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Fall--Derm EENT > Ear Conditions > Flashcards

Ear Conditions Flashcards

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1
Q

tuning fork test used to confirm unilateral hearing loss–to determine wether loss is sensorineural or conductive–details

A

Weber Test

  • -conductive: heard best on affected side
  • -sensorineural: heard best on unaffected side
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2
Q

causes of conductive hearing loss (3)

TX

A
  1. cerumen impaction
  2. auditory (eustachian) tube dysfunction associated w/ URI
  3. Otosclerosis (stapes bone impeded)
    - -medical and surgical
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3
Q

weber test heard best on ________ side

A

unaffected

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4
Q

air conduction > bone conduction –but not __:__ ratio like normal hearing

A

Rinne test,

2:1

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5
Q

sensory hearing loss etiology (5)

A
  1. age
  2. excessive noise exposure
  3. diabetes
  4. head trauma
  5. ototoxicity
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6
Q

patient hears sound when tuning fork is pressed on mastoid bone

A

Rinne test

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7
Q

progressive loss of high-fq sounds w/ age advancement

A

prsbyacusis

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8
Q

Neural etiology of presbyacusis

A
  1. MS
  2. Cerebrovascular disease
  3. acoustic neuroma
  4. CN VIII lesion
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9
Q

SUDDEN sensorineural hearing loss etiologies:

TX

A

usually idiopathic, ototoxic, vascular infarct,

–oral steroids asap

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10
Q

most frequent cause of PROGRESSIVE sensory hearing loss

A

presbycusis–most pt’s notice loss of speech discrimination

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11
Q

acoustic neuroma aka

A

vestibular schwannoma

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12
Q

non-malignant tumor of CN 8–most of cerebellopontine angel tumors CPAs in adults–
test
TX

A

vestibular schwannoma,
MRI,
neurosurgery

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13
Q

etiology of tinnitus (4)

A
  1. conductive hearing loss
  2. sensorineural hearing loss
  3. ototoxic drugs
  4. head and neck injury
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14
Q

______ _____ activated w/ tinnitus, exacerbated by emotional cues

A

limbic system

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15
Q

conductive ________ fq

sensorineural _____ fq

A

lower,

high

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16
Q

________ tinnitus has vascular etiology

A

Pulsatile

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17
Q

prevention of tinnitus: screen for (4)

A
  1. Hypertension
  2. cholesterol
  3. thyroid
  4. diabetes
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18
Q

treatment for tinnitus

A
  1. steroid for sudden sensorineural HL
  2. benzos
  3. habituation
  4. sleep hygiene (Trazodone for sleep)
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19
Q

hematoma of subperichondrial space caused by blunt trauma

A

Traumatic auricular hematoma aka caulaflower ear –

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20
Q

insect in canal

A

paralyze w/ lidocaine

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21
Q

most common etiology of otitis externa (7)

A
  1. Staph. epidermidis
  2. S. aureus
  3. pseudomonas (may become necrotizing)
  4. anaerobes
  5. fungal (candida, aspergilis nigres)
  6. contact dermatitis
  7. seborrheic (chronic)`
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22
Q

Physical exam otitis externa(4)

A
  1. pain w/ tragal pressure
  2. pain when auricle pulled superiorly
  3. edema and erythema of canal
  4. debris (yellow, brown, white)
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23
Q

Tx otitis externa (3)

A
  1. remove debris
  2. antibiotic (Cipro) and steroid
  3. Fungal (Fluconazole)
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24
Q

otitis extera may progress into _______ may require ____ _____

A

cellulitis ,

IV antibiotics

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25
Q

erythema and pruritus of external auditory canal from contact w/ allergen; ex causes

A

Contact dermatitis,

hair spray, cheap ear rings, etc.

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26
Q

differential Dx of contact dermatitis (2)

A
  1. seborrheic dermatitis

2. psoriasis

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27
Q

Rare, very aggressive tumor of ear canal.

Most common type?

A

External auditory canal carcinoma,

squamous cell carcinoma

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28
Q

external auditory canal carcinoma presentation (3)

A
  1. bloody otorrhea
  2. friable lesion in ear canal–surrounding pus
  3. hearing loss/ facial paralysis
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29
Q

bony overgrowths of ear canal

A

exostosis and osteomas

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30
Q

exostoses generally acquired from repeated exposure to cold water–rq surg removal

A

“surfer’s ear”

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31
Q

history for eustachian (auditory) tube dysfunction

A
  1. ear pain
  2. ear fullness
  3. “plugged ear”
    - -different from ear infection
32
Q

eustachian tube fails to provide adequate ventilation

A

Eustachian tube dysfunction

33
Q

Dx of eustachian tube dysfunciton

A

Meniere disease

34
Q

etiology of eustachian tube dysfunction (5)

A
  1. days-weeks after viral URI
  2. allergies
  3. irritants (tobacco!)
  4. GERD
  5. hormonal changes
35
Q

middle-ear effusion WITHOUT acute signs of infection–Tx

A

serous otitis media (otitis media w/ effusion) (ALLERGIES),

same as auditory tube dysfunction oral corticosteroids (antibiotics have little/no benefit)

