I can't hear you
What type of delay might you see if you are concerned your patient has hearing loss?
Speech delay, would refer to EI with any hearing loss
"Swimmers ear" is synonymous to what infection of the ear
Otitis externa
What is the standard treatment and dosing for an uncomplicated bacterial AOM?
High dose Amoxicillin, 90 mg/kg/day split BID
Tugging at ears is a reliable exam finding for otitis media.
False
What are the two types of hearing loss?
Conductive – More common type of hearing loss due to disruption of mechanical components required for transduction of sound wave energy.
Sensorineural hearing loss – less common; caused by dysfunction of sensory epithelium, cochlea, or neural pathway connecting to auditory cortex via Cranial Nerve 8; usually more severe and affects higher frequencies.
How long after initiation of antibiotic therapy with worsening or no improvement would you consider treatment failure or consider switching antibiotics for AOM
72 hours
What is the standard treatment for mild-moderate otitis externa?
Topical (ear drops) fluoroquinolone-containing agent: Polymyxin b/Neosporin, Ciprofloxacin, ofloxacin
Viruses are the most common cause of AOM.
True
List at least 2 causes of conductive hearing loss (extra 50 pts for each additional)
Cerumen impaction, foreign body, middle ear infection/effusion, tumor/growth, congenital abnormality of ear, perforated TM
What are the three most common bacteria associated with acute otitis media
Strep pneumoniae, non-typeable H. Influenzae and Moraxella
What is one (of two) reasons you may favor Augmentin use over amoxicillin in AOM
Concurrent conjunctivitis or amoxicillin within the last 30 days
AOM is typically painful when pulling on ear.
False, usually an exam finding for otitis externa
List at least 2 causes of sensorineural hearing loss (25 extra pts for each additional answer)
Aging, loud noises, trauma, genetic, infection, Ototoxic drugs [aminoglycosides]
Infections: CMV, Toxoplasma, rubella, syphilis, meningitis due to H influenza and Pneumococcal infection (Routine vaccination has reduced the incidence of infections resulting in hearing loss).
What are the two most common causative bacteria in otitis externa?
Pseudomonas and staph. aureus
What frequency of AOM is considered recurrent and warrants ENT referral?
3 or more infection in 6 months or 4 or more infections in 12 months
Swimming is the most common way to contract otitis externa
What are the three options for treating hearing loss?
Hearing aides, cochlear implants, auditory brain stem implant
What vaccine has been responsible for shifting the most common cause of bacterial AOM to Non-typeable H. Influenza and what was the leading cause?
Pneumococcal conjugate vaccines (PCVs)
What is the duration of treatment for AOM by age
<2 years old, 10 days of antibiotics
>2 years old, 5 days of antibiotics
A perforated tympanic membrane changes the duration of antibiotic course.
True, increases to 10 days