11/19/2013

11/19/2013

Answers:

How many episodes of AOM are required to diagnose "recurrent AOM"?
A) 2 in 6 months with complete resolution of symptoms 
B) 4 in six months without complete resolution of symptoms 
C) 4 in one year with complete resolution of symptoms 
D) 2 in one year without complete resolution of symptoms 
E) None of the above

Recurrent AOM = 3+ episodes in 6 months or 4+ in a year w/ complete resolution of symptoms in between episodes.

Name an example of both functional and anatomic eustachian tube dysfunction.

Functional = failure of tensor veli palatini to contract.  
Anatomic = Adenoid Hypertrophy

MC Questions:
All of the following are risk factors for AOM except...
A) Parental Smoking 
B) Daycare 
C) Allergic Rhinitis 
D) Breast Feeding 
E) Craniofacial Anomalies

Free Response Question:
The acronym "COMPLETES" is often used to help guide a thorough otoscopic exam. What does "COMPLETES" stand for?

Quick Facts:

Management of OM
-Most episodes of AOM resolve spontaneously.
-Only marginal benefit to using Abx.
-Amoxicillin is first line.
-Observation for 48hrs for fever or progressive symptoms is safe as well.
-Decongestants/vasoconstrictors/antihistamines have no impact.
-OME treated w/ observation/close follow up (if asymptomatic) or prolonged Abx (symptomatic)
-RCT show ABx indicated in OME.
-If Abx fail to improve symptoms in OME then surgical intervention is warranted.
-Abx prophylaxis for OME is unlikely to help.