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Medical Sciences B > Ear > Flashcards

Ear Flashcards

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USMLE® Step 1 flashcards
1
Q

What is tinnitus?

A

ringing in the ears

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2
Q

What is presbyscusis?

A

age related sensorineural loss of hearing

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3
Q

What questions do you ask a patient with hearing problems?

A
  • How long?
  • Gradual or sudden onset?
  • Are some sounds harder to hear?
  • One ear or both?
  • Previous head injury, ear infections, allergies?
  • Occupation and hobbies with loud noises?
  • Vertigo, dizziness?
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4
Q

What is otitis externa?

A
  • inflam. of external ear canal skin
  • any skin diseases can cause this
  • exacerbated by water, sweating, trauma

• FROM: Infective, Seborrhoeic, Allergic

  • pruritus, pain (canal, nodes) worse by movement of pinna or tragus
  • discharge maybe
  • canal can block -> deafness
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5
Q

What is bad about using cotton buds?

A

damages the epithelium -> impairs the self cleaning mechanism of the external ear

-> can lead to otitis media

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6
Q

What is the aetiology of Otitis externa (infective)?

A
  • bacterial-Gram negative rods
  • fungal
  • viral-herpes
  • furunculosis-staph inf. of hair follicle
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7
Q

What is the aetiology of Otitis externa (seborrhoeic)?

A

comes with dermatitis of scalp)

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8
Q

What is the aetiology of Otitis externa (allergic)?

A

from treatments

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9
Q

Acute suppurative otitis media

A
  • 2nd most common childhood disorder
  • viral or bacterial
  • microorganisms enter from nasopharynx
  • neonates: E. coli, S. aureus
  • older kids: Strep. pneumonia, H. influenza
  • > 14yrs: strep. pneumoniae, Beta hemolytic strep, S aureus
  • earache, fever, hearing loss, vomiting, diarrhoea
  • erythematous, buldging tympanum
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10
Q

What are the complications of Acute suppurative otitis media?

A

• possible otorhoea if tympanic membrane is ruptured

  • glue ear (very common)
  • acute mastoiditis
  • labyrinthitis
  • meningitis or intracranial infection
  • hearing loss
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11
Q

Barotitis media

A
  • damage as result of sudden elevations in environmental pressure
  • plane, deep-sea diving
  • air can’t move from nasopharynx into auditory tube to equalize pressure on both sides of tympanic membrane
  • FROM: allergies, inflammation, damage to middle ear
  • severe ear pain
  • conductive hearing loss

• tympanum may rupture

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12
Q

What are all the synonyms for glue ear?

A
  • secretory otitis media
  • otitis media with effusion
  • serous otitis media
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13
Q

What is serous otitis media?

A
  • effusion in middle ear
  • FROM: unresolved acute otitis media or obstruction of the auditory tube (allergy, inflammation, enlarged adenoids) -> relative negative pressure in middle ear -> retraction of tympanic membrane and transudation of fluid from blood vessels in middle ear -> fluid up in middle ear -> impaired sound conduction
  • variable conductive hearing loss
  • often presents as learning difficulties and behavioural problems
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14
Q

What is mastoiditis?

A
  • bacterial infection of mastoid process
  • extension of middle ear infection, by same causative agent
  • coalescence of mastoid air cells
  • Hx of acute otitis media not well treated (2 weeks after)
  • increasing aural pain (persistent and throbbing)
  • fever, otorrhoea,
  • redness, swelling, tenderness over mastoid process
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15
Q

What is otosclerosis?

A
  • bony ossicles disorder
  • conductive hearing loss
  • hereditary
  • foci of new, irregularly arranged bone develop within ossicles -> ankylosis -> impaired vibration of ossicles
  • late teens or early adulthood
  • slowly progressive
  • sensorineural hearing loss if ankylosis adjacent to Scala media
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16
Q

What is Acoustic neuroma?

A
  • tumour of Schwann cells of vestibulocochlear nerve
  • unknown aetiology

Pathology: tumour encapsulated -> distorts and compresses nerves V and VII -> compress pons, medulla, obstruct flow of CSF

  • gradual sensorineural hearing loss
  • tinnitus
  • dizziness and unsteadiness
17
Q

What is Benign paroxysmal positional vertigo (BPPV)?

A
  • severe vertigo >30 seconds
  • granular masses in posterior semicircular canal
  • result of trauma, infection, degeneration or vascular occlusion
  • episodes precipitated by head movements
  • lasts weeks-months, may recur
18
Q

What is Labyrinthitis?

A
  • usually bacterial infection
  • often secondary to acute otitis media or purulent meningitis
  • severe vertigo, nausea, vomiting
  • nystagmus
  • hearing loss
19
Q

What is Menieres disease?

A
  • paroxysmal episodes of vestibular function with increasing deafness
  • from increased amount of endolymph
  • progressive deafness and tinnitis
  • episodes of sudden vertigo (with tinnitus, nausea, vomiting, sweating, weakness, fainting) lasting min-hrs
  • frequency of attacks decreases, can last years
  • nystagmus and ataxia
20
Q

What is Noise induced hearing loss?

A
  • sensorineural hearing loss as a result of intense noise
  • isolated event or ongoing
  • > 85dB damages (industrial, shooting, concerts)
  • damages hair cells in Organ of Corti

Features:
• first loose 4kHz, then higher and lower
• high frequency tinnitus

21
Q

What is Presbycusis?

A
  • age related sensorineural hearing loss
  • exposure or genetic
  • men > women
  • loose high frequency sounds first
  • hard to hear when background noise
22
Q

What is Vestibular neuritis?

A

• viral infection
• sudden severe vertigo, nausea, vomiting, nystagmus
• episode of 7-10 days
or recurrent

23
Q

Using your understanding of the conduction of sound through the ear, describe possible causes of hearing loss involving the ear or the vestibulocochlear nerve.

A
  • External auditory canal: blockage (wax, bug), tympanic membrane damage (pressure)
  • Middle ear: ossicles (sclerosis, degeneration with age), fluid,
  • Inner ear: hair cells in cochlear (loud sounds, old age), nerve (acoustic neuroma, neuritis), tumour
24
Q

What is the relation between Acute suppurative otitis media and Serous otitis media?

A

Serous otitis media may be the consequence of repeated or poorly treated Acute suppurative otitis media

Medical Sciences B (23 decks)

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