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