Question 1

Which are risk factors for developing otitis externa? (Select all that apply.)&#10;A) Cooler, low-humidity environments&#10;B) Exposure to someone with otitis externa&#10;C) Having underlying diabetes mellitus&#10;D) Use of ear plugs and hearing aids&#10;E) Vigorous external canal hygiene

Accepted Answer

Otitis externa, often referred to as swimmer's ear, is an inflammation of the external ear canal. Risk factors include conditions that can lead to skin breakdown or moisture retention in the ear canal, facilitating bacterial or fungal growth. Diabetes mellitus (C) can impair healing and increase the risk of infections. The use of ear plugs and hearing aids (D) can trap moisture and provide a conducive environment for microbial growth. Vigorous external canal hygiene (E), such as aggressive cleaning with cotton swabs, can lead to microabrasions in the ear canal, disrupting the protective skin barrier and increasing infection risk. Cooler, low-humidity environments (A) and exposure to someone with otitis externa (B) are not recognized risk factors, as the condition is not typically airborne or directly contagious in the manner of respiratory or contact infections.

Question 2

A patient has an initial episode otitis external associated with swimming. The patient's ear canal is mildly inflamed, and the tympanic membrane is not involved. Which medication will be ordered?&#10;A) Cipro HC&#10;B) Fluconazole&#10;C) Neomycin&#10;D) Vinegar and alcohol

Accepted Answer

Cipro HC is a topical combination of an antibiotic (ciprofloxacin) and a steroid (hydrocortisone) that is commonly used to treat otitis externa, especially when associated with swimming. The antibiotic component helps to kill bacteria that may be present in the ear canal due to exposure to contaminated water, while the steroid helps to reduce inflammation and swelling. Fluconazole is an antifungal medication that is not usually effective against the bacteria that commonly cause otitis externa. Neomycin is an antibiotic that can be used to treat ear infections, but it is not as effective against the bacteria commonly found in otitis externa as ciprofloxacin. Vinegar and alcohol are sometimes recommended as a DIY remedy for ear infections, but there is little evidence to support their effectiveness, and they can actually make symptoms worse by drying out the ear canal and causing irritation.

Question 3

A patient reports a feeling of fullness and pain in both ears and the practitioner elicits exquisite pain when manipulating the external ear structures. What is the likely diagnosis?&#10;A) Acute otitis externa&#10;B) Acute otitis media&#10;C) Chronic otitis externa&#10;D) Otitis media with effusion

Accepted Answer

The symptoms of fullness and pain in both ears along with exquisite pain upon manipulation of the external ear structures point towards acute otitis externa, which is inflammation of the external auditory canal. Acute otitis media primarily affects the middle ear, and chronic otitis externa typically presents with persistent itching and discharge rather than pain. Otitis media with effusion is characterized by a feeling of pressure or fullness in the ear without pain.

Deck 67: Otitis Externa