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