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ER -2- Ear

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
What are the primary causes of otalgia   trauma, infections, foreign bodies, cerumen impaction, cholesteatoma, neoplasms  
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What are the secondary causes of otalgia   TMJ disease, abscessed teeth, malocclusion, bruxism, trauma, tonsillitis, abscess, neoplasms  
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What are the predisposing factors for developing otitis externa   trauma to skin of external auditory canal, elevation of local PH, constant contact with water/humid environments  
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What are the most likely organisms to cause otitis externa   pseudomonas and staph aureus are most common also consider otomycosis in immunocompromised patients (DM, HIV and CA)  
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What is the tx for otitis externa   analgesia, cleansing of EAC, acidifying agents, topical antimicrobials. Cortisporin Otic  
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What for of Cortisporin Otic should you use always because of ototoxicity concern when you use it to tx otitis externa   always use suspension and not solution  
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What is a good med to treat both the staph and pseudomonal causes of otitis externa   quinolones only topical Ofloxacin is approved by FDA for tx of TM if perforation exists  
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What is the potentially life threatening form of otitis externa   malignant otitis externa which extends from EAC into basilar skull,  
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What is the most common cause of malignant otitis externa   P. Aeruginosa  
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What is the progression of malignant otitis externa   starts as simple OE and then extends into the cartilage, periosteum, bone  
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What factors generally predispose a pt to developing malignant OE from just normal OE   elderly diabetic or Aids patient  
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If you have been tx a patient for Otitis externa and they have not started to improve after 2-3 weeks of meds what should you suspect may be happening   malignant otitis externa  
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What is the tx for malignant otitis externa   IV antibiotics, consult with ENT and get them admitted  
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What are the usual causes of otitis media   Strep Pneumoniae, H. Flu, M. Cat  
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What are some complications of otits media   TM perf, mastoiditis, meningitis, brain abscess, sinus thrombosis, cholesteatoma  
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What do you need to do if a pt presents with pain over the mastoid, post auricular erythema, swelling and protrusion of auricle   CT of mastoid check for mastoiditis  
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What tx would you likely give for mastoiditis   IV Ab, tympanocentesis and myringotomy  
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When would a bullous myringitis likely form   after an URI, they are very painful with a bulla forming on the TM and deep external auditory canal  
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What are the likely causes of bullous myringitis   mycoplasma pneumoniae, chlamydia psittaci or viral causes  
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What is the tx for bullous myringitis   warm compresses, analgesia, and Ab  
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If pt has a complete laceration of the external ear what should you do   probably refer to plastics or ENT as the cartilage has be approximated with 5-0 or 6-0 absorbable sutures  
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What is the rule of using Silvadene   no Silvadene above the clavicles due to skin pigmentation changes  
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When should you avoid irrigation to remove a foreign body   when you can't visualize the TM or perf is suspected or organic material that may expand if moistened  
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Where is the most likely place to have a TM perf   par tensa which is only a few cell layers thick  
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What may a pt complain of with TM perforation   acute onset of pain and hearing loss and possible bloody otorrhea may also complain of tinnitus, vertigo these may indicate injury to inner ear  
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T/F most TM perfs will heal on their own   T  
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IF the perforation is in the posterior superior quadrant what should you be concerned about   possible ossicular disruption so refer to ENT  
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Pt has a honey crusted lesion on their skin what is the likely cause   impetigo from strep pyogenes, group A strep or Staph aureus  
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