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A 3-year-old girl is brought to the physician because of fever and ear pain for 1 day. She also has had clear nasal discharge and cough for 3 days. She has a history of several ear infections and one episode of streptococcal pharyngitis over the past 12 months. Her father smokes in the house, and the family has two cats. She swims frequently in the family's swimming pool. Her temperature is 38.5C (101.3F), pulse is 110/min, respirations are 22/min, and blood pressure is 80/50 mm Hg. Examination shows clear nasal discharge, erythema and bulging of the right tympanic membrane, and erythema of the throat without exudate. The lungs are clear to auscultation. Which of the following is the most appropriate recommendation to prevent recurrence of this patient's condition?
A) Avoidance of passive smoke exposure
B) Removal of cats from the house
C) Use of earplugs when swimming
D) Daily otic antibioti drops
E) Prophylactic oral decongestants
F) Tonsillectomy
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It seems A) is a plausible option, yet why does she has a fever with merely irritation by passive smoke exposure? Any thoguhts?
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i go for c as thats the main reason she is getting ear infections. this episode might again be an ear infection... but i cant correlate hypotension for this answer
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why should there be bulging of tymp in examination...if its a ?
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but swimming has association with external otitis not otitis media in our case which has to do with smoking habit in dad
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ok .. ya checked it out... passive smoking does cause all those symp
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ScienceDaily (May 19, 2008) ” A new report from Perth's Telethon Institute for Child Health Research has found a strong link between childhood ear infections and exposure to tobacco smoke.
See Also:
Health & Medicine
Hearing Loss
Children's Health
Infant's Health
Attention Deficit Disorder
Smoking
Staying Healthy
Reference
Equilibrioception
Upper respiratory tract infection
Tinnitus
Bacterial meningitis
The families of 100 Aboriginal children and 180 non-Aboriginal children participated in the Kalgoorlie Otitis Media Research Project, allowing the collection of social, demographic, environmental and biological data to investigate the causes of otitis media (middle ear infections). The children had regular ear examinations from birth until 2 years of age.
Chief Investigator Dr Deborah Lehmann, who heads the Institute's infectious diseases research, said ear infections were the most common reason that young children see a doctor and can cause life-long problems.
"Up to 20 per cent of children have more than three ear infections between 1 and 2 years of age. If their hearing is damaged, it can seriously affect their educational outcomes and social circumstances in adulthood," Dr Lehmann said.
"In Aboriginal children, these ear infections typically start at a younger age, are much more common and more likely to result in hearing loss."
Key findings from the project include:
Otitis media was diagnosed at least once in 74% of Aboriginal children and 45% of non-Aboriginal children.
64% of Aboriginal children and 40% of non-Aboriginal children were exposed to environmental tobacco smoke.
If we eliminated exposure to tobacco smoke we estimate that we could reduce ear infections by 27% in Aboriginal children and 16% in non-Aboriginal children
The impact of passive smoking in the home on ear infections was reduced if the children also attended day care.
