CMN 568 - Unit 1 (Part 1) Exam
Questions and Answers
Essentials of diagnosis: Otitis externa (OE) - Correct Answer ✅
1) RAPID ONSET of symptoms in last 3 weeks, AND
2) Symptoms of ear canal inflmamatino, including otalgia, itching,
or fullness, with or without hearing loss or jaw pain, AND
3) Signs of ear canal inflammation
Differential - Acute otitis media with TM rupture, furunculosis
(boils) of ear canal, herpes zoster oticus, mastoiditis.
Essentials of diagnosis: Acute Otitis Media (AOM) - Correct
Answer ✅ 1) Moderate to severe bulging of tympanic membrane
(TM) or new otorrhea not associated with otitis externa (OE)
2) Mild bulging of the TM AND less than 48 hours of otalgia or
intense erythema of TM
3) *Middle ear effusion*, proven by pneumatic otoscopy or
tympanometry must be present!
*--Classic Case--*
+ Complains of ear pain (otalgia), popping noises, muffled
hearing.
+ Recent history of a cold or flare-up of allergic rhinitis.
,CMN 568 - Unit 1 (Part 1) Exam
Questions and Answers
+ Adult infections usually develop much more slowly than in
children.
+Afebrile or low-grade fever.
*Complications*
TM rupture
Cholesteatoma
Differential -- Otitis media with effusion (OME), bullous myringitis
(boils on eardrum), acute mastoiditis and inner ear mass.
Essentials of diagnosis: Otitis media with effusion (OME) - Correct
Answer ✅ 1) Middle ear effusion with decreased tympanic
membrane (TM) mobility. (TM may be opaque or whitish/amber in
color. *NOT RED*)
2) No signs or symptoms of acute inflammation (e.g. no fever)
3) May precede or follow an episode of acute otitis media (AOM)
or can be caused by chronic allergic rhinitis
*--Classic case--*
,CMN 568 - Unit 1 (Part 1) Exam
Questions and Answers
Complains of ear pressure, popping noises, and muffled hearing in
affected ear. No fever. Usually not painful.
NOTES: Acute pain is NOT characteristic. Does not benefit from
treatment with ABX, antihistimines or steroids. Most people will
have OME after a case of AOM. Watch for improvement over 3
mos before considering tympanostomy tube placement.
Essentials of diagnosis: Mastoiditis - Correct Answer ✅ 1) Acute
otitis media is almost always present
2) Post auricular pain and erythema
3) Ear protrusion (late sign)
Differential - Lymphadenitis, parotitis, trauma, tumor,
hisitiocytosis, OE, furuncle (boil)
NOTES: CT scan best dx technique. IV abx followed by surgery to
treat confirmed cases. Meningitis can be complication -- suspect if
pt has high fever, stiff neck, severe HA, etc.
Essentials of diagnosis: Chronic Suppurative Otitis Media (CSOM) -
Correct Answer ✅ 1) Ongoing purulent drainage
, CMN 568 - Unit 1 (Part 1) Exam
Questions and Answers
2) Nonintact TM - perforation or tympanostomy tubes
3) May be associated with cholesteatoma
Essentials of diagnosis: Acute Viral Rhinitis (Common cold) -
Correct Answer ✅ 1) Clear or mucoid rhinorrea, nasal
congestion, sore throat
2) Possible fever, particularly in younger children (<5-6 years)
3) Symptoms resolve by 7 - 10 days
Differential - Rhinosinusitis (acute or chronic), allergic rhinitis,
nonallergic rhinitis, influenza, pneumonia, GERD, asthma and
bronchitis.
Essentials of diagnosis: Acute Bacterial Rhinosinusitis (ABRS) -
Correct Answer ✅ 1) Symptoms may include nasal congestion,
purulent nasal drainage, facial pain, ear pressure/fullness, cough,
headache and fever.
2) DX should not be made until sx present 10 or more days
beyond onset, or symptoms worsen within 10 days after initial
period of improvement
3) Symptoms complete resolve within 30 days.