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Neuro Block 3 > Ear Clinical Correlates > Flashcards

Ear Clinical Correlates Flashcards

1
Q

What is the most importnat part of an ear workup?

A

taking a good history

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2
Q

What tuning fork is usually used for rinne and weber?

A

512

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3
Q

What’s probably the most important scor eyou get out of an audiogram?

A

the speech discrimination score, since this is what patient’s really care about

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4
Q

What is considered a normal hearing threshold?

A

less than 25 DB

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5
Q

What are you measuring in tympanometry?

A

the impedence of the ear drum in comparison to the pressure behind the ear drum

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6
Q

What’s the most common cause of sensorineural hearing loss?

A

presbycusis - age-related sound induced progressive hearing loss (loss of the hair cells)

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7
Q

What happens in otosclerosis?

A

it’s an autosomal dominant disease where you get bony growth of the stapes, such that it stuffens and you get conductive hearing loss

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8
Q

What is a way to prevent otosclerosis? What is the treatment?

A

fluoride prevents

hearing aids to stapedectomy with proshtesis

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9
Q

What symptoms would a patient complaint of in an acoustic neuroma?

A

asymmetric hearing loss

vertigo

facial nerve paralysis

aural fullness

trigeminal numbness

diplopia

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10
Q

What is the difference between subjective and objective tinnitus?

A

subjective: perception of sound in the abscence of acoutstic, electrical or external stimulus

Objective: perception of sound caused by internal body sound or vibration

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11
Q

What type of hearing loss is associated with subjective tinnitus and which is associated with objective tinnitus?

A

subjective is associated with high frequency sensorineural hearing loss

objective tinnitus is exacerbated by conductive hearing loss - the “inner” sounds aren’t masked by normal external sounds anymore

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12
Q

Compare the following: vertigo, dysequilibrium, and imbalance

A

vertigo = illusion of movement

dysequilibrium = sense of poor coordination with erect posture or movement

imbalance = implies orthopedia or neuro problem

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13
Q

What are some tests to include in the vestibular work up?

A

H&P obviously

MRI or CT

Electronystagmography

Rotary chair

vestibular evoked myogenic potentials

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14
Q

What is hte most common cause of vertigo?

A

benign paroxysmal positional vertigo

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15
Q

What is thought to be the cause of benign paroxysmal positional vertigo

A

post-trauma or post-viral infection, the otoconia get dislodged and roll around in the semicircular canals

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16
Q

What does a presentation of benign paroxysmal positional vertigo look like?

A

positional vertigo that is latent after movement and brief

normal hearing

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17
Q

How do you diagnose benign paroxysmal positional vertigo

A

with the Dix-hallpike maneuver and history

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18
Q

What are the symptoms of meniere’s disease?

A

episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, aural fullness, progressive

often totally asymptomatic between spells

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19
Q

What’s tricky about the meniere’s disease diagnosis?

A

it’s really a diagnosis of exclusion

you need to rule out things that can mimic meniere’s, like stroke or tumor

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20
Q

What is vestibular neuronitis?

A

a viral infection of the vestibular nerve - it causes vertigo, but no hearing loss

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21
Q

How do you treat a bacterial labyrinthitis?

A

you have to use IV antibiotics because ear drops wont get to th einner ear

also vestibular suppressants

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22
Q

What is anotia? What is the treatment?

A

Developmental issue where there is NO ear

may or may not be a middle and inner ear

treat with a reconstruction or prosthesis. if middle ear is intact, use a bone anchored hearing aid

23
Q

What is microtia?

A

developmental issue where the ear is not completely formed

this can range from almost unnoticeable (grade 1) to having only a few bits of cartilage sticking off (grade 3)

24
Q

What is hte most common external anomaly?

A

lop ear (abscence of the anihelical fold, so ears kinda stick out)

25
Q

What is a preauricular pit?

A

it’s an area that didn’t fuse completely and a fistula forms from the sinus to the front ot he ear. You can get drainage form the area and they often become infected

26
Q

What is an auricular appendage?

A

it’s arrested development or fusion of the hillocks of his, resulting in a cartilage part of the ear located int he wrong spot

27
Q

What is relapsing polychondritis and how does it affect the ear?

