Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Core clinical problems > 41. Change in hearing > Flashcards

41. Change in hearing Flashcards

1
Q

most common causes of hearing loss

A

ear wax, otitis media and otitis externa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

differentials hearing loss

A

Conductive hearing loss
(otitis media)
Glue ear
Otosclerosis
Impacted wax
Eustachian tube dysfunction

Sensorineural hearing loss
Presbycusis - Age related
Occupational
(Meniere’s disease)
(labyrinthitis) (Meningitis → labyrinthitis)
Drug toxicity
(Acoustic neuroma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

history taking hearing loss

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

examination hearing loss

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

causes conductive hearing loss

A

(otitis media)
Glue ear
Otosclerosis
Impacted wax
Eustachian tube dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

causes sensorineural hearing loss

A

Presbycusis - Age related
Occupational
(Meniere’s disease)
(labyrinthitis) (Meningitis → labyrinthitis)
Drug toxicity
(Acoustic neuroma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is primary tinnitus

A

no identifiable cause and often occurs with sensorineural hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is secondary tinnitus?

A

identifiable cause:

Impacted ear wax
Ear infection
Ménière’s disease
Noise exposure
Medications (e.g., loop diuretics, gentamicin and chemotherapy drugs such as cisplatin)
Acoustic neuroma
Multiple sclerosis
Trauma
Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what systemic conditions can cause tinnitus

A

Anaemia
Diabetes
Hypothyroidism or hyperthyroidism
Hyperlipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

red flags tinnitus

A

Unilateral tinnitus
Pulsatile tinnitus
Hyperacusis (hypersensitivity, pain or distress with environmental sounds)
Associated unilateral hearing loss
Associated sudden onset hearing loss
Associated vertigo or dizziness
Headaches or visual symptoms
Associated neurological symptoms or signs (e.g., facial nerve palsy or signs of stroke)
Suicidal ideation related to the tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Invetsigation tinnitus

A

Full blood count (anaemia)
Glucose (diabetes)
TSH (thyroid disorders)
Lipids (hyperlipidaemia)

Audiology can be used to assess the hearing in detail and help establish the underlying cause.

Imaging (e.g., CT or MRI) may be rarely required to investigate for underlying causes such as vascular malformations or acoustic neuromas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

management tinnitus

A

Tinnitus tends to improve or resolve over time without any interventions.

Underlying causes of tinnitus can be treated, such as impacted ear wax or infection.

Several measures can be used to help improve and manage symptoms:

Hearing aids
Sound therapy (adding background noise to mask the tinnitus)
Cognitive behavioural therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

newborn hearing test

A

Otoacoustic emission test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what test is done if otoacoustic emission test is abnormal

A

Auditory Brainstem Response test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

hearing 6-9 months

A

Distraction test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

heairng testing > 3 years

A

Pure tone audiometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

complications of hearing impairment/unrecognised hearing impairment in children

A

Poor speech development
Impaired learning
Mental health
Learning difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

causes of hearing loss in chidlren

A

Congenital:
Maternal rubella or cytomegalovirus infection during pregnancy
Genetic deafness can be autosomal recessive or autosomal dominant
Associated syndromes, for example Down’s syndrome

Perinatal:
Prematurity
Hypoxia during or after birth

After birth:
Jaundice
Meningitis and encephalitis
Otitis media or glue ear
Chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

audiogram interpretation

A

20dB
anything above the 20dB line is normal

sensioneural = bone and air impaired so both below line

conduction = only air is impaired so air below line and bone above line

20
Q

what is glue ear

A

otitis media with effusion. The middle ear becomes full of fluid, causing a loss of hearing in that ear.

21
Q

ototscopy glue ear

A

dull tympanic membrane with air bubbles or a visible fluid level, although it can look normal.

22
Q

investigation glue ear

A

Referral for audiometry to help establish the diagnosis and extent of hearing loss.

