ER -2- Ear

Question Answer
What are the primary causes of otalgia trauma, infections, foreign bodies, cerumen impaction, cholesteatoma, neoplasms
What are the secondary causes of otalgia TMJ disease, abscessed teeth, malocclusion, bruxism, trauma, tonsillitis, abscess, neoplasms
What are the predisposing factors for developing otitis externa trauma to skin of external auditory canal, elevation of local PH, constant contact with water/humid environments
What are the most likely organisms to cause otitis externa pseudomonas and staph aureus are most common also consider otomycosis in immunocompromised patients (DM, HIV and CA)
What is the tx for otitis externa analgesia, cleansing of EAC, acidifying agents, topical antimicrobials. Cortisporin Otic
What for of Cortisporin Otic should you use always because of ototoxicity concern when you use it to tx otitis externa always use suspension and not solution
What is a good med to treat both the staph and pseudomonal causes of otitis externa quinolones only topical Ofloxacin is approved by FDA for tx of TM if perforation exists
What is the potentially life threatening form of otitis externa malignant otitis externa which extends from EAC into basilar skull,
What is the most common cause of malignant otitis externa P. Aeruginosa
What is the progression of malignant otitis externa starts as simple OE and then extends into the cartilage, periosteum, bone
What factors generally predispose a pt to developing malignant OE from just normal OE elderly diabetic or Aids patient
If you have been tx a patient for Otitis externa and they have not started to improve after 2-3 weeks of meds what should you suspect may be happening malignant otitis externa
What is the tx for malignant otitis externa IV antibiotics, consult with ENT and get them admitted
What are the usual causes of otitis media Strep Pneumoniae, H. Flu, M. Cat
What are some complications of otits media TM perf, mastoiditis, meningitis, brain abscess, sinus thrombosis, cholesteatoma
What do you need to do if a pt presents with pain over the mastoid, post auricular erythema, swelling and protrusion of auricle CT of mastoid check for mastoiditis
What tx would you likely give for mastoiditis IV Ab, tympanocentesis and myringotomy
When would a bullous myringitis likely form after an URI, they are very painful with a bulla forming on the TM and deep external auditory canal
What are the likely causes of bullous myringitis mycoplasma pneumoniae, chlamydia psittaci or viral causes
What is the tx for bullous myringitis warm compresses, analgesia, and Ab
If pt has a complete laceration of the external ear what should you do probably refer to plastics or ENT as the cartilage has be approximated with 5-0 or 6-0 absorbable sutures
What is the rule of using Silvadene no Silvadene above the clavicles due to skin pigmentation changes
When should you avoid irrigation to remove a foreign body when you can't visualize the TM or perf is suspected or organic material that may expand if moistened
Where is the most likely place to have a TM perf par tensa which is only a few cell layers thick
What may a pt complain of with TM perforation acute onset of pain and hearing loss and possible bloody otorrhea may also complain of tinnitus, vertigo these may indicate injury to inner ear
T/F most TM perfs will heal on their own T
IF the perforation is in the posterior superior quadrant what should you be concerned about possible ossicular disruption so refer to ENT
Pt has a honey crusted lesion on their skin what is the likely cause impetigo from strep pyogenes, group A strep or Staph aureus

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