NU 664 EXAM 1 QUESTIONS AND
CORRECT ANSWERS
Concurrent otitis media and conjunctivitis is likely due to which organism. ANSW✅✅Haemophilus
Influenza
Examination of TM ANSW✅✅Pull auricle down and back in children <3 Pull auricle up and back
for children >3
Conductive hearing loss ANSW✅✅hearing impairment caused by interference with sound or
vibratory energy in the external canal, middle ear, or ossicles
Sensorineural hearing loss ANSW✅✅hearing loss caused by damage to the cochlea's receptor
cells or to the auditory nerves; also called nerve deafness
Treatment of otitis externa ANSW✅✅Withdraw any foreign bodies or debri by gentle irrigation
Topical abx drops (ofloxacin) Insert cotton wick if significant swelling Analgesics Avoid getting ear
wet
Etiology of AOM ANSW✅✅After viral URI Highest incidence 6-36 months Winter/spring males
First line therapy for AOM ANSW✅✅Amoxicillin (cefdinir if allergy)
Second line therapy for AOM ANSW✅✅Augmentin (no improvement 48-72 hrs, recurrence within
1 month, concomitant conjunctivitis)
Third line therapy for AOM ANSW✅✅Ceftriaxone
If allergic to penicillin what do you treat the AOM with ANSW✅✅Cephalosporin
If a child is being treated for an AOM and is vomiting or unable to tolerate oral medication what do
you prescribe ANSW✅✅Rocephin IV or IM
, Otitis media with effusion what is the most common organism ANSW✅✅H. influenzae
What is the most common cause of hearing loss in children ANSW✅✅otitis media with effusion
Refer to ENT for AOM ANSW✅✅Persistent, resistant to treatment over 1-2 months; 3 infections
in 6 months or 4 infections in 1 year
Management/treatment of OME ANSW✅✅Most cases resolve w/o abx Limit use of abx
prophylaxis due to marginal benefit Limit passive smoking exposure, control allergies Referral to ENT
if persists >3 months f/u every 3-4 weeks
Treatment for chlamydia conjunctiva ANSW✅✅Systemic Erythromycin 50mg/kg/day in four
divided doses for 14 days or Azithromycin 20mg/kg for 3 days (not topical)
Chlamydia conjunctiva symptoms ANSW✅✅Begins 5-14 days of life up to 6 weeks; moderate
eyelid swelling and palpebral or bulbar conjunctival injection and moderate, thick, purulent
discharge, assess for systemic infection (pharyngitis, ear infection, pneumonia)
At 12 months of age the head and chest circumference should be ANSW✅✅Equal
Mastoiditis ANSW✅✅suppurative infection of the mastoid cells that may occur with AOM or
follow an AOM, mucoperiosteal lining of the mastoid air cells becomes inflamed with subsequent
progressive swelling and obstruction caused by drainage from the mastoid
What vaccines decrease the incidence of mastoiditis and what are the two most common causes?
ANSW✅✅Hib and S. pneumoniae are the 2 common causes Pneumococcal vaccine decreases
incidence
Mastoiditis management and treatment ANSW✅✅Urgent ENT referral, hospitalization, abx,
myringotomy, tube placement, mastoidectomy
What is the most common cause of otitis media ANSW✅✅Streptococcus pneumoniae
CORRECT ANSWERS
Concurrent otitis media and conjunctivitis is likely due to which organism. ANSW✅✅Haemophilus
Influenza
Examination of TM ANSW✅✅Pull auricle down and back in children <3 Pull auricle up and back
for children >3
Conductive hearing loss ANSW✅✅hearing impairment caused by interference with sound or
vibratory energy in the external canal, middle ear, or ossicles
Sensorineural hearing loss ANSW✅✅hearing loss caused by damage to the cochlea's receptor
cells or to the auditory nerves; also called nerve deafness
Treatment of otitis externa ANSW✅✅Withdraw any foreign bodies or debri by gentle irrigation
Topical abx drops (ofloxacin) Insert cotton wick if significant swelling Analgesics Avoid getting ear
wet
Etiology of AOM ANSW✅✅After viral URI Highest incidence 6-36 months Winter/spring males
First line therapy for AOM ANSW✅✅Amoxicillin (cefdinir if allergy)
Second line therapy for AOM ANSW✅✅Augmentin (no improvement 48-72 hrs, recurrence within
1 month, concomitant conjunctivitis)
Third line therapy for AOM ANSW✅✅Ceftriaxone
If allergic to penicillin what do you treat the AOM with ANSW✅✅Cephalosporin
If a child is being treated for an AOM and is vomiting or unable to tolerate oral medication what do
you prescribe ANSW✅✅Rocephin IV or IM
, Otitis media with effusion what is the most common organism ANSW✅✅H. influenzae
What is the most common cause of hearing loss in children ANSW✅✅otitis media with effusion
Refer to ENT for AOM ANSW✅✅Persistent, resistant to treatment over 1-2 months; 3 infections
in 6 months or 4 infections in 1 year
Management/treatment of OME ANSW✅✅Most cases resolve w/o abx Limit use of abx
prophylaxis due to marginal benefit Limit passive smoking exposure, control allergies Referral to ENT
if persists >3 months f/u every 3-4 weeks
Treatment for chlamydia conjunctiva ANSW✅✅Systemic Erythromycin 50mg/kg/day in four
divided doses for 14 days or Azithromycin 20mg/kg for 3 days (not topical)
Chlamydia conjunctiva symptoms ANSW✅✅Begins 5-14 days of life up to 6 weeks; moderate
eyelid swelling and palpebral or bulbar conjunctival injection and moderate, thick, purulent
discharge, assess for systemic infection (pharyngitis, ear infection, pneumonia)
At 12 months of age the head and chest circumference should be ANSW✅✅Equal
Mastoiditis ANSW✅✅suppurative infection of the mastoid cells that may occur with AOM or
follow an AOM, mucoperiosteal lining of the mastoid air cells becomes inflamed with subsequent
progressive swelling and obstruction caused by drainage from the mastoid
What vaccines decrease the incidence of mastoiditis and what are the two most common causes?
ANSW✅✅Hib and S. pneumoniae are the 2 common causes Pneumococcal vaccine decreases
incidence
Mastoiditis management and treatment ANSW✅✅Urgent ENT referral, hospitalization, abx,
myringotomy, tube placement, mastoidectomy
What is the most common cause of otitis media ANSW✅✅Streptococcus pneumoniae
