CORRECT ANSWERS
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
What groups are at risk for AOM ANSW✅✅children younger than 24 months, recent beta-lactam
drugs, exposed to large number of other children, immune deficiency, smoke exposure in household,
bottle fed
With otitis media with effusion when should a myringotomy or tympanostomy tubes be considered
ANSW✅✅children 6 month to 12 years who have had bilateral effusion for a total of 3 months or
longer with documented hearing deficiency or for children with recurrent AOM who have evidence
of middle ear effusion at the time of assessment for tubes
Otitis Externa most common organism ANSW✅✅pseudomonas aeruginosa
Acute otitis externa discharge color ANSW✅✅scant white mucous
Chronic otitis externa discharge ANSW✅✅bloody
Fungal otitis externa discharge ANSW✅✅fluffy, and white to off-white discharge but may be
black, gray, bluish-green, or yellow
Retinoblastoma ANSW✅✅Tumor arising from a developing retinal cell
Leukocoria ANSW✅✅abnormal appearance of a white film in the pupil
Management/treatment of retinoblastoma ANSW✅✅Curable if diagnosed early Urgent referral to
pediatric ophthalmologist; eval within 72 hours Chemo, radiation, laser therapy and/or surgical
removal Genetic counseling
Hordeolum ANSW✅✅Infection of meibomian glands (internal) or glands of Zeis or Moll (external
or stye) of eyelid