23
Q

management glue ear

A
  1. active observation: the management for a child with a first presentation of otitis media with effusion is active observation for 3 months - no intervention is required
  2. grommet insertion - to allow air to pass through into the middle ear and hence do the job normally done by the Eustachian tube. The majority stop functioning after about 10 months
  3. adenoidectomy
24
Q

Presentation eustachain tube dysfunction

A

PC: reduced or altered hearing, popping noises/sensations in ear, fullness in ear, pain/discomfort, tinnitus

25
Q

pathophysiology eustachian tube dysfunction

A

When the Eustachian tube is not functioning correctly or becomes blocked, the air pressure cannot equalise properly and fluid cannot drain freely from the middle ear. The air pressure between the middle ear and the environment can become unequal. The middle ear can fill with fluid.

26
Q

invetsigation eustachain tube dysfunction

A

If typical history and trigger:
clinical diagnosis
If persistent:
Tympanometry, audiometry, nasopharyngoscopy, CT

27
Q

management eustachian tube dysfunction

A

Will resolve spontaneously with no treatment

Valsalva manoeuvre (holding the nose and blowing into it to inflate the Eustachian tube)
Decongestant nasal spray
Antihistamine and a steroid nasal spray for allergic rhinitis
Otovent is an over the counter device where the patient blows into a balloon using a single nostril, which can help inflate the Eustachian tube, clear blockages and equalise pressure.

Surgical
Treating any other pathology that might be causing symptoms, for example, adenoidectomy (removal of the adenoids)
Grommets
Balloon dilatation Eustachian tuboplasty

28
Q

what is otosclerosis

A

Otosclerosis describes the replacement of normal bone by vascular spongy bone.

It causes a progressive conductive deafness due to fixation of the stapes at the oval window.

29
Q

inheritance otosclerosis

A

Otosclerosis is autosomal dominant and typically affects young adults

30
Q

presentation otosclerosis

A

Onset is usually at 20-40 years - features include:
conductive deafness
tinnitus
tympanic membrane
the majority of patients will have a normal tympanic membrane
10% of patients may have a ‘flamingo tinge’, caused by hyperaemia
positive family history

31
Q

management otosclerosis

A

hearing aid
stapedectomy

32
Q

management impacted ear wax

A

olive oil
sodium bicarbonate 5%
almond oil

33
Q

how may impacted ear wax present

A

pain
conductive hearing loss
tinnitus
vertigo

34
Q

sudden onset sensorineural hearing loss plan

A

urgent referral to ENT.

The majority of SSNHL cases are idiopathic.

High-dose oral corticosteroids are used by ENT for ALL cases of SSNHL.

35
Q

what type of HL does otosclerosis cause

A

conductive

36
Q

what type of HL does presbycusis cause

A

SN

37
Q

what type of noise is difficult to hear presbycusis

A

high-frequency hearing is affected bilaterally, which can lead to conversational difficulties, particularly in noisy environments.

38
Q

what type of noise is difficult to ehar in otoscleorsis

A

It tends to affect the hearing of lower-pitched sounds more than higher-pitched sounds. Female speech may be easier to hear than male speech (due to the generally higher pitch). This is the reverse of the pattern seen in presbycusis.

39
Q

pathophysiology presbycusis

A

sensory hair cells and neurons in the cochlea atrophy over time

The precise cause is unknown however is likely multifactorial
Arteriosclerosis: May cause diminished perfusion and oxygenation of the cochlea, resulting in damage to inner ear structures
Diabetes: Acceleration of arteriosclerosis
Accumulated exposure to noise
Drug exposure (Salicylates, chemotherapy agents etc.)
Stress
Genetic: Certain individuals may be programmed for the early ageing of the auditory system

40
Q

presentation presbycusis

A

chronic, slowly progressing history of:
Speech becoming difficult to understand
Need for increased volume on the television or radio
Difficulty using the telephone
Loss of directionality of sound
Worsening of symptoms in noisy environments
Hyperacusis: Heightened sensitivity to certain frequencies of sound (Less common)
Tinnitus (Uncommon)

41
Q

investigations presbycusus

A

Audiometry

42
Q

what frequencies are particualrly affected occupational hearing loss

A

3000-6000 Hz

43
Q

what drugs are ototoxic

A

aminoglycosides (e.g. Gentamicin), furosemide, aspirin and a number of cytotoxic agents

44
Q

What is the nerve found within the middle ear?

A

facial nerve

45
Q
A

Core clinical problems (94 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions