Diseases Of The Ear Flashcards by Brandon edlund

What is a clinical pearl for hearing loss?

History

Duration
Bi or unilateral 
Sudden or progressive
Exposure
Trauma
Associated symptoms
Tympanometry

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What is the differential diagnosis of otalgia?

Tbd

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What is a positive rinne test indicative of?

Conductive hearing loss

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What frequency of running fork should you use?

512hz

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What is the normal hearing threshold?

Less than 25dB

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What is profound hearing loss?

Threshold above 90dB

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What is the otoacoustic emission test?

The outer hair cells emit low intensity sound following acoustic stimulation.
Unconsciously

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What is the newborn screening test for hearing?

Otoacoustic emission test

Kids less than 2yrs old

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What is the auditory brainstem response?

An output of 5 peaks that mean different things

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What is the most common cause of sensorineural hearing loss?

Presbycusis

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What is presbycusis?

Progressive loss of hair cells

Most common sensorineural hearing loss

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What drugs are too toxic?

NSAIDs, cysplatin, antimalarials (quinine, chloroquine)

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What is otosclerosis?

Autosomal dominant

Bone formation on stapes
60% have family hx
Hearing aids or stapedectomy

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What are some symptoms, diagnosis, and treatment of acoustic neuroma?

Vertigo
Facial nerve paralysis 
Trigeminal numbness
Diplopia 
Dx: MRI with contrast
Rx: surgery, observation

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What are some work ups of vertigo?

MRI, CT
Lumbar puncture
Electronystagmography
Rotary chair

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What is the most common peripheral vertigo and how do you diagnosis it?

Benign paroxysmal positional vertigo (BPPV)

Dx with Dix-hallpike

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What causes BPPV?

Post trauma

Post viral infection

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What is Ménière’s disease?

Endolymphatic hydrous

Vertigo, low pitched tinnitus, hearing loss

Sometimes bilateral
Progressive
Episodic vertigo

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What is vestibular neuronitis?

Viral infection of the vestibular nerve
Vertigo for days
No hearing loss
URI
Last weeks to months
Meclizine, benzos, antiemetics

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What neurological diseases can cause facial nerve paralysis?

Guillain-Barré

Myasthenia gravis

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What is Anotia?

No ear
Only 10% syndromic
With ear canal atresia
Bone anchored hearing aid

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What is microtia?

Small ear
Grade I,II,III
I - slightly smaller ear, cup, usually no surgery
II - auricle is half sized, all structures, surgery is beneficial
III - small cartilage piece, surgical repair at age 5-6, prostheses looks good

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What is the most common external ear anomaly?

Lop ear

Like dad

What must you worry about when removing a auricular appendage?

The facial nerve because it is superficial

What is relapsing polychondritis?

``` Inflammation of the pinna Autoimmune Episodic and progressive Involves other things Steroids and NSAIDs ```

What proteins are elevated in relapsing polychondritis?

ESR and IgG

What is an inflammation of the ear that looks like skin cancer and is extremely painful?

Nodularis chronicus helicus

How do you treat keloids of the ear?

Early with steroids | Late with excision

What is an auricular hematoma?

Seperation of the epithelium from the elastic cartilage Repeat causes cauliflower ear

What causes cellulitis of the ear?

Staph, pseudomonas

What looks like a cholesteatoma?

Osteomas In Norwegians

What can herpes zoster oticus cause?

Decreased hearing Pain Facial nerve paralysis Immunocompromized present higher risk

What is otorrhea?

Ear drainage

What test do you do on ear drainage?

Culture, gram stain Beta 2 transferrin for CSF

What is otomycosis?

Itching, painful ear drainage and decreased hearing Complication of prior antibacterial treatment Antifunal drops and pills relieve pain Debridement

What is bulbous myringitis and what is it associated with?

Inflamed tympanic membrane with serous Bullard Associated with virus or mycoplasma post URI

What is tympanosclerosis?

White plaques on TM Hyalin or calcium depositions Normal hearing if only TM Conductive if middle ear

What is a cholesteatoma?

Soft ball of keratin Involved skin Causes bone erosion Need surgery

Where does middle ear cholesteatoma appear and what does it do?

Appears in squamous epithelium ``` Bone and soft tissue destruction Pressure necrosis Secondary infection Hearing loss and vertigo Surgical removal ```

What are the first and second most common diseases in children?

URI | Acute otitis media

What results in trasudative fluid collection in the middle ear?

Middle ear pressure

What are the three most common causes of AOM?

S. pneumonia H. influenza Mor. catarrhalis

What is otalgia?

Ear pain

What happens to the ear drum during crying?

The ear drum turns red

How do you treat AOM with a perforated TM?

Topical antibiotic otic drops

What is a mastoidectomy and what does it do?

Remove part of the mastoid bone Remove cholesteatoma Preserves hearing and vestibular function Reconstruction of middle ear structures

What are some things that affect smell?

Endocrinological state Delayed puberty with Anosmia - kallmann syndrome Meds Surgeries

What is a dermoid cyst and how is it caused?

Cysts of squamous cell epithelium containing epidermal appendages Epidermal appendages displaced during development

What is nasal Encephalocele?

Protrusion of meninges, CSF, and neural tissue into nasal cavity

What is the hypothesis of nasal glioma formation?

Develop from extra cranial rests of glial tissue Abnormal closure of fonticulus nasofrontalis Maybe encephaloceles that have lost CSF connection

What is rhinitis?

Irritation and inflammation of the mucous membrane in the nose

How is allergic rhinitis mediated?

IgE mediated hypersensitivity 20% of us population Almost always present by 20yrs

What is the atropy of allergic rhinitis?

Genetic predisposition to respond to enviornmental allergens with production of specific IgE antibodies

What is highly indicative of allergic rhinitis?

Prurtitis (nasal, ocular, oral, pharyngeal)

How do you diagnosis allergic rhinitis?

RAST ELISA ( long time, less sensitive) Antigen skin testing (affected by anti histamine therapy)

What is the pathogenesis of sinusitis?

S. aureus Mot. Catarrhalis H. Flu Biofilms Fungi IgE (chronic)

What is the gold standard for diagnosing sinusitis?

CT scan without IV contrast