11/20/2013

11/20/2013

Answers:

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

Breast feeding is actually protective and the absence of breast feeding is a risk factor for AOM/OME.

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

-Color
-Other
-Mobility
-Position
-Lighting
-Entire Surface
-Translucency
-EAC/Auricle
-Seal

MC Questions:
What is the first line antibiotic for AOM?
A) Vancomycin 
B) Cipro 
C) Amoxicillin 
D) Keflex 
E) Imipenem

Free Response Question:
What is a Bezold's abscess?

Quick Facts:

Petrositis
-rare
-infection spreads within temporal bone into petrous apex.
-Gradenigo’s syndrome = classic triad = rare = retro orbital pain, AOM, ipsilateral abducens nerve paresis.
-Confirm dx w/ film showing bony destruction of petrous apex.
Facial Nerve Paresis:
-two mechanisms:
-release of locally produces bacteria-mediated toxins
-direct effect of inflammatory tissue adjacent to facial nerve (as it traverses mastoid cavity)
-Difficult to pinpoint site of lesion: use emg, eng, MRI w/ gadolinium.
-In adults this is most often in cholesteatoma, in children it is most common in AOM.
Labyrinthitis:
-present w/ sudden SNHL, severe vertigo, nystagmus w/ n/v
-Caused by bacterial infection invading through round window causing suppurative labyrinthitis.
-Bacteria can track further to cochlear aqueduct creating conduit btwn perilymph and CSF = meningeal infiltration.
-Must dx and treat labyrinthitis quickly to prevent development of meningitis.