Otitis Externa

Front 1

which endocrine disease is mostly associated with causing ear problems?

Back 1

HYPOthyroidism

Front 2

what should you consider if otitis externa fails to respond or if it gets worse after you start treatment?

Back 2

contact dermatitis

Front 3

what is the definition of otitis externa?

Back 3

inflammation of the external auditory canal, and it is a symptom not a disease

Front 4

is otitis externa more common in the cat or dog?

Back 4

the cat

Front 5

otitis externa in the cat is due to what half the time?

Back 5

ear mites - otodectes cyanotis

Front 6

the most recent classification scheme divides causes of externa into what three categories?

Back 6

predisposing
primary
perpetuating causes

Front 7

what are some examples of predisposing factors of otitis externa?

Back 7

ear canal conformation like stenotic ear canals, or increased number of ceruminous glands, hair in the canal, maceration from increased wetness
iatrogenic - too much ear cleaning

Front 8

which does NOT usually cause otitis externa: otodectes cyanotis, demodex or scabies?

Back 8

scabies - usually isolated to the ear margin and outer ear pinna

Front 9

is otitis externa caused by FB usually unilateral or bilateral?

Back 9

often unilateral and often never find the FB

Front 10

what is the most common cause of persistant or recurrent otitis externa in the dog?

Back 10

atopy

Front 11

when otitis externa is due to hypersensitivities, what does it start out looking like, and then progress to?

Back 11

usually starts out as redness of the inner pinna and vertical canal and then chronic inflamation leads to proliferative changes and secondary bacteria and yeast infections

Front 12

is otitis externa commonly seen with food allergies in dogs?

Back 12

yes up to 88% of dogs with food allergies have ear involvement

Front 13

breeds prone to what keratinization disorder tend to have otitis externa?

Back 13

idiopathic seborrhea

Front 14

how do keritinazation disorders with otitis externa often present?

Back 14

with chronic ceruminous otitis externa and they often have other skin problems

Front 15

dogs that have sebaceous adenitis may have ears that look how? describe.

Back 15

dry , scaly

Front 16

do immune-mediated diseases tend to involve the pinna or the canal more?

Back 16

the PINNA

Front 17

what types of lesions are seen in the ears with canine juvenile cellulitis?

Back 17

vesicles, pustules and papules/nodules and exudative otitis externa
dogs usually 3 weeks to 4 months old, and their muzzle and around the eyes is usually involved, enlarged LN

Front 18

from where can feline inflammatory polyps originate from?

Back 18

lining of the tympanic cavity, the auditory canal, the nasopharynx

Front 19

what is the most common external ear neoplasia in the dog and cat?

Back 19

ceruminous gland adenoma and AC

Front 20

what is a perpetuating factor? definiton and example

Back 20

one that can perpetuate the otitis even if the primary cause has been eliminated - like bacteria and yeast

Front 21

which bacteria is most commonlhy isolated in otitis externa?

Back 21

Staph intermedius

Front 22

which gram negative orgs are commonly isolated in otitis externa?

Back 22

Pseudomonas
Proteus
E. coli
Klebsiella

Front 23

how do the perpetuating factors bacteria and yeast perpetuate the problem?

Back 23

they proliferate thanks to changes in the microenvironmentdue to predisposing or primary factors

Front 24

which yeast is normally found in the ear canal in small numbers?

Back 24

Malassezia pachydermamtis

Front 25

what is probably the most complicating factor of allergic otitis?

Back 25

yeast

Front 26

what are three common treatment mistakes with treating otitis externa and what can happen as a result?

Back 26

overtreatment
undertreatment
wrong treatment
and can lead to chronic pathological changes in/of the ear

Front 27

what does ear discharge that looks like coffee grounds typical of?

Back 27

ear mites

Front 28

what is yellow to tan waxy, greasy discharge usually associated with?

Back 28

cocci, but sometimes a sign of yeast too, or a mixed infection

Front 29

what is purulent creamy to yellow exudates often seen with??

Back 29

gram neg infections like with Pseunomonas aeroginusoa which is also usually associated with very inflamed, eroded to ulcerated ear canals, and pain

Front 30

what are calcified or ossified cartilage of the external ear canal indicative of?

