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CMN 568 Exam 1 questions with complete solutions.
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  • August 25, 2024
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  • 2024/2025
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  • cmn 568 exam 1 questions with complete solutions

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CMN 568 Exam 1 questions with complete
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proper \otoscopic \technique \- \(correct \answer) \-Proper \technique:

Note \that \he \is \bracing \his \finger \against \the \child's \cheek, \if \patient \moves, \so \does \otoscope

OTITIS \EXTERNA \- \(correct \answer) \-Cellulitis \of \the \soft \tissues \of \the \external \auditory \canal

-AKA \swimmers \ear

Otitis \externa \pathogens \- \(correct \answer) \-Pseudomonas \aeruginosa

Staphylococcus \aureus

Aspergillus \or \other \fungi \(especially \diabetics)

Risk \Factors \otitis \externa \- \(correct \answer) \-Moisture \in \the \ear \from \swimming, \showering, \etc

Trauma \to \the \external \canal \from \Q-tips, \ear \plugs, \hearing \aids, \or \scratching

Keeping \ears \too \clean \removes \protective \cerumen \and \increases \pH \which \promotes \bacterial \
growth

s/s \of \otitis \externa \- \(correct \answer) \-Edema \and \erythema \of \external \canal, \may \be \swollen

shut

Severe \ear \pain, \made \worse \by \movement \of \the \pinna \or \tragus

Purulent \discharge \from \the \external \canal, \canal \may \be \filled \with \debris, \making \visualization \
of \the \TM \difficult \or \impossible

May \have \periauricular \or \cervical \lymphadenopathy

,Differential \Dx \of \otitis \externa \- \(correct \answer) \-Acute \Otitis \Media \with \TM \rupture \or \
patent \PE \tubes

\• \Furunculosis \of \the \ear \canal, \Mastoiditis


treatment \of \otitis \externa \- \(correct \answer) \-Careful \exam \to \see \if \the \TM \is \intact. \If \you \can
\not \visualize \the \TM \due \to \swelling \or \debris, \you \MUST \assume \perforation \and \manage \
accordingly.

-Gentle \removal \of \debris \from \canal \if \possible. \If \TM \is \intact, \gently \irrigate \with \NS \and \a \
bulb \syringe. \Do \NOT \irrigate \if \TM \not \visualized.

Pain \control: \Tylenol \or \Ibuprofen \for \mild \pain, \may \need \narcotic \analgesic \for \severe \pain.

Antibiotics \for \otitis \externa \- \(correct \answer) \--Topical \eardrums \unless \signs \of \system \infection

-Fluoroquinolone \drops \are \first \line

-Neomycin/polymyxin \b/hydrocortisone \cream

-oral \atnitibiotcs \for \systemic

Fluoroquinolone \drops \- \(correct \answer) \-• \Covers \pseudomonas \and \Staph

• \Safe \to \use \if \TM \is \perforated \or \PE \tubes \are \in \place

Ciprofloxacin/dexamethasone \(Ciprodex) \contain \cipro \and \a

steroid \for \inflammation. \(4g \gtts \BID \x \7 \days)

Ciprofloxacin \otic \alone \(.25ml \BID \x \7days)

Ciprofloxicin \otic \liquid \to \gel \(Otiprio): \0.2ml \in \ear \x \1

Ciprofloxacin/dexamethasone \(Ciprodex) \- \(correct \answer) \-contain \cipro \and \a

steroid \for \inflammation. \(4g \gtts \BID \x \7 \days)

Ciprofloxacin \otic \alone \- \(correct \answer) \-(.25ml \BID \x \7days)

Ciprofloxicin \otic \liquid \to \gel \(Otiprio) \- \(correct \answer) \-0.2ml \in \ear \x \1

Neomycin/ \Polymyxin \B/ \Hydrocortisone \(Cortisporin \otic) \- \(correct \answer) \-• \3-4 \gtts \TID-QID \
for \7-10 \days• \Do \NOT \use \if \TM \is \perforated \or \PE \tubes \in \place

Use \of \an \ear \wick \- \(correct \answer) \--If \canal \is \swollen, \insert \a \Pope \ear \wick \to \allow \
antibiotic \drops \to \get \deep \into \canal.

-Insert \dry \wick, \then \moisten \with \ear \drops \to \expand

, -Wick \will \fall \out \when \swelling \decreases

Prevention \of \otitis \externa \- \(correct \answer) \-• \Avoid \vigorous \ear \cleaning \which \removes \
protective \cerumen \and \changes \pH

• \Avoid \use \of \Q-tips \which \can \damage \ear \canal

• \Use \drying \agents \after \swimming:• \2-3 \gtts \of \1:1 \solution \of \white \vinegar/ \70% \ethyl \
alcohol \• \Commercial \products \such \as \Swim \Ear \drops• \Acidify \and \dry \canal \to \inhibit \bacterial
\growth


Acute \otitis \media \(AOM) \- \(correct \answer) \-• \Acute \infection \of \the \middle \ear \space \with \
inflammation \and \effusion

• \2 \things \must \be \present \to \diagnose:

A \bulging \TM

Middle \ear \effusion \(MEE) \as \demonstrated \by \pneumatic \otoscopy \or \tympanometry

Pathogens \of \AOM \- \(correct \answer) \-• \Streptococcus \pneumoniae \(35-40%) \• \Haemophilus \
influenzae \(30-35%)• \Moraxella \catarrhalis \(15-25%)• \Streptococcus \pyogene

Risk \Factors \for \AOM \- \(correct \answer) \-Eustachian \tube \dysfunction: \equalizes \pressure \and \
allows \drainage \from \middle \ear. \Tubes \in \infants \are \shorter, \wider, \floppier \and \more \
horizontal \that \in \adults, \making \them \prone \to \dysfunction.

Bacterial \colonization \of \the \nasopharynx \with \AOM \pathogens

Viral \URI: \inflammation \of \eustachian \tubes \impairs \function \leading \to \middle \ear \effusion

Smoke \exposure: \inflames \eustachian \tubes, \impeds \drainage, \and \increases \pathogen \colonization

Clinical \Manifestations \of \AOM \- \(correct \answer) \-• \Symptoms:• \Ear \pain: \pulling \or \tugging \on \
ear \in \young \infant \• \Fever

Signs:

-Bulging, \inflamed \(erythematous) \TM

Signs \of \effusion: \decreased \mobility \of \TM \on \insufflation \with \pneumatic \otoscope \or \flat \
tympanometry \wave

-Loss \of \bony \landmarks \and \light \reflex \on \otoscopic \exam

-Yellow \or \white \effusion \behind \TM \(pus)

-Purulent \drainage \(otorrhea) \if \TM \is \ruptured \or \patent \PE \tubes \in \place

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