36
Q

history w/ serous otitis media

A
  1. hearing loss
  2. fullness in ear
  3. ear pain
  4. tinnitus
37
Q

P/E of otitis media w/ effusion

A
  1. dull TM
  2. bubbles may be visible
  3. hypomobile TM
  4. decreased hearing
38
Q

barotrauma aka

A

barotitis media

39
Q

middle ear infection

etiology (4)

A

acute otitis media,

  1. Strep pneumoniae
  2. H. influenzae
  3. M. catarrhalis
  4. viral
40
Q

pathophys of acute otitis media

A
  1. URI –> edema of eustachian tube, nose, nasopharynx
  2. negative pressure in middle ear
  3. virus/bac enters middle ear
  4. microb overgrowth
  5. effusion
41
Q

history and PE of otitis media

A
  1. ear pain, hearing loss, vertigo
  2. otorrhea, swelling, erythema around ear may indicate spread to mastoid
    3.
42
Q

children w/ otitis and conjunctivitis likely from

A

H. influenza

43
Q

symptoms of AOM usually resolve w/in ___-___ hrs of antibiotic tx

A

24-72 – recheck

44
Q

wait and see w/ uni/bilateral AOM w/out otorrhea in pt’s ___ ___ or older w/ ______ AOM

A

6 months,

uncomplicated

45
Q

Tx for AOM

A

high dose amoxicillin (if no relief–may be organism resistant to beta-lactam antibiotics)

46
Q

augmentin used when:

A
  1. antibiotics prescribed w/in last 30 days
  2. otitis-conjunctivitis syndrome
  3. pt’s recieving amoxicillin for chemoprophylaxis for recurrent AOM
47
Q

3+ distinct episodes of AOM w/in 6 months or 4+ w/in 12 months may indicate

A

TM tubes

48
Q

inflammation of mastoid air cells of temporal bone resulting from unresolved otitis media

A

acute mastoiditis

49
Q

___ and ____should always be perfomred when mastoiditis suspected

A

CT and CBC

50
Q

chronic infection of middle ear due to recurrent AOM

A

Chronic suppurative (purulent ear discharge) otitis media CSOM

51
Q

CSOM often have,

Tx

A
  1. ruptured TM
  2. sclerosis
  3. granulation tissue
    - -Cipro
52
Q

squamous epithelium-lined sac, fills w/ keratin debris when obstructed/closed–will then become chronically infected

A

cholesteatoma

53
Q

complications of cholesteatoma

A

erosion and mastoiditits, facial nerve palsy or intracranial complications

54
Q

dislodged otoconia (otoliths) causing vertigo–most common type

A

BPPV

55
Q

DDX of vertigo VINDICATE

A

Vascular–basilar or cerebral artery aneurysm
Inflammatory/ Infection: Meniere, acute labyrinthitis, otits media, migraine, meningitis
Neoplasm–acoustic neuroma, pituitary adenoma, brain tumor, olfactory meningioma, cerebellar lesion/tumor
Deficiency–
Intoxication–
Congenital–
Autoimmune– MS
Trauma– allergic rhinitis, wax, concussion , TM perf, subdural hematoma
Endocrine–

56
Q

rhythmic oscillation of eyes occuring physiologically from vestibular and optokinetic stimulation or pathologically in wide variety of diseases

A

nystagmus

57
Q

2 types of vertigo

A

Central vs. peripheral

58
Q

brief positional vertigo

A

benign paroxysmal positional vertio BPPV – Ca++ debris w/in POSTERIOR semicircular canal

59
Q

most common form of positional vertigo – 1/2 of pt’s w/ peripheral vestibular dysfunction

A

BPPV

60
Q

*Best treatment for BPPV

A

Antihistamine (meclizine)

61
Q

lorazepam

A

benzodiazepine

62
Q

most common cause of temporary vertigo accompanied by N&V

A

vestibular neuronitis (labyrinthitis)

63
Q

Neuritis:
Labyrinthitis:

A
  • -inflammation of nerve–affects vestibular nerve

- -inflammation of labyrinth (inner ear) CAUSES hearing changes AS WELL AS dizziness or vertigo

64
Q

labyrinthitis may be post (5)

A

viral URI, EBV, Measles, Mumps, Herpetic

65
Q

idiopathic vertigo due to endolymphatic hydrops

A

Menier’s syndrome (endolymphatic hydrops)

66
Q

2 know causes of Menier’s

A

syphilis and head trauma

67
Q

distention of the endolymphatic compartment of inner ear as pathologenesis of this disorder

A

Menier’s disease

68
Q

PE of Menier’s

A

peripheral nystagmus

69
Q

concussion due to head trauma–traumatic peripheral vestibular injury causing vertigo, N&V, imbalance worse following trauma, improves over days/months

A

traumatic vertigo

70
Q

vertigo secondary to neck injury–position receptors located in facets of cervical spine are important physiologically in coordination of head and eye movements

A

cervical vertigo

71
Q

lesions of the midbrain or cerebellum can result in

A

UP/DOWN beat nystagmus

72
Q

normally air conduction is 2X ______ than bone conduction

A

greater

73
Q

if ac and bc are equally bad

A

CN VIII issue

74
Q

In Weber’s test: lateralization will be ______ from side w/ neurosensory deficit

A

AWAY

75
Q

In Weber’s test: lateralization will be ______ side of air conduction deficite

A

TO

Fall--Derm EENT (8 decks)

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