Back 30

chronicity

Front 31

what signs might you see in an animal with otitis externa with middle ear involvement?

Back 31

signs seen with facial nerve involvement
drooping of inability to move ear or lip
drooling
decreased or absent palpebral reflex
exposure kereatitis

Front 32

what signs might you see in an animal with otitis externa with inner ear involvment?

Back 32

head tilt
nystagmus
ataxia
circling

Front 33

if the mouth of a patient really hurts, which type of otitis may it have?

Back 33

media

Front 34

if an ear is so inflamed that you cannot do a decent ear exam, what can you do?

Back 34

start treating the inflammation and then take a good look in the ear in 4-7 days

Front 35

so for otitis externa you take two swabs from the ear. what are each for?

Back 35

one to look for mites or demodex
one to do cytology - do gram stain

Front 36

when treating otitis how often do you check the cytology?

Back 36

at every recheck

Front 37

when do you do a C&S?

Back 37

every time you see gram negative rods on cytology bc they could be Pseudomonas aeroginuosa or Proteus which easily develops resistance to antibiotics
also if empirical therapy doesn't work

Front 38

when are rads indicated?

Back 38

when otitis media is suspected

Front 39

when should you do a histopath?

Back 39

difficult to biopsy so do when do a lateral ear resection or ear canal ablation

Front 40

what is the goal of successful treatment?

Back 40

id-ing and resolving or controlling the predisposing and primary factors if possible

Front 41

in-hospital ear cleaning

Back 41

clinician or experienced tech should do
necessary to get a good look in ear - take a look at tympanic membrane to see if patent before cleaning. if you can't see it then use saline to clean

Front 42

how might you be able to tell if the tympanic membrane is ruptured if you cannot actually see it on examination?

Back 42

if hte animal gags, swallows or coughs when you put fluid in the ear

Front 43

is it a big deal if the tympanic membrane is ruptured as far as doing ear cleanigns?

Back 43

yes - there is no 100% safe way to clean ears when membrane is ruptured. even just using water can cause a loss of cochlear or vestibular function

Front 44

how do you choose the cleaning solution for at home ear cleanings?

Back 44

based on the type of exudate and degree of inflammation

Front 45

if the ear canals are eroded or ulcerated, which type of ear cleaners do you want to avoid?

Back 45

acidic solutions bc they will cause more pain and can make the inflammation worse

Front 46

how often should the owner clean the ears?

Back 46

depends on the severity of the condition, usually start with SID, then once a week is good for maintenance for recurrent cases, like in allergic animals

Front 47

if there are single or doublet gram positive cocci in the ear, what is this probably, and what should you use to tx it?

Back 47

Staph
neomycin, gentamycin or chloramphenicol

Front 48

if there are chains of gram positive cocci in the ear, what his this most likely to be, and what do you treat with?

Back 48

Strep
something with penicillin

Front 49

how do you treat for yeast in the ears?

Back 49

topical antifungals
may need po antifungals too

Front 50

many ear meds contain glucocorticoids. how do they help with inflammation of the ear?

Back 50

they decrease itching, swelling, exudate and tissue proliferation

Front 51

what can long term use of glucocorticoids in the ears cause?

Back 51

they can result in systemic absorption and cause liver enzymes to go up, and can suppress the adrenal response to ACTH

Front 52

how do you treat chonic proliferative otitis?

Back 52

need systemic steroids, and topical therapy too
***these ears will never get better so need to treat forever, and if ears are calcified med tx won't work and need to do sx

Front 53

what are some systemic antibiotics that are good for ear stuff based on C&S?

Back 53

Baytril
Zeniquin
Primor
TMS
Cephs

Front 54

is ototoxicity common or rare in vet memd?

Back 54

extremely rare

Front 55

when do you need to do ear sx on a patient?

Back 55

lateral ear resection - increases ventilation and drainage, not a cure but helps with medicating and tx
Vertical ear ablation - when proliferative changes are present in the vertical ear canal but the horizontal is not effected, but be aware that many animals will then develop an nfection in the horizontal canal after this sx
total ear ablation and lateral bulla osteotomy - severe irreversible proliferation and or calcification of auricular cartiilates of vertical and horizontal ear canals and otitis media; deafness, can get damage to facial nerve, which in most cases is reversible