otitis media

Question 1

expected findings in a middle ear effusion (4)

Answer 1

ANY OF

• grey-white fluid behind tymp membrane
• loss of tymp membrane lucency
• type B tympanogram
• immobile tymp membrane on pneumatic otoscopy

Question 2

expected findings for middle ear inflammation (1)

Answer 2

bulging tympanic membrane

Question 3

otitis media - indications for antibiotic therapy (7)

Answer 3

personal factors

• infants < 6 months
• ATSI children
• high risk of complications - immunocompromised

disease factors

• younger than 2 with bilateral infections
• systemic unwellness ( sx +/- fever)
• otorrhoea
• failure to improve at 48-72 hours

Question 4

otitis media with effusion

• expected findings
• when is it considered persistent

Answer 4

signs of middle ear effusion, but no acute signs (pain, bulging tymp membrane)
persistent is >3 mo

Question 5

otitis media with effusion

- when to refer for tympanostomy tube

Answer 5

children with audiometry showing bilat hearing loss

Question 6

chronic suppurative otitis media

• definition
• management

Answer 6

• middle ear infection + otorrhoea, for at least 6 weeks

- ciprofloxacin 0.3% ear drops, 5 drops BD , until ear clear of discharge for 3/7

Question 7

recurrent acute otitis media

- definition (2)

Answer 7

> 3 episodes in 6 months
OR
4 episodes in 12 months

Question 8

management of recurrent AOM

• nonATSI
• ATSI

Answer 8

nonATSI - check strep vaccination up-to-date

ATSI - prophylactic amoxil 50mg/kg/day for 3-6 months

Question 9

acute otitis media requiring antibiotics

• nonATSI
• ATSI without perfo
• ATSI with perf

Answer 9

• amoxil 15mg/kg TDS 5 days
• do the same for 7 days
• do the same for 14 days

Question 10

paediatirc otitis media - non medical lifestyle things to consider (3)

Answer 10

avoid passive smoking exposure
check development milestones
good personal hygiene

Question 11

acute otitis media requiring antibiotics

- nonATSI

Answer 11

• amoxil 15mg/kg TDS 5 days

Question 12

acute otitis media requiring antibiotics

- ATSI without perforation

Answer 12

• amoxil 15mg/kg TDS 7 days

Question 13

acute otitis media requiring antibiotics

- ATSI with perforation

Answer 13

• amoxil 15mg/kg TDS 14 days

Question 14

complications of acute otitis media (7)

Answer 14

ears

• acute otitis media with perforation
• chronic suppurative otitis media
• persistent otitis media with effusion
• atelectasis of tymp membrane
• cholesteatoma (long term)

cranial

• acute mastoiditis
• meningitis
• facial nerve palsy