Ear Flashcards
Pt hears Weber test on unaffected side?
sensory/sudden hearing loss
Pt hears Weber test on affected side?
cerum impaction
If pt gets a bug in the ear?
use lidocaine to paralyze the bug
If pt gets FB in the ear?
DO NOT USE AQUEOUS SOLUTION
Cerum impaction - tx?
do NOT use QTIP - mechanical or solution removal
Contact dermatitis - tx?
mineral oil
Pt hears LOW pitch (tinititus)?
conductive hearing loss
Ototoxic drugs?
gentamyacin (aminoglycosides)
loop diuretics (Ferusomide)
oral steroids
Pt hears HIGH pitch (tinitus)?
sensorineural hearing loss
Facial nerve is compressed?
acoustic neuroma/vesticular schwannoma
Pt has blunt trauma while playing baseball?
traumatic auricular hematoma
Complication of traumatic auricular hematoma if not tx?
cauliflower
Progressive unilateral hearing loss?
acoustic neuroma/vesticular schwannoma
Surfer has ear pain?
exostoses
Parent smokes and child has “plugged ear” - what PE finding?
retracted tympanic membrane
NO fever
Post URI? -child
eustachian tube dysfxn
Pt is flight attendant + ear pain - PE?
red + retracted
Barotrauma - tx?
decongestants
Otits externa - bugs?
Pseudomonas
S. Epidermidis
S. Aureus
Pt has pain when pulling on ear?
otitis externa
Pt has repeated exposure to COLD water?
exostoses
osteomas
How to tx Surfer’s ear?
one - observe
many - remove if hearing impaired
Pt has red + retracted ear drum?
barotitis media
Cx of barotitis media?
pressure gradient from flying/diving
Sx of barotitis media?
hearing loss
tinnitus
Tx for barotitis media?
decongestants - pseudophedrine
refer if severe
When do you insert a tube in the ear?
chronic serous otitis media >3mo
recurrent AOM 3x/6mo OR 4x/12mo
complication of AOM
complication of eustachian tube
Pt has “plugged ear” + retracted tympanic membrane + NO fever?
eustachian tube dysfxn
Risks for eustachian tube dysfxn?
URI
allergy
smoke
Bugs for otitis externa?
PSEUDOMONAS
S. aureus
S. epidermis
Excessive cleaning and scratching of ear?
otitis externa
Tx otitis externa?
quinolone abx drops cipro HC (cover for pseudomonas and s. aureus)
Bloody otorrhea + lesions + facial paralysis + hearing loss?
external ear canal carcinoma
BUBBLES + NO infxn?
serous otitis media
Tx for serous otitis media?
self limiting 4-6wks
+/- pseudoephedrine (RUI)
+/- corticosteroids - allergy
Bugs for acute otitis media?
S. pneumonia
H. influenzea
M. catarrahlis
What are the bugs for acute otitis media the same as?
meningitis, pneumonia, sinusitis
s. pneumonia
h. influenzae
m. catrrahalis
Pt has fever and posterior ear pain?
acute mastoiditis
Child has conjunctivitis + ear tugging? Bug?
acute otitis media
bug: h. influenzae
Gold standard dx for AOM?
insufflation
Tx for AOM?
tylenol
WASP 24-48hrs
first line- Amoxicillin HD 90mg/kg/day BID
When to use abx in AOM?
> 6mo + otorrhea
6mo + severe sx
6mo to 2yo + bilateral sx
When to WASP in AOM?
> 2yo + NO otorrhea + bilateral
>6mo + NO otorrhea + unilateral
Imaging for mastoiditis?
ct scans
Tx for mastoiditis?
admit + IV abx
Painless + purulent ear discharge + ruptured?
chronic suppurative otitis media
Cx for chronic suppurative otitis media?
recurrent AOM
Tx for chronic suppurative otitis media?
cipro
Recurrent AOM + NO hearing loss + NO dizziness + NO otorrhea?
cholesteatoma (keratin filled sacs)
Tx for cholesteatoma?
surgically remove
“Room is spinning” + NO hearing + NO ear pain?
benign paroxysmal positional vertigo
When is complaint common for BPPV (time of day)?
getting up from bed
What skills test for BPPV?
Dix-hallpike
Tx for BPPV?
epley manuever
antihistime
anitcholinergics
Cx of BPPV?
Ca debris in POSTERIOR semicircular canal
Pt has vertigo for min to hrs + hearing loss + ear fullness?
menieres syndrome
Cx for meniere’s sx?
TOO MUCH endolymphatic hydrops
Tx for meniere’s sx?
REDUCE hydrops –> reduce Na, use diuretics
Prognosis for meniere’s sx?
peak @2yrs and vertigo free after 5-8yrs
Pt has TEMPORARY vertigo + N/V + post ivral?
vestibular neuronitis/labryinthitis
Tests for vestibular neuronitis?
horizontal nystagmus
Tx for vestibular neuronitis?
supportive
+/- abx for infxn
