Flashcards in Middle Ear Basic Deck (30):
1
Acute Otitis media - ES cause
ES too small OR ES inflamed shut
2
Age range of eustachian tube growing
Birth - age 2
3
OM w/ diffusion fluid type
Clear
4
AOM - common bacteria
<3 months
E coli
S aureas
5
AOM - common bacteria
3 months - 14 years
S pneumoniae
H influenzae
M catarrhalis
6
AOM - common bacteria
>14 yrs
*S pneumoniae
*GAS (group a hemolytic strep)
*S aureus
7
Most frequent dx in sick children + most common antibio administration reason
Acute otitis media
8
Peak incidence AOM
6-18 months old
9
PCV 7 / 13 vaccines treat only
Strep pneumo
10
Risk factors for AOM
Smoke, pollution
Day care, family exposure
11
AOM presentation
OTALGIA, +/- OTORRHEA
Headache, apathy
12
AOM signs
fever, irritability, poor feeding
13
AOM = BC vs. AC?
BC>AC
14
Gold standard for AOM dx
pneumatic otoscopy
15
Good extra support evidence for AOM dx?
URI
16
AAP Dx
AOM , 6-12yo
Guidelines?
New otorrhea (w/o AOE)
Mod-Severe TM bulge
Mild TM bulge + otalgia
Mild TM bulge + TM erythema
17
AOM differential
AOE, OME, ETD, Cholesteatoma
18
AOM Tx general
Reduce pain
Antibio vs. watchful wait
19
AOM Tx
6 months-23 months
Severe - ABX
Not severe - ABX bilateral
-decide unilateral
20
AOM Tx
>24 months
Severe = ABX
Not severe = decide
21
AOM first line ABX
Amoxicillin 80-100mg/kg/day every 12 hrs x 10days
Amoxi clavulanate (augmentin)
22
AOM 2nd line ABX
Cefnidir
Cefuroxime
10 days
3RD gen cephalosporins
23
AOM 3rd line ABX
Azithromycin Z pack or single (x3)
Ceftriaxone
24
Follow up: when to suspect OME?
<2 yrs old + 8-12 weeks
>2yrs old + learning/language problems
25
AOM red flags
*Red swelling behind ear
*Spread bilateral in infant
*Persistent high grade (103) fever
26
Mastoiditis TX
Ceftriaxone IV
Mastoidectomy
27
Bullous Myringitis Tx
ABX
28
Recurrent AOM infxn Tx
(W/in 15 days of tx completion)
Change to Ceftriaxone or Levaquine
29
Chronic Otitis Media P.E.
TM perf
Polyps
Choesteoma
30