Podcast
Questions and Answers
What is a hallmark sign of acute otitis externa?
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?
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?
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?
Which treatment is appropriate for acute otitis externa in cases of a ruptured tympanic membrane?
Which statement about cerumen is true?
Which statement about cerumen is true?
What is a common fungal cause of acute otitis externa?
What is a common fungal cause of acute otitis externa?
Which ear drops can be safely used when the tympanic membrane is NOT intact?
Which ear drops can be safely used when the tympanic membrane is NOT intact?
What is the purpose of using an ear wick in treatment?
What is the purpose of using an ear wick in treatment?
What is a common symptom of acute rheumatic fever?
What is a common symptom of acute rheumatic fever?
Which condition is associated with a risk of airway obstruction that may require emergency referral?
Which condition is associated with a risk of airway obstruction that may require emergency referral?
What virus is responsible for causing mononucleosis?
What virus is responsible for causing mononucleosis?
What is a common laboratory test used to diagnose mononucleosis?
What is a common laboratory test used to diagnose mononucleosis?
Which finding is indicative of poststreptococcal glomerulonephritis?
Which finding is indicative of poststreptococcal glomerulonephritis?
What caution should be taken with physical activity in patients with mononucleosis?
What caution should be taken with physical activity in patients with mononucleosis?
Which symptom is NOT typically associated with acute rheumatic fever?
Which symptom is NOT typically associated with acute rheumatic fever?
What should be avoided in patients with mononucleosis who present with strep throat?
What should be avoided in patients with mononucleosis who present with strep throat?
What is the recommended method to dry the ears after exposure to water?
What is the recommended method to dry the ears after exposure to water?
Which of the following is NOT a recommended prevention method for ear infections?
Which of the following is NOT a recommended prevention method for ear infections?
What is the main etiology of Acute Otitis Media (AOM)?
What is the main etiology of Acute Otitis Media (AOM)?
What symptom is associated with Otitis Media with Effusion (OME)?
What symptom is associated with Otitis Media with Effusion (OME)?
What is the first-line treatment for Acute Otitis Media (AOM) across all age groups?
What is the first-line treatment for Acute Otitis Media (AOM) across all age groups?
Which of the following findings is characteristic of Acute Otitis Media (AOM)?
Which of the following findings is characteristic of Acute Otitis Media (AOM)?
Which of the following actions can cause trauma to the external auditory canal?
Which of the following actions can cause trauma to the external auditory canal?
What is a common consequence if fluid remains in the middle ear after an episode of AOM?
What is a common consequence if fluid remains in the middle ear after an episode of AOM?
What is the main presentation symptom of allergic rhinitis?
What is the main presentation symptom of allergic rhinitis?
Which treatment is considered first-line for allergic rhinitis?
Which treatment is considered first-line for allergic rhinitis?
What complication is commonly associated with allergic rhinitis?
What complication is commonly associated with allergic rhinitis?
What is the first-line treatment for Streptococcal pharyngitis?
What is the first-line treatment for Streptococcal pharyngitis?
Which of the following is NOT a symptom of allergic rhinitis?
Which of the following is NOT a symptom of allergic rhinitis?
Which symptom is characteristic of scarlet fever?
Which symptom is characteristic of scarlet fever?
What should be done after 24 hours of starting antibiotics for strep throat?
What should be done after 24 hours of starting antibiotics for strep throat?
What does the presence of 'racoon eyes' indicate in a patient with allergic rhinitis?
What does the presence of 'racoon eyes' indicate in a patient with allergic rhinitis?
Which nasal spray would be used if a patient only experiences partial relief from allergic rhinitis?
Which nasal spray would be used if a patient only experiences partial relief from allergic rhinitis?
Which complication is characterized by painful and tender joints that may migrate?
Which complication is characterized by painful and tender joints that may migrate?
What is a typical presentation of a peritonsillar abscess?
What is a typical presentation of a peritonsillar abscess?
What is a risk factor that can lead to anterior nasal bleeds?
What is a risk factor that can lead to anterior nasal bleeds?
What is an effective first step in treating an anterior nasal bleed?
What is an effective first step in treating an anterior nasal bleed?
What is the proper alternative treatment for patients with a penicillin allergy?
What is the proper alternative treatment for patients with a penicillin allergy?
Which of the following is a symptom of poststreptococcal glomerulonephritis?
Which of the following is a symptom of poststreptococcal glomerulonephritis?
Which symptom would likely not be associated with streptococcal pharyngitis?
Which symptom would likely not be associated with streptococcal pharyngitis?
What is the recommended dosage of Amoxicillin for children diagnosed with an acute bacterial infection?
What is the recommended dosage of Amoxicillin for children diagnosed with an acute bacterial infection?
Which medication should not be used in children under 10 years of age?
Which medication should not be used in children under 10 years of age?
