AMK stuff to do with the ear

Question 1

Otitis media

Answer 1

• Infection in the middle ear
• Lack of light reflection due to out bulging of the tympanic membrane
• Erythema and bulging when infected
• More common in children due to narrower and flatter eustachian tube
• Viral infection tracking into middle ear
• First line is fluids, analgesia and bed rest
• Second line is oral amoxicillin

Question 2

• Glue ear

Answer 2

Otitis media with effusion

• Commonly follows after acute attack
• Fluid in middle ear, not affected
• Treated with gromets – small plastic tube that goes through tympanic membrane to release pressure

Question 3

Cholesteatoma

Answer 3

• Skin growing on inside of tympanic membrane
• Inflammation and fowl smelling discharge and hearing loss
• Pearly white mass visible with otoscope
• Removed surgically

Question 4

Ototoxic drugs

Answer 4

• Gentamicin, streptomycin, loop diuretics

- Cause damage to the middle ear bones, vestibulocochlear nerve damage, vestibule

Question 5

Otosclerosis

Answer 5

Otosclerosis

• Fusion of bones in middle ear

Question 6

Presbycusis

Answer 6

• Hearing loss in older people

- Lose high pitch, keep lower pitch

Question 7

Vertigo

Answer 7

• Dizziness and nausea
• Otological causes - BPPV
• Neuro – stroke, migrane, neuropathy, tumour

Question 8

BPPV

Answer 8

• Benign paroxysmal positional vertigo
• Episodic, caused by otoliths in wrong places in canal
• Feeling dizzy after moving too quickly
• Dix hallpike test – head turned rapidly causing nystagmus
• Treatment – epley manoeuvre (D before E)

Question 9

Vestibular neuritis

Answer 9

Sudden onset severe vertigo

• Presents following viral infection
• Usually settles over 2-4 days
• Can give Histamine 1 antagonist
• Treat nausea with prochlorperazine (zine is generally a histamine antagonist)

Question 10

Meniners disease

Answer 10

• Disorder of the inner ear caused by change in fluid volume
• Fullness in the ear, tinnitus, hearing loss
• Acute attacks are sudden onset and treated with H1 antagonists
• Long term treatmen

Question 11

Otitis externa

Answer 11

• Swimmer, surfer (ear canal damp)
• Inflammation of external ear, painful over tragus, topical antibiotics
• Adult repeat, dip urine to check for diabetes