Otitis Media With Effusion

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| By Pascolini

Pascolini

Community Contributor

Quizzes Created: 8 | Total Attempts: 6,713

Questions: 10 | Attempts: 412 | Updated: Mar 22, 2023

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Baileys 90/91 - OME answer as asked

Questions and Answers

1.

Owing to eustachain tube complications the angle in an infant is
- A.
  
  10 degrees
- B.
  
  20 degrees
- C.
  
  30 degrees
- D.
  
  40 degrees
Correct Answer
A. 10 degrees

Explanation
The angle in an infant is 10 degrees due to eustachian tube complications. The eustachian tube is responsible for equalizing pressure between the middle ear and the back of the throat. In infants, the eustachian tube is shorter and more horizontal, making it more difficult for fluid to drain properly. This can lead to complications such as ear infections and a buildup of fluid in the middle ear, causing the angle to be smaller than in adults.

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2.

In large cohort studies the numeral pressure gradient across a tympanic membrane in a pediatric patient is
- A.
  
  0-100 mmHg
- B.
  
  -10-75 mmHg
- C.
  
  0-175 mmHg
- D.
  
  1-200 mmHg
Correct Answer
C. 0-175 mmHg

Explanation
In large cohort studies, the numeral pressure gradient across a tympanic membrane in a pediatric patient can range from 0 to 175 mmHg. This means that the pressure difference between the outer and middle ear can vary within this range in different patients. It is important to measure and understand this pressure gradient as it can provide valuable information about the health and functioning of the middle ear in pediatric patients.

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3.

In the first year of life what percentage of children experience OME
- A.
  
  25%
- B.
  
  50%
- C.
  
  75%
- D.
  
  >90%
Correct Answer
B. 50%

Explanation
In the first year of life, approximately 50% of children experience OME (Otitis Media with Effusion). OME is a common condition characterized by the accumulation of fluid in the middle ear, often causing temporary hearing loss. This prevalence suggests that OME is a relatively common occurrence among infants, highlighting the importance of early detection and appropriate management to prevent any potential long-term effects on speech and language development.

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4.

Several large meta-analysis studies have proven the benefit of decongestants in the prevention and treatment of OME
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
The given statement is false. Several large meta-analysis studies have actually found no significant benefit of decongestants in the prevention and treatment of OME (Otitis Media with Effusion). Therefore, the correct answer is false.

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5.

The second most common pathogen in OME is
- A.
  
  H. flu type E
- B.
  
  H. flu (nontypable)
- C.
  
  S. pneumonia
- D.
  
  M. cat
Correct Answer
B. H. flu (nontypable)

Explanation
The correct answer is H. flu (nontypable). OME stands for Otitis Media with Effusion, which is a condition characterized by the presence of fluid in the middle ear. Among the given options, H. flu (nontypable) is the second most common pathogen associated with OME. H. flu refers to Haemophilus influenzae, a bacterium that can cause various respiratory infections. The nontypable strains of H. flu do not possess a specific outer capsule, making them more difficult to classify. These strains are commonly found in cases of OME, contributing to the development of the condition.

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6.

Of which of the following isolates are most likely to be Beta lactamase
- A.
  
  H. flu
- B.
  
  S. pneumonia
- C.
  
  Staph. Aureus
- D.
  
  M. cat
Correct Answer
D. M. cat

Explanation
M. cat refers to Moraxella catarrhalis, which is most likely to be Beta lactamase. Beta lactamase is an enzyme produced by certain bacteria that can break down beta-lactam antibiotics, rendering them ineffective. Moraxella catarrhalis is known to produce beta-lactamase and is therefore more likely to be resistant to beta-lactam antibiotics compared to the other isolates mentioned.

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7.

Which of these prevention measures has shown to decrease incidence of AOM
- A.
  
  Oral decongestants in child care patients
- B.
  
  Breastfeeding in the first six months
- C.
  
  Oral vitamins B and C
- D.
  
