Exam (elaborations)
CMN 568 Exam 1 QUESTIONS AND ANSWERS (2024/2025) (VERIFIED ANSWERS)
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CMN 568 Exam 1 QUESTIONS AND ANSWERS (2024/2025) (VERIFIED ANSWERS)
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CMN 568 Exam 11. proper otoscopic technique: Proper technique:
Note that he is bracing his finger against the child's cheek, if patient
moves, so does otoscope
2. OTITIS EXTERNA: Cellulitis of the soft tissues of the external auditory
canal
-AKA swimmers ear
3. Otitis externa pathogens: Pseudomonas
aeruginosa Staphylococcus aureus
Aspergillus or other fungi (especially diabetics)
4. Risk Factors otitis externa: 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 pro- motes bacterial growth
,5. s/s of otitis externa: 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
6. Differential Dx of otitis externa: Acute Otitis Media with TM rupture or
patent PE tubes
•Furunculosis of the ear canal, Mastoiditis
7. treatment of otitis externa: 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.
8.Antibiotics for otitis externa: -Topical eardrums unless signs of system
infection
-Fluoroquinolone drops are first line
-Neomycin/polymyxin b/hydrocortisone cream
-oral atnitibiotcs for systemic
9. Fluoroquinolone drops: • 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
, 10.Ciprofloxacin/dexamethasone (Ciprodex): contain cipro
and a steroid for inflammation. (4g gtts BID x 7 days)
11.Ciprofloxacin otic alone: (.25ml BID x 7days)
12.Ciprofloxicin otic liquid to gel (Otiprio): 0.2ml in ear x 1
13.Neomycin/ Polymyxin B/ Hydrocortisone (Cortisporin otic): • 3-4
gtts TID-QID for 7-10 days• Do NOT use if TM is perforated or PE
tubes in place
14.Use of an ear wick: -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
15.Prevention of otitis externa: • 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
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