1
ACAGNP NR569
CHAMBERLAIN ACAGNP NR569 DIFF
DX. FINAL EXAM| QS & AS| GRADE A|
(NEW 2026/ 2027)
Acute Otitis Media (AOM) - ANS ✓an infection of the middle ear space. Most
common in kids <8 yo
cause of acute otitis media - ANS ✓Often secondary to viral URI
w/eustachian tube dysfunction
Most common bacterial agent: Streptococcus pneumoniae
symptoms of acute otitis media - ANS ✓unilateral otalgia (ear pain), pulling
& tugging at the ears, irritability, headache, restlessness, poor feeding,
anorexia, vomiting, or diarrhea, ears feel full, low grade fever.
PE: tympanic membrane inflamed (erythema) and bulging, decreased light
reflex, decreased mobility on insufflation.
How is acute otitis media diagnosed? - ANS ✓clinical presentation
objective findings on physical exam (otoscopy) combined with the patient's
history and presenting signs and symptoms
Management of acute otitis media - ANS ✓-the goal of treatment is to
control pain and to treat the infectious process with antibiotics
-Adults with AOM should be treated with antibiotics: first line agent is
amoxicillin/clavulanate
ACAGNP NR569
, 2
ACAGNP NR569
-Recurrent cases that do not resolve despite treatment may need referral to
otolaryngologist
first line treatment for acute otitis media - ANS ✓amoxicillin 875 mg with
clavulanate 125 mg orally twice daily.
mild to moderate: five to seven days
severe: 10 days
otitis media with effusion - ANS ✓presence of fluid in the middle ear
without symptoms of acute infection.
As fluid builds up in the middle ear and Eustachian tube, it places pressure
on the tympanic membrane
precipitating factors of otitis media w/ effusion - ANS ✓URI
Symptoms of otitis media w/ effusion - ANS ✓hearing loss,
ear fullness,
complain of communication difficulties,
withdrawal, and lack of attention,
intermittent otalgia,
popping sensation of the ear
Management of otitis media w/ effusion - ANS ✓-Otitis media with effusion
generally resolves spontaneously with watchful waiting.
-However, if it is persistent, myringotomy with tympanostomy tube
insertion is considered an effective treatment.
ACAGNP NR569
, 3
ACAGNP NR569
Acute Otitis Externa (AOE) - ANS ✓is an inflammation, that can be either
infectious or non-infectious, of the external auditory canal. "Swimmers ear"
symptoms of Acute Otitis Externa (AOE) - ANS ✓complain of pruritus and
ear pain that is usually worse with manipulation of the tragus, pinna, or
both. It can also present with otorrhea, fullness sensation, and hearing loss.
Severity scale: Acute Otitis Externa (AOE) - ANS ✓-Mild: pruritus, mild
discomfort, and ear canal edema
-Moderate: ear canal is partially occluded
-Severe: The external ear canal is completely occluded from edema. There is
usually intense pain, lymphadenopathy, and fever.
Physical exam of Acute Otitis Externa (AOE) - ANS ✓Otoscopy will reveal an
erythematous and edematous ear canal with associated debris (yellow,
white, or gray).
Treatment of Acute Otitis Externa (AOE) - ANS ✓Topical antibiotics are the
treatment of choice for AOE, with or without steroids
Topical antibiotics are the preferred therapy because a higher
concentration of the antimicrobial can be delivered to the infected tissue
than systemic antibiotics
An ear wick may be inserted in the ear to facilitate installation of antibiotic
drops in a tight canal
Systemic antibiotics are not indicated unless the patient also has a co-
existing AOM infection
cholesteatoma - ANS ✓an abnormal skin growth or skin cyst trapped
behind the eardrum, or the bone behind the ear. begins as a build-up of ear
ACAGNP NR569
ACAGNP NR569
CHAMBERLAIN ACAGNP NR569 DIFF
DX. FINAL EXAM| QS & AS| GRADE A|
(NEW 2026/ 2027)
Acute Otitis Media (AOM) - ANS ✓an infection of the middle ear space. Most
common in kids <8 yo
cause of acute otitis media - ANS ✓Often secondary to viral URI
w/eustachian tube dysfunction
Most common bacterial agent: Streptococcus pneumoniae
symptoms of acute otitis media - ANS ✓unilateral otalgia (ear pain), pulling
& tugging at the ears, irritability, headache, restlessness, poor feeding,
anorexia, vomiting, or diarrhea, ears feel full, low grade fever.
PE: tympanic membrane inflamed (erythema) and bulging, decreased light
reflex, decreased mobility on insufflation.
How is acute otitis media diagnosed? - ANS ✓clinical presentation
objective findings on physical exam (otoscopy) combined with the patient's
history and presenting signs and symptoms
Management of acute otitis media - ANS ✓-the goal of treatment is to
control pain and to treat the infectious process with antibiotics
-Adults with AOM should be treated with antibiotics: first line agent is
amoxicillin/clavulanate
ACAGNP NR569
, 2
ACAGNP NR569
-Recurrent cases that do not resolve despite treatment may need referral to
otolaryngologist
first line treatment for acute otitis media - ANS ✓amoxicillin 875 mg with
clavulanate 125 mg orally twice daily.
mild to moderate: five to seven days
severe: 10 days
otitis media with effusion - ANS ✓presence of fluid in the middle ear
without symptoms of acute infection.
As fluid builds up in the middle ear and Eustachian tube, it places pressure
on the tympanic membrane
precipitating factors of otitis media w/ effusion - ANS ✓URI
Symptoms of otitis media w/ effusion - ANS ✓hearing loss,
ear fullness,
complain of communication difficulties,
withdrawal, and lack of attention,
intermittent otalgia,
popping sensation of the ear
Management of otitis media w/ effusion - ANS ✓-Otitis media with effusion
generally resolves spontaneously with watchful waiting.
-However, if it is persistent, myringotomy with tympanostomy tube
insertion is considered an effective treatment.
ACAGNP NR569
, 3
ACAGNP NR569
Acute Otitis Externa (AOE) - ANS ✓is an inflammation, that can be either
infectious or non-infectious, of the external auditory canal. "Swimmers ear"
symptoms of Acute Otitis Externa (AOE) - ANS ✓complain of pruritus and
ear pain that is usually worse with manipulation of the tragus, pinna, or
both. It can also present with otorrhea, fullness sensation, and hearing loss.
Severity scale: Acute Otitis Externa (AOE) - ANS ✓-Mild: pruritus, mild
discomfort, and ear canal edema
-Moderate: ear canal is partially occluded
-Severe: The external ear canal is completely occluded from edema. There is
usually intense pain, lymphadenopathy, and fever.
Physical exam of Acute Otitis Externa (AOE) - ANS ✓Otoscopy will reveal an
erythematous and edematous ear canal with associated debris (yellow,
white, or gray).
Treatment of Acute Otitis Externa (AOE) - ANS ✓Topical antibiotics are the
treatment of choice for AOE, with or without steroids
Topical antibiotics are the preferred therapy because a higher
concentration of the antimicrobial can be delivered to the infected tissue
than systemic antibiotics
An ear wick may be inserted in the ear to facilitate installation of antibiotic
drops in a tight canal
Systemic antibiotics are not indicated unless the patient also has a co-
existing AOM infection
cholesteatoma - ANS ✓an abnormal skin growth or skin cyst trapped
behind the eardrum, or the bone behind the ear. begins as a build-up of ear
ACAGNP NR569
