CMN-568 Test Questions Correctly Answered & Verified

CMN-568 Test Questions Correctly Answered & Verified Otitis Externa - ANSWER Inflammation of skin lining the ear canal and surrounding soft tissues from loss of protective ear wax. Can be from swimming, trauma, contact dermatitis, or secondary infections from OM. Usually S. aureus or Peudomonas. Present with pain and itching in ear and with movement of earlobe. minimal drainage unless TM is punctured. normal hearing. Give Fluoroquinolone ear drops. Keep ear dry and follow up in 1 week. Acute Otitis Media - ANSWER infection with middle ear effusion and ear drainage. Symtoms must be acute, there must be inflammation, and there must be fluid in the middle ear. present with bludging TM, impair visibility of ossicular landmarks, inflammated ear drum, and yellow or white effusion. usually preceded by URI. Usually RSV, influenza, M. cat, or Strep pyogens. Give Amoxicillin 90/mg/kg. (If child is older than 2 and with nonsever dx, watch for 48-72 hrs). If clinical failure after 3 days (usually influenzae), give Amoxicillin Clavulante 90/mg/kg/d. Cephalosporins are a good alternitive if rash occurs from amoxicillin. Do not give macrolides because of resistance Management of OM - ANSWER stop smoking in house, stop day care, stop pacifiers, stop proping bottle in crib, start breast feeding. PCV13 vaccine. If effusion presists, observe for 4 months. NO ABX. tube placment if longer than 4 months and 20 dB hearing loss. Mastoiditis - ANSWER Middle ear infection spreads to mastoid bone. Present with postauricular pain, fever, and displaced pinna. Mastoid itself appears red and swollen. AOM is ALWAYS present. Usually S. pneumoniae, S. aures, H. influenzae, or Strep pyogens. Need CT scan. Monitor for sinus thrombosis or abscess. Need myringotomy, with or without tube placement, cipro ear drops, and IV ceftriazone and Clindamycin. If clinical failure in 2 days, surgical drainage needed. then continue PO ABX for 3 weeks. Acute Trauma to middle ear - ANSWER from head injuries, blow to the ear, sudden impact, or perforated TM from objects inserted into ear. ABX not necessary. watch and wait. If not hearing change, no need to refer. If hearing changes, REFER. hearing should return in 6-8 weeks. Perferted TM may or may not heal on its own. Foreign Bodies in Ear - ANSWER if object is large, wedged, or difficult to remove, REFER! Emergency if it is a battery: causes burns and scaring. Hematoma of Pinna - ANSWER boggy purple swelling on the upper half of ear from trauma. can lead to necrosis and cauliflower ear. REFER for drainage and pressure dressing application. Atreasia of ear Canal - ANSWER congential ear malformation. closure of the ear canal. results in conductive hearing loss. refer within the first 3 months of life Low-set ears - ANSWER upper pole is below eyebrow. associated with renal disorders because developed during the same time of embrygenesis. need renal u/s ASAP Conductive hearing loss - ANSWER blockage of sound transmission. Commonlly from fluid in middle ear, ear wax, eustachian tube dysfunction, atresia, or middle ear abnormalities. correctable with surgery. assess hearing in children with recurrent OM for 3 months or longer Sensorineural Hearing Loss - ANSWER defect in the cochlear hair cells or auditory nerve (CN VIII). can be congenital or acquired, hereditary or nonhereditary. Not reversable. need plavement of cochlear implantation Congenital hearing loss- prenatal infections, tertogenic drugs, perinatal inuries, mutation in GJB2 gene, or be part of a syndrome. Acquired Hearing loss-meningitis, ototoxic meds (such as aminoglycosides and diuretics), noise exposure, trauma, CMV or syphilis infection. hearing loss can lead to communication impairment, delayed development, or difficulties in scool or behavior. Acute Viral Rhinitis - ANSWER the common cold. very common in children. Usually Rhinoviruses, enterovirus, influenza, or RSV. present with clear pr mucoid runny nose, nasal congestion, sore throat or sneezing (sometimes fever). nose, throat, and TM are red. treatment is symtomatic and usually resolves in 7-10 days. can lead to bacterial rhinosinusitis or PNA Acute Bacterial Rhinosinusitis - ANSWER Bacterial infection of paranasal sinusus. lasts less than 30 days. always preceded by viral URI that does not get better in 10 days (URI=mucosal injury and swelling leading to obstruction loss of ciliary function, and mucous hypersecretion). symptoms include viral rhinitis and also headache, facial pain, fev