What is the maximum duration for which topical decongestants such as Afrin should be used?
What is the maximum duration for which topical decongestants such as Afrin should be used?
What is a common side effect of Amoxicillin-clavulanate (Augmentin)?
What is a common side effect of Amoxicillin-clavulanate (Augmentin)?
What alarming symptom might indicate the need to refer a patient to the emergency department for meningitis?
What alarming symptom might indicate the need to refer a patient to the emergency department for meningitis?
Which of the following is a treatment indicated for pain or fever in both adults and children?
Which of the following is a treatment indicated for pain or fever in both adults and children?
What is the primary concern associated with prescribing levofloxacin?
What is the primary concern associated with prescribing levofloxacin?
Which nasal spray is advised for using as a mucolytic agent as well as a treatment for nasal congestion?
Which nasal spray is advised for using as a mucolytic agent as well as a treatment for nasal congestion?
Flashcards
Acute Otitis Externa (OE)
Acute Otitis Externa (OE)
Inflammation or infection of the external ear canal, the auricle, or both.
Tympanic Membrane (TM)
Tympanic Membrane (TM)
The eardrum, separates the outer ear from the middle ear, appears translucent off-white to gray, with the cone of light intact.
Pinna
Pinna
The external part of the ear, made mostly of cartilage.
Tragus
Tragus
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Cerumen
Cerumen
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Bacterial Causes of OE
Bacterial Causes of OE
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Fungal Causes of OE
Fungal Causes of OE
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Risk Factors for OE
Risk Factors for OE
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Otitis Externa (OE)
Otitis Externa (OE)
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How to Prevent Otitis Externa
How to Prevent Otitis Externa
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Acute Otitis Media (AOM)
Acute Otitis Media (AOM)
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Otitis Media with Effusion (OME)
Otitis Media with Effusion (OME)
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Treatment for Acute Otitis Media (AOM)
Treatment for Acute Otitis Media (AOM)
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Treatment for Otitis Media with Effusion (OME)
Treatment for Otitis Media with Effusion (OME)
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Symptoms of Acute Otitis Media (AOM)
Symptoms of Acute Otitis Media (AOM)
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Symptoms of Otitis Media with Effusion (OME)
Symptoms of Otitis Media with Effusion (OME)
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Strep Throat
Strep Throat
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Rapid Strep Test
Rapid Strep Test
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Tonsillitis
Tonsillitis
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Petechiae
Petechiae
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Scarlet Fever
Scarlet Fever
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Acute Rheumatic Fever
Acute Rheumatic Fever
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Peritonsillar Abscess
Peritonsillar Abscess
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Poststreptococcal Glomerulonephritis
Poststreptococcal Glomerulonephritis
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What is Allergic Rhinitis?
What is Allergic Rhinitis?
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What are the main symptoms of Allergic Rhinitis?
What are the main symptoms of Allergic Rhinitis?
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What is a key physical finding on examination of an Allergic Rhinitis patient?
What is a key physical finding on examination of an Allergic Rhinitis patient?
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What is the first-line treatment for Allergic Rhinitis?
What is the first-line treatment for Allergic Rhinitis?
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What additional medication provides temporary relief for Allergic Rhinitis?
What additional medication provides temporary relief for Allergic Rhinitis?
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What is Rhinitis medicamentosa?
What is Rhinitis medicamentosa?
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What complications can occur with Allergic Rhinitis?
What complications can occur with Allergic Rhinitis?
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How is a nosebleed from Allergic Rhinitis treated?
How is a nosebleed from Allergic Rhinitis treated?
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Amoxicillin-clavulanate (Augmentin)
Amoxicillin-clavulanate (Augmentin)
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Levofloxacin
Levofloxacin
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Doxycycline
Doxycycline
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Ibuprofen
Ibuprofen
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Pseudoephedrine
Pseudoephedrine
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Guaifenesin
Guaifenesin
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Preorbital or orbital cellulitis
Preorbital or orbital cellulitis
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Cavernous sinus thrombosis
Cavernous sinus thrombosis
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What is Acute Rheumatic Fever?
What is Acute Rheumatic Fever?
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What are the typical joint symptoms of Acute Rheumatic Fever?
What are the typical joint symptoms of Acute Rheumatic Fever?
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What is a Peritonsillar Abscess?
What is a Peritonsillar Abscess?
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What is Poststreptococcal Glomerulonephritis?
What is Poststreptococcal Glomerulonephritis?
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What is Mononucleosis?
What is Mononucleosis?
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What are some common symptoms of Mononucleosis?
What are some common symptoms of Mononucleosis?
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What are some important considerations with a Mononucleosis patient's physical exam?
What are some important considerations with a Mononucleosis patient's physical exam?
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What are important guidelines for patients with Mononucleosis and their physical activity?
What are important guidelines for patients with Mononucleosis and their physical activity?
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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.
