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CLIPP 14 18m Ears


How many words should a 18mo old say 3 words in addition to mama and dada
OTC cough and cold meds should not be used on kids <___ yo <2yo
define:otalgia rubbing or tugging at the ears
AOM resolves spontaneously how often? 50-80% of the time
Persistent URI xs >10days with day an dnight cought are most common in pediatric sinusitis
Ddx for: fever, tuggint at ears, congestion/rhinorrhea, cough AOM, URI, Sinusitis, Pneumonia, Allergies, OM
AOM v. OM AOM is a type of OM
Types of OM Acute (AOM) and Chronic (OME, persisetne performation of TM, and Chronic Suppurative Otitis Media CSOM)
Viral v. Bacterial Pneumonia viral (mod fever, nonprod cough, gradual onset of URT sx) and bacterial (high fever, prod cough, ill appearance and sometimes chest pain)
AOM --what is it fluid in middle ear with signs or sx of ear infx: bulging eardrum with ear pain, or perforated eardrum w purulent drainage
AOM risk factors daycare attendance, tobacco exposure, allergies, poor financially, pacifier use, bottle propping at bedtime, formula instead of breastfeeding, male, fam hx of AOM, AOM in first year of life, craniofacial structure abnormalities (Downs and cleft palate)
AOM complications mastoiditis, meningits, intracranial spread
AOM Etiology Bacterial v. Viral
AOM Bacterial MCC Strep pneumo, h. influinza, moraxella catarrhalis, strep pyogenes
AOM Viral MCC RSV, Influenza, Rhinovirs
AOM Tx 1st line and 2nd line amoxicillin (first line) and ceftriaxone, amoxicillin/clavulanate and cefuroxime
Don't treat AOM when kids >2yo unless severe illness, <2mo old always, 2-6mo only if you know they've got it
OME: what is it fluid in middle ear WITHOUT signs or sx of infection
When does OME occur? alone, secondary to URI, or consequence of AOM
OME tx abx not recommended; place tubes of persistent OME (with language delay or other risk factors)
Untreated OME complications permanent sensory neural hearling loss, tympanosclerosis, adhesive OM, cholesteatoma
what is cholestatoma? keratinizing squamous epithelium and its desquamated components within middle ear; sequela of middle ear perforations, severe retraction pockests or recurrent OM; complication of untreated OME
TM perforation associated with AOM usually heals within hours
if TM perforation does not heal, what happens? persistent drainage (otorrhea)
Chronic TM perforation tx observation for months to wait for closure
if Chronic TM perforation does not heal, then what? tympanoplastic surgery
What is CSOM? (Chronic Suppurative Otitis Media) chronic perforation and chronic drainage OM --> chronic inflammation of middle ear and mastoid
What causes CSOM? P aeruginosa, S. aureus
CSOM Tx ototopical meds (ofoxacin otic) may need IV abx and/or middle ear/astoid surgery if severe
What is Otitis Externa? Swimmer's ear: edematous external auditory canal and pain with retraction on earl lobe; can follow TM perf post AOM
What are complications of tympanostomy tupes? otorrhea, tympanosclerosis, nonfx tube due to blockage, residual perforaration after extrusion of tympanostomy tubes
AUDIOLOGY TESTS: what is a tympanogram? evaluates TM mobility
AUDIOLOGY TESTS: what is conventional audiometry? what age do you use it? >4yo; earhones t measure auditory thresholds in response to speech and frequency
AUDIOLOGY TESTS: what is "Visual Reinforcement Audiometry"? what age do you use it? 6mo-2.5y; behavioral test measuring response of kid to speech
AUDIOLOGY TESTS: what is "otoacoustic emissions" what age do you use it? newborns; measures cochlear fx in response to stimuli
Is a red ear alone a good predictor of AOM or fluid in middle ear? No
Created by: stephanie.thomas