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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

Chronic Otits Media Tx

Long term aural ABX
Sometimes oral ABX