producing bacterial strains
Azithromycin is first-line for penicillin allergies.
Pain treated with oral analgesics like acetaminophen or ibuprofen.
Treat eustachian tube dysfunction with NSAIDs.
Patients with AOM and TM tubes get antibiotic otic drops (Ciprodex, Floxin).

Mastoiditis

Mastoiditis is a bone infection typically resulting from a middle-ear infection.
It can cause pus-filled cysts.
Symptoms can include redness, swelling, tenderness around the affected bone, fever, and ear pain.
Refer for a CT scan and possible IV antibiotics.

Hearing Assessment

Various methods (whisper test, Weber test, Rinne test) are used to assess hearing function.
These tests help identify conductive or sensorineural hearing loss.

Nose Conditions

Maxillary and frontal sinuses are most commonly affected after a viral upper respiratory infection (URI).
Secondary bacteria infections often stem from trapped fluid within the sinuses.
Symptoms include unilateral facial pain.
Secondary bacterial infection may be caused by Streptococcus pneumoniae and Haemophilus influenzae.

Acute Bacterial Rhinosinusitis

Symptoms may include thick nasal discharge, facial pain, fever, and headache, lasting more than 10 days.
Examination may reveal a posterior pharynx with purulent postnasal drip, tenderness to palpation on the face above the sinuses. Transillumination may appear duller compared to the normal sinus.
Acute bacterial rhinosinusitis treatment depends on factors such as symptoms duration (e.g. more than 10 consecutive days), whether the patient exhibits severe symptoms and/or immunocompromised, and allergy.
First-line treatment may include amoxicillin-clavulanate.
Secondary treatments and decongesting agents (as needed) or over-the-counter therapies may be prescribed.

Allergic Rhinitis

Allergic Rhinitis is an inflammatory response involving the nasal mucosal tissue.
Presentation includes chronic or seasonal nasal congestion, clear mucus rhinorrhea (runny nose).
Patient will cough, have itchy or watery eyes, and/or sneezing.
Examination typically finds pale, boggy turbinates; rhinorrhea (discharge); and/or underlying dark circles.
Treatment involves limiting exposure to/managing environmental allergens, and administering nasal steroids (e.g., fluticasone), or combination therapies (e.g., azelastine + fluticasone).

Epistaxis

Anterior nasal bleeds are more frequent than posterior bleeds, which are considered more serious.
Risks for epistaxis include use of aspirin or anticoagulants.
Most cases are self-limiting.
Treatment involves applying direct pressure to the anterior portion of the nose, utilizing nasal decongestants, and potentially cauterization or chemical treatment as needed.

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Description

Test your knowledge on acute otitis externa and associated conditions. This quiz covers common causes, treatments, and related symptoms for diagnoses such as mononucleosis and acute rheumatic fever. Challenge yourself to understand the intricacies of these ear conditions and their management.