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713: Wk 2 Otitis Media & Externa

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Answer
show Pain, otalgia, fever, irritability, URI signs & symptoms, night awakenings  
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OM physical exam   show
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Laboratory Findings of OM   show
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show Strep pneumonia (40-50%), H flu (40%), Moraxella catarrhalis, ALSO Group A Beta hemolytic strep, Staph aureus, anerobic bacteria, viruses  
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show HIB vaccine, & prevnair (pneumococcal) vaccine  
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RX for OM   show
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show not improved in 48-72 hours reevaluate, if no other pathology found, cover Beta Lactamase organism (augmentin) Supportive: antipyretics and analgesics Auralgan and Otocain topical pain meeds reevaluated after 3-4 weeks with an acute otitis media  
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show Defined as a chronic bacterial infection persisting more than 2 weeks Terms used synonymously Secretory otitis Serous otitis Chronic purulent otitis  
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OM with effusion   show
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Causative organisms of OM with effusion   show
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show Majority will clear spontaneously within 2 months Treatment if complications associated with chronic middle ear effusions- if kid already has hearing speech delay Investigate underlying etiology Sinusitis Allergy Immune deficiency Submucus cleft pa  
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show -watch & wait: reexamine 3 mth, refer at 6. Nonsurgical- abx = acute OM. Surgical: myringotomy with aspiration of fluid, PE tubes.  
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show Distinct acute episodes interspaced by periods of complete resolution- these are kids that need PE tubes  
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show First episode at age less than 6 months Siblings in home Patient is male Formula fed Day care attendance Cigarette smoke in home Cold weather months of the year  
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Rx for recurrent AOM   show
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When to refer recurrent AOM   show
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show Swimmer’s ear. Etiology: common in summer Water causes breakdown of protective lining, bacteria multiply Acute= localized. Chronic = Secondary infection from tympanic cavity discharge, multiple pathogens Malignant = Occurs in immunocompromised patients  
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show >2 years of age Swelling of ear canal Erythema and purulent exudate Mild to severe otalgia, especially with movement of the pinna Can be associated with concomitant acute otitis media, hearing loss, ear fullness, pressure, pruritis, and severe deep pa  
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Causative pathogens of ostitis externa   show
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show Topical antibiotics Cortisporin suspension Fluoroquinolones Ciprofloxacin Ofloxacin Fluoroquinolones with steroids Ciprodex OtoWick Analgesics  
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show Solutions of half alcohol and vinegar instilled into ear after swimming Molded ear plugs Particularly for PE tubes Referral Draining ear that persists for greater than 2 weeks with treatment  
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Cholesteotoma   show
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Complications of OM & OE   show
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Created by: JennRN
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