A

it’s an autoimmune diseases that causes inflammation affecting cartilginous areas like the ears, nose, joints, and airways

you get inflamed ear

28
Q

How cna you tell the difference between a relapsing polychondritis and a cellulitis of the auricle?

A

polychondritis will have elevated ESR, CRP, and IgG, but normal CBC

whereas cellulitis will have normal IgG and abnormal CBC

29
Q

What is nodularis chronicus helicus?

A

It’s a benign area of growth in the external ear, which is common in olde rpatients

it looks like a skin cance,r but it’s not - very painfult though

30
Q

What is a keloid and how do you treat it>

A

it’s development of scar tissue after trauma, like piercing the ears

if early, inject iwth steroids

if too big, excise and then inject with steroids

31
Q

What is an auricular hematoma and why do they need to be treated?

A

it’s a hematoma in the external ear that’s caused by trauma

you have to treat them with incision, drainage, and bolster

If you don’t trea thtme, the patient will end up with a cauliflower ear deformity

32
Q

What are hte most common organisms that cause a cellulitis of the pinna?

A

staphylococcus

streptococcus

pseudomonas

33
Q

What is an ear canal osteoma? Is it an issue?

A

It’s a benign bony projection intot he canal - often seen in orweigians and people who have been exposed to cold water (so minnesotans)

it’s really not an issue at all - surfical excision is rearely neeed

34
Q

What is the treatment for carcinaoms of the ear canal?

A

excision and/or radiation

35
Q

What will you see in herpes zoster oticus?

A

purulent ulcers in and around the ear - vesicles

it’s super painful, decreases hearing, facial nerve paralysis

36
Q

What are some things that can cause otorrhea?

A

otorrhea = ear drainage

otitis media, externa, allergy, trauma, CSF leak

37
Q

What is ear canal stenosis?

A

it’s when the ear canal is too small - can be congenital, post-trauma, or post-infeciton

often you’ll need surgery to widen it because small amoutns of wax will plug it

38
Q

What is otomycosis?

A

fungal growht in the ear - it will look like modly bread pretty much

39
Q

What is the risk factor for developing otomycosis?

A
  1. prior antibacterial drops for an ear infection
40
Q

What is the treamtent for otomycosis?

A

debridement and antifungal drops

41
Q

What method for cerumen removal do otologists prefer?

A

instrument techniques like suctioning, curetting, or grasping with alligators

they really don’t use irrigation

42
Q

What symptoms will you see in a tympanic membrane perforation

A

ear pain, hearing loss, otorrhea, tinnitus

43
Q

What is the management for a TM perf?

A

they don’t all require surgery - many will heal with time

if you’re not doing surgery, you need to keep the ear dry til it heals

44
Q

What is bullous myringitis?

A

an inflammation of the TM with serous bullae formation - associated with virus or mycoplasma

45
Q

What is tympanosclerosis?

A

white plaque formaiton on the TM (hyaline or calcium) after trauma like tubes for otitis media

benign if it only affects the TM, if it involves the middle ear you might have some conductive loss

46
Q

What is a cholesteatoma?

A

a soft ball of keratin that ends up int he ear and causes bone erosion

47
Q

What is the treatment for cholesteatoma?

A

all of them have to be surgically excised to prevent complete destruction of the ear

48
Q

What are the 3 most common pathogens that cause acute otitis media?

A

S. pneumoniae, H influenza, Moraxella catarrhalis

49
Q

What is a serous otitis media? WHat is the management?

A

if’s when you have fluid behind the TM but no infection

antibiotics will do nothing

make them go home and if it’s still there in 12 weeks, put in tubes

50
Q

Why might a child have a red TM and still be completely healthy?

A

crying iwll turn the TM red

51
Q

What is the management for acute otitis media/

A

oral antibiotics (or topical antibiotic drops if the TM is already perforated).

52
Q

What are the indications for PE tubes?

A

recurrent OM - over 3 episodes in 3 months or over 4 episodes in a year

persistent effusin over 3 months

poor response to ABx

cleft palate

immnocompromis

chronic eustachian tube dysfunction

53
Q
A

Neuro Block 3 (24 decks)

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