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30 Cards in this Set
- Front
- Back
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Inflammation of the middle ear is?
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Otitis media
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Please describe the difference between acute, subacute, and chronic otitis media
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Acute OM - rapid onset of signs & sx, < 3 wk course
Subacute OM - 3 wks to 3 mos Chronic OM - 3 mos or longer |
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Amoxicillin MOA? what virulence factor makes it less effective?
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they are in the penicillin family
break down cell wall b-lactamase makes it less effective |
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diagnosis of acute otitis media requires the presence of middle ear effusion and most of the following... 4
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Otalgia
Otorrhea Bulging red or yellow TM Fever |
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why are kids more likely to get acute otitis media?
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pretty straight shot to the ear drum and the tube is narrow
short distance, more horizontal, they put stuff in there |
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Pathogenesis of acute otitis media?
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Eustachian tube dysfunction → bacteria multiply → effusion/suppuration → perforation and/or resolution
note the initial dysfunction is usually caused by viral infections |
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What is the precipitating event leading to AOM? what is the causitive agent
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viral infection
most likely RSV, then parainfluenza |
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What is the common bacteria that causes AOM? When does this occur?
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bacterial infection occurs after the initial viral infection (RSV)
most common bacteria: Haemophilus influenzae nontypable (40-50%) (followed by Streptococcus pneumoniae (20-30%) Moraxella catarrhalis (15-20%) |
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Gram postive, lancet shaped, diplococci...
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strep pneumo
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what allows strep pneumo to live in the body? (this was on the last test)
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polysaccharide capsle
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Moraxella catarrhalis
gram stain? |
Gram negative diplococcus
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Moraxella catarrhalis
oxidase? |
Positive
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Moraxella catarrhalis
Virulence factors? 4 |
Endotoxin
Pili for adherence Protein confers resistance to MAC Lactoferrin |
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when a child has an ear infection what should be your first consideration for treatment?
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watch and wait... it will likely clear up in 48 hours
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if a child is >2 years and afebrile, what should be your treatment for OM?
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consider analgesic without antibiotics
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how necessary is antibiotic treatment for ear infection?
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Must treat 17 children with antibiotics to prevent 1 child from having pain beyond 2 days!
so basically not that necessary! |
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what can you expect in the middle ear following resolved AOM?
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Expect a middle ear effusion for 1-3 months following resolved AOM
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patient presents with unilateral facial pain, maxillary toothache, and symptoms lasting longer than 10-14 days... what do they have?
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bacterial sinusitis
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what is the Most important pathologic process in sinusitis?
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obstruction of natural ostia
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what is the pathophysiology of sinusitis?
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obstruction of natural ostia
Obstruction leads to hypooxygenation Hypooxygenation leads to ciliary dysfunction and poor mucous quality Ciliary dysfunction leads to retention of secretions |
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major causes of acute sinusitis? Most often?
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respiratory viruses--MOST OFTEN (probably a cold)
Bacteria: strep pneumonaie, haemophilus influenzae nontypable |
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what do antibiotics do for patients with sinusitis?
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antibiotics are at best helpful in decreasing symptoms for a few days, without affecting cure rates or complications
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what do you want to do for a patient with acute sinusitis?
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Acute maxillary sinusitis commonly resolves spontaneously... so you want to wait
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if you do decide to treat sinusitis with drugs, what would you use for uncomplicated situations?
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14 days amoxicillin
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if you do decide to treat sinusitis with drugs, what would you use for complicated situations? 4
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Azithromycin
Fluoroquinolones Ceftriaxone Augmentin |
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what is our strongest reason to treat sinusitis with antibiotics?
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Length of symptoms (2 weeks minimum) should be your strongest reason to treat with antibiotics
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what does green snot with sinusitis indicate?
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NOTHING
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what is the cornerstone of non-antibiotic treatment in acute sinusitis?
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drainage usually with topical decongestants and sometimes antihistamines
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Moraxella catarrhalis can cause what problem? In a list of causitive agents, where does it fall?
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AOM
remember that this is normally viral (RSV) then bacterial...even then it falls behind Haemophilus influenzae nontypable and strep pneumo |
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major cause of acute sinusitis?
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viral
thus antibacterials don't do much |