  Hand sanitizer
Correct Answer
B. Breastfeeding in the first six months

Explanation
Breastfeeding in the first six months has shown to decrease the incidence of Acute Otitis Media (AOM). Breast milk contains antibodies and other immune-boosting components that help protect infants against infections, including AOM. It also promotes the development of a healthy immune system, reducing the risk of ear infections. Studies have shown that exclusively breastfeeding for the first six months can significantly decrease the occurrence of AOM in infants.

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8.

A three year old male presents with a 30 db hearing loss for last 13 weeks. Currently the patient has just finished a 2 week course of Augmentin 90 mg/kg. Pt currently denies pain. What is the appropriate next step?
- A.
  
  Repeat Augmentin
- B.
  
  Conservative Observation
- C.
  
  Myringotomy with PE tube
- D.
  
  Bactrim DS for ten days if not allergic
Correct Answer
C. Myringotomy with PE tube

Explanation
Based on the given information, the three-year-old male has been experiencing a 30 db hearing loss for the past 13 weeks and has just completed a two-week course of Augmentin. Since the patient currently denies pain, it suggests that the hearing loss may be due to fluid buildup in the middle ear rather than an infection. Therefore, the appropriate next step would be to perform a myringotomy with PE tube insertion. This procedure would help drain the fluid and relieve the hearing loss.

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9.

A 9 month old female presents to ED with a 48 hour hx of fever and fussy with decreased PO intake. Exam shows AOM and III/VI H-B facial paresis. CT scan shows no focal abscess. Next clinical step is
- A.
  
  Admission and IV beta lactam abx
- B.
  
  Immediate mastiodectomy and CN VII decompression
- C.
  
  Myringotomy with PE tube and IV Abx
- D.
  
  IV Beta lactam and high does IV steroids
Correct Answer
C. Myringotomy with PE tube and IV Abx

Explanation
The correct answer is Myringotomy with PE tube and IV Abx. This is the next clinical step because the patient has acute otitis media (AOM) with facial paresis, which suggests mastoiditis. Myringotomy with PE tube placement allows for drainage of the middle ear and relief of symptoms. IV antibiotics are necessary to treat the infection. Immediate mastoidectomy and CN VII decompression would be indicated if there were signs of complications such as a focal abscess, but the CT scan showed no evidence of this. IV beta lactam and high dose IV steroids are not the appropriate next step in management.

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10.

Adenoidectomy does decrease time to OM in the reccurent OME
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
Adenoidectomy, the surgical removal of the adenoids, has been shown to decrease the time to onset of otitis media (OM) in cases of recurrent otitis media with effusion (OME). OME is a condition characterized by the presence of fluid in the middle ear without signs of acute infection. Adenoids can contribute to the development of OME by blocking the Eustachian tube, which can lead to fluid buildup in the middle ear. By removing the adenoids, the obstruction is eliminated, reducing the occurrence and duration of OME. Therefore, the statement that adenoidectomy decreases time to OM in recurrent OME is true.

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Otitis Media With Effusion

Owing to eustachain tube complications the angle in an infant is

In large cohort studies the numeral pressure gradient across a tympanic membrane in a pediatric patient is

In the first year of life what percentage of children experience OME

Several large meta-analysis studies have proven the benefit of decongestants in the prevention and treatment of OME

The second most common pathogen in OME is

Of which of the following isolates are most likely to be Beta lactamase

Which of these prevention measures has shown to decrease incidence of AOM

A three year old male presents with a 30 db hearing loss for last 13 weeks. Currently the patient has just finished a 2 week course of Augmentin 90 mg/kg. Pt currently denies pain. What is the appropriate next step?

A 9 month old female presents to ED with a 48 hour hx of fever and fussy with decreased PO intake. Exam shows AOM and III/VI H-B facial paresis. CT scan shows no focal abscess. Next clinical step is

Adenoidectomy does decrease time to OM in the reccurent OME