Diseases of the Ear Board Review Questions, Free CME Quick Quiz
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Diseases of the Ear Board Review Questions: Free CME Quiz
Ear Diseases CME Quiz courtesy of Med-Challenger Online Medical Education
This week's Med-Challenger free CME quiz - Diseases of the Ear - the quick quiz covers signs and symptoms of cholesteatoma, presentation of an early case of Ramsey Hunt Syndrome, etiology of otitis media (organisms), and work up of SSRI withdrawal dizziness.
A free sample Diseases of the Ear question included below. The full Diseases of the Ear CME quiz is free online for a limited time. You can earn AMA CME credit - and now you can earn ANCC contact hours as well! Play now.
QQ210617: Primary Immunodeficiency Disorders
1st Person of Interest
2nd Superagonist
Here's this week's sample CME board review question on diseases of the ear.
A mother brings in her fussy 8-week old boy who is found to have a markedly reddened tympanic membrane (TM) on the right that is different from his left TM.
The patient went through a normal pregnancy and a normal term vaginal delivery and is bottle-fed, which he continues to take well.
He has a 38.0 fever and appears vigorous with unlabored breathing.
What are the most likely pathogens to cause an acute otitis media in this patient?
Gram negative bacteria, Chalmydia trachomatis, Streptococcus pyogenes
Streptococcus pyogenes, Staphylococcus aureus, gram-negative bacteria
Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella (Branhamella) catarrhalis
Staphylococcus aureus, Chlamydia trachomatis, Haemophilus influenzae
Discuss the shift in typical organisms in recent years that cause acute otitis media (AOM) in healthy newborns.
Newer studies have found that healthy newborns with AOM (a rare event) are infected with the same organisms as older children and adults with AOM.
Formerly, the most common causes of bacterial infection in children were Streptococcus pneumoniae, Haemophilus influenzae (primarily nontypeable), and Moraxella (Branhamella) catarrhalis.
Due to the widespread vaccination with the 13-valent (and 7-valent) pneumocioccal vaccine, the incidence of Streptococcus pneumonia AOM has decreased sharply, with a concomitant increase in nontypeable Haemophilus influenza AOM.
Only newborns that require neonatal intensive care or intubation tend to have different pathogens (Staphylococcus aureus and gram-negative bacteria).
Studies have found viruses to be present as a co-infection in 90% of AOM, but as the sole organism in only 5-6% of cases.
The following pathogens are all uncommon in very young patients with an isolated AOM: mycoplasma, mycobacterium tuberculosis (more common in older children) and Chlamydia trachomatis (mostly in children under 6 months of age with concomitant pneumonia and possibly conjunctivitis).
Pearls: The H. flu vaccination protects against invasive disease (meningitis, sepsis, pneumonia) caused by encapsulated H. flu organisms (eg. H. flu type B). The non-encapsulated H. flu organisms are NOT targeted by the H. flu vaccine and have actually risen in incidence. They cause less invasive disease – most commonly otitis media in all age groups.
Pfaff JA. Moore GP. Otolaryngology. (Chapter 62) In: Walls R, et al. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed., 2018: 820 -831.e2
Haemophilus influenzae Disease (Including Hib). Centers for Disease Control and prevention.
Tags:bacteria, board review, Branhamella, catarrhalis, ear, ear pain, eent, haemophilus, infection, influenzae, Moraxella, pediatrics, pneumoniae, quick quiz, streptococcus, treatment