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ENT & Opthalmology > Ear > Flashcards

Ear Flashcards

1
Q

Which group of people are more at risk of otitis media and why?

A

Children

- more narrow, horizontal and short eustachian tube

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2
Q

What causes otitis media?

A

Often viral
Bacterial - S. pneumonia and H. influenzae
Often preceded by URTI

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3
Q

What are some complications of otitis media?

A

mastoiditis
meningitis
facial palsy
brain abscess

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4
Q

How would you categorise otitis media?

A

acute OM: increasing otalgia, no discharge, bulging red eardrum
acute suppurative OM: increasing otalgia, watery discharge (pop), perforation of eardrum

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5
Q

How would you treat otitis media?

A

oral antx are contrary to evidence (do decrease pain in children) - amoxicillin / erythromycin
analgesia
perforated eardrum give steroid and antx drops (gentisoneHC)

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6
Q

What would you see in otitis media on otoscopy?

A

bulging eardrum, redding or dull appearance, prominent blood vessels
+/- perforated eardrum

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7
Q

What are some symptoms of otitis media?

A

ear ache, nausea, vomiting, cough, runny nose, fever, conductive hearing loss

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8
Q

How would you treat otitis externa?

A

gentisoneHC or flucloxicillin / erythromycin

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9
Q

What are 5 causes of vertigo and how they are different?

A

Labrynthitis - constant
BPPV
Migrane - episodic, aura, headache, photophobia
Meniere’s disease - hours, unilateral hearing loss, tinnitus, aural pressure
Acoustic neuroma

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10
Q

What is benign paroxysmal postional vertigo?

A

loose otoliths in semicircular canals cause abnormal movement of endolymph within canal causing vertigo
(crystals which should be at the bottom move to the middle of the canals

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11
Q

What are some symptoms of benign paroxysmal postional vertigo?

A

vertigo participated by head movements, sudden and disturbing onset (secs-mins), becomes less severe on repeated movements

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12
Q

How do you test for BPPV?

A

Dix-hall pike maneuver

Will show rotational nystagmus

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13
Q

How do you treat BPPV?

A

Epley maneuver

Brandt-Daroff exercise for maintainence

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14
Q

What are some causes of referred otalgia?

A

dental problems, TMJ dysfunction, osteoarthritis of cervical spine, malignant pharynx and larynx, infection of pharynx, degenerative neck pain, throat infection

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15
Q

What are the 4 main causes of otalgia?

A

Acute otitis media, ottits externa, furuncule, necrotising otitis externa

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16
Q

What are some pathogenic causes of otitis media?

A

VIRAL - RSV, rhinovirus, parainfluenza

BACTERIAL - strep pneumo, haem influenza, moraxella catarrhalis

17
Q

How would you treat otitis media?

A

antibiotics do not benefit children (unless severe)

so give reassurance

18
Q

What are some complications of otitis media?

A

mastoiditis, tympanic membrane perforation
Intracranial - meningitis, abscess, lateral thrombosis
Extracranial - petrositis, LMN VII palsy, labyrinthitis, hearing loss, TM perforation

19
Q

What is otitis externa? What are some predisposing factors?

A

painful, discharging ear caused by pseudomonas or fungal infection
eczema or dermatitis is predisposing

20
Q

How would you treat and prevent otitis media?

A

TREAT - microsuction, pope wick, topical antibiotics, water precautions, clotrimazole for fungal
PREVENT - hands out, ear dry, treat skin disease, acetic acid spray

21
Q

What is a furuncule? How would you treat it?

A

It is a staphylococcal abcess on hair follicle in ear = exquisitely tender
TREAT - flucloxicillin, wick insertion

22
Q

What is necrotising otitis externa?

A

potentially fatal osteomyelitis of EAM nad bony tympanic plate (can spread along inferior surface of skull base)

23
Q

What are risk factors for necrotising otitis externa?

A

DM, elderly, immunocompromised

24
Q

How would you treat necrotising otitis externa? What are some complications of necrotising otitis externa?

A

Admission into hospital, IV antibiotics

Complications - meningitis, cerebral abscess, dural sinus thrombosis

25
Q

What are the symptoms of necrotising otitis externa?

A

huge pain, not impacted by topical antibiotics

26
Q

What is Rinne’s test?

A

press tuning fork against mastoid bone and then hold 1cm away
- is it louder behind hear or in front?

27
Q

What is Weber’s test?

A

tuning fork placed in midline or forehead

- to find unilateral hearing loss

28
Q

What is conductive hearing loss? Give 3 possible causes

A

problem with middle or inner ear, eardrum etc

- wax, osteosclerosis, otitis media

29
Q

What is sensorineural deafness? Give 3 possible causes

A

problem with cochlear, nerves or brain function (bone conduction is better in tests
- congenital, age related, occupational, meniere’s disease, drug toxicity, post-infective

30
Q

What is osteosclerosis?

A

commonest cause of hearing loss in young adults, F>M, autosomal dominant
conductive hearing loss from bone deposition around stapes footplate

31
Q

What are symptoms of osteosclerosis?

A

hearing loss, tinnitus, vertigo

- worse in pregnancy, menstruation and menopause

32
Q

How would you treat osteosclerosis?

A

surgically with stapedectomy or with hearing aids

33
Q

What is Meniere’s disease?

A

uncommon condition where dilation of endolymphatic system in cochlear duct and saccule which can cause vestibular membrane of Reissner can rupture, compressing adjacent structures

34
Q

What are the symptoms and treatment of meniere’s diasase?

A

attacks of nausea, vertigo, nystagmus, tinnitus and hearing loss that can last for up to 12 hrs
cyclizine helps for vertigo, possibly betahistamine can help, operative decompression helps prevent progression of disease

35
Q

What are the common causative agents of labyrinthitis?

A

usually viral - mumps, cytomegalovirus, rubella

- usually spontaneous resolution

36
Q

What is glue ear?

A

at least 3 months of persistant middle ear effusion

not infection, is mucus overproduction or under clearance

37
Q

What are the symptoms of glue ear?

A

conductive hearing loss

pain is unlikely

38
Q

How would you treat glue ear?

A

conservative
hearing aids
grommets

ENT & Opthalmology (5 decks)

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