I didn’t realize how poor I was at using the otoscope until this first week of Pediatrics. While I visualized hundreds of tympanic membranes (TMs) in 60 year old men while on occupational medicine, unfortunately 2 year olds with ear infections don’t sit still very long, or at all. What’s worse, even if the child restrains themselves just long enough to visual the TM, I struggle describing & diagnosing what I see to my preceptors. Third year is quickly demonstrating that medicine is not “easy” and what I assumed was as simple as red TM = otitis media & red external auditory canal = otitis externa is not that cut and dry. Foolish me, time to keep learning. Here are three pretest questions to test your skils:
- (1) A TM color commonly associated with otitis media with effusion (OME) is:
- Red, Amber, Pale yellow, White?
- (2) OME is defined as:
- Fluid in the middle ear space regardless of pathogenesis
- Acute otitis media (AOM) or middle ear effusion (MEE)
- Inflammation of the middle ear in the presence of acute infection
- Liquid in the middle ear in the absence of acute infection
- (3) Describe the TM shown below:
- Grey, translucent and neutral
- White, semi-opaque and mildly full
- Amber, semi-opaque and mildly retracted
- Grey, opaque and full
If you didn’t answer Amber, Liquid in the middle ear in the absence of acute infection and Amber, semi-opaque and mildly retracted, I’m here to help! My school required us to complete 2 online interactive module series that are free to anyone with an email address and surprisingly excellent quality! (That’s where the 3 questions above are from). The website provides step-by-step instructions on how to correctly identify and describe the color/mobility/position/translucency of the TM as well the fluid behind it through high resolution images & short video clips. It even offers 1 continuing medical education credit (CME) if eligible (sadly I am not). The site is http://pedsed.pitt.edu and is published by the Children’s Hospital of Pittsburgh for Pediatric educational purposes. Simply click on “New User Registration” on the upper left-hand corner, provide your email address (no less than twice of course) and then do not check “I am a University of Pittsburgh Medical Student“. That’s it! I completed #2 Otitis Media with Effusion (OME) and #3 Acute Otitis Media (AOM) and will subsequently redo both this weekend to further master this material before I subject any more children to my slowly improving (but currently still poor) clinical skills. Hope this helps 1 out there. Enjoy!