TEST BANK FOR PRIMARY CARE 6TH EDITION BY BUTTARO
Chapter 67: Otitis Externa Buttaro: Primary Care: A Collaborative Practice, 6th Edition MULTIPLE CHOICE 1. 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? a. Acute otitis externa b. Acute otitis media c. Chronic otitis externa d. Otitis media with effusion ANS: A
This patient’s symptoms are classic for acute otitis externa. Chronic otitis externa more commonly presents with itching. Acute otitis media is accompanied by fever and tympanic membrane inflammation, but not external canal inflammation. Otitis media with effusion causes a sense of fullness but not pain. 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? a. Cipro HC b. Fluconazole c. Neomycin d. Vinegar and alcohol ANS: A
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In the absence of a culture, the provider should choose a medication that is effective against both P. aeruginosa and S. aureus. Cipro HC covers both organisms and also contains a corticosteroid for inflammation. Fluconazole is an oral antifungal medication used when fungal infection is present. Neomycin alone does not cover these organisms. Vinegar and alcohol are used to treat mild fungal infections. MULTIPLE RESPONSE 1. Which are risk factors for developing otitis externa? (Select all that apply.) a. Cooler, low-humidity environments b. Exposure to someone with otitis externa c. Having underlying diabetes mellitus d. Use of ear plugs and hearing aids e. Vigorous external canal hygiene ANS: C, D, E
Otitis externa is a cellulitis of the external canal that develops when the integrity of the skin is compromised. Diabetes mellitus predisposes patients to skin disorders. Using devices that cause moisture retention and irritation will increase the risk. Vigorous cleansing removes protective cerumen. Warm, high-humidity environments increase risk. The disease is not contagious.
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