A patient's mother complains that her child seems to have a decreased response to sound. These are the possible causes.
What are infection, trauma, foreign object, and hearing loss?
100
Sucking motion and mastication
What are actions that aggravate acute otitis media?
100
The child is not reaching developmental milestones for language development and has had more than five episodes in one year of otitis media.
What is what determines the need for intervention and referral to an ENT when hearing loss is affecting language development?
200
This air-filled cavity containing the malleus, incus, stapes, the oval and round window and the opening of the eustachian tubes and the posterior side of the tympanic membrane.
What is the middle ear?
200
Bulging tympanic membrane; impaired visibility of ossicular landmarks; a yellow, white or bright red color; opacification of ear drum; squamous exudates or bullae on the ear drum.
What are otoscopic findings for acute otitis media?
200
When gathering a history of an infant that presents with signs and symptoms of otitis media, it is essential to ask about this type of history, as characteristics such as smoking increase the child's risk of developing acute otitis media.
What is an environmental history?
200
These are placed due to complications of otitis media, which include severe retraction of the tympanic membrane and multiple infections that have not been controlled with antibiotics. (Please view this image before answering: http://www.minti.com/image/36177/bilmyrintube.jpeg)
What are myringotomy tubes?
200
Acute otitis media with signs and symptoms such as fever, nausea, vomiting, and irritability.
What is when to prescribe Acetaminophen or Benzocaine with Antipyrine drops for pain and an appropriate antibiotic?
300
Passive smoking, crowded living, large family size, attending childcare, lack of breastfeeding, pacifier use, fall and winter seasons, and poverty or lower socioeconomic status.
What are environmental risk factors for otitis media?
300
Non-bulging ear drum, which may be retracted or neutral but always has decreased mobility, may have opacification, and may have white or amber discoloration.
What is otitis media with effusion, also known as serous otitis media?
300
When gathering a history, it is important to know a patient's antibiotic usage for this reason.
What is some antibiotics have ototoxic side effects?
300
This is the most common intracranial complication of otitis media. It is most commonly caused by Strep pneumoniae and spreads from the ear to the temporal bone. Symptoms include fever, confusion, and nucal rigidity.
What is meningitis?
300
Referral to an ENT for need of tympanostomy tubes.
What is what the PNP must consider after 10 to 14 days of treatment with appropriate antibiotics, no response to treatment, and recurrent otitis media?
400
This may decrease chances of otitis media, reflux, allergies and viral respiratory infections due to IgA transfer.
What is breastfeeding?
400
Strep pneumoniae (40-50%), H. Influenza (20-30%), Moraxella catarrhalis (10-15%), and Staph aureus (2-4%)
What are the most common bacterial pathogens causing acute otitis media?
400
Gathering a history of concurrent illnesses, especially upper respiratory infections, is essential in ruling out acute otitis media for this reason.
What is the mucous membranes of the eustachian tubes, mastoid, and middle ear are continuous with the respiratory system allowing easy access for infection to enter?
400
Symptoms may not be present in this type of otitis media.
What is serous otitis media?
400
A child needs to undergo hearing tests.
What is a child that has had otitis media with an effusion for three months?
500
During the second month of gestational development, cessation of cochlea development causes common bony abnormality of the inner ear, which results in congenital sensorineural hearing loss.
What is Mondini's deformity?
500
Predisposes children to chronic or recurrent otitis media.
What is chronic obstructive adenoidal hypertrophy?
500
This test detects increased levels of IgA or IgM, which are a result of Toxoplama, rubella, cytomegalovirus, syphillis, and herpes slimplex in the mother and newborn infant.
What is the TORCH test?
500
This complication is a result of chronic otitis media and is associated with dehiscence or destruction of the bony facial canal by cholesteatoma.
What is facial nerve palsy?
500
Antibiotics are not prescribed for otitis media with effusion when severe illness and irritability are not present and the child is over the age of two because 50 percent of otitis media externa (OME) cases resolve spontaneously without prescribed antibiotics.
What are the current recommendations from the American Academy of Pediatrics for the management of children presenting with otitis media with effusion.