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7 Cards in this Set
- Front
- Back
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Otitis media - acute
- Mx - When to offer an immediate antibiotic prescription - Antiobiotic |
Paracetamol/ibuprofen
Systemically v. unwell High risk of complications: heart, lung etc AOM >4 days and not improving Child <2 with bilateral AOM Child with perforation or discharge ass with AOM
5 day course amoxicillin - double dose |
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Differential diagnosis middle ear inflammation
When to admit AOM |
URTI OME Acute mastoiditis Bullous myringitis - Mycoplasma pneumoniae
Acute complications: meningitis, facial paralysis or mastoiditis
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Chronic suppurative OM - Diagnosis - Mx |
- Ear discharge >2 weeks w/o pain + fever - Hx AOM - Painless ear examination - +/- hearing loss
- Refer to ENT |
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Otitis media with effusion - Prognosis - Mx - when would you refer? - Options in secondary care? |
Very good - 90% have resolution at 1 yr
Watchful waiting 6-12 weeks Refer if persistent, foul smelling discharge, significant impact of hearing loss
Non-surgical: active obs, hearing aids Surgical: grommets |
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Otitis externa - Risk factors - 4 symptoms to assess - Mx - Advice |
Diabetes, immunosuppression, water (swimmers), ear plugs, trauma, dermatoses, atopic dermatitis
Pain, discharge, itch and hearing loss
Paracetamol/ibuprofen Mild: topical acetic acid spray Severe: betnesol, otosporin, gentisone - abx and steroid combined Other considerations - ear wick, cleaning
No cotton buds, ears clean + dry, control skin conditions |
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Benign paroxysmal positional vertigo - Advice re course + safety - Mx - Referral |
Most people recover over several weeks Get out of bed slowly, don't drive if dizzy, let work know
Rx may help sx resolve more quickly - Epley manoeuvre (also Brandt-Daroff)
Refer to balance specialist - ENT, audiovestibular |
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Meniere's - Sx - Refer - Mx of acute attack - Prophylaxis |
Hearing loss, tinnitus and vertigo
To hospital if severe sx, otherwise to ENT for diagnosis
Acute attacks usually settle in 1-2 days, buccal prochlorperazine or antihistamine
Betahistine to reduce fx attacks |
