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Y2 ENT > Ear Conditions > Flashcards

Ear Conditions Flashcards

1
Q

what ages are affected by cholesteatoma

A

any age

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2
Q

what is the presentation of cholesteatoma

A

unilateral pain/discomfort, mild hearing loss, cheesy discharge

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3
Q

what type of hearing loss can cholesteatoma cause

A

conductive

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4
Q

what is common causes of cholesteatoma

A

chronic otitis media, trauma or metaplasia

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5
Q

what type of metaplasia occurs in cholesteatoma

A

middle ear respiratory epithelium becomes keratinized squamous epithelium

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6
Q

what is the pathology of cholesteatoma

A

keratinous flakes and -ve middle ear pressure cause a vacuum which retracts the TM until it perforates

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7
Q

what is done in primary care for cholesteatoma

A

otoscope and referral

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8
Q

what is done is secondary care for cholesteatoma and why

A

diffusion weighted MRI to assess ossicle involvement

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9
Q

what is the management of cholesteatoma

A

removal under general anaesthetic

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10
Q

what are the complications of cholesteatoma

A

brain abscess, vertigo, ossicle damage

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11
Q

what is the presentation of meniere’s disease

A

acute attacks and hearing and balance function destroyed over years, feeling of aural fullness

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12
Q

what happens in an acute attack of meniere’s disease

A

hours of unilateral tinnitus, nausea and vomiting, nystagmus

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13
Q

what type of hearing loss does meniere’s disease cause

A

low frequency sensineural loss

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14
Q

how is meniere’s disease diagnosed

A

exclusion, MRI to exclude vestibular trauma and SOL

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15
Q

what is the management of meniere’s disease in an acute attack

A

vestibular sedative

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16
Q

what is the prophylaxis of meniere’s disease attacks

A

betahistine

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17
Q

what is the management of meniere’s disease to stop vertigo (only when hearing completely abolished)

A

grommet delivering intratympanic gentamicin

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18
Q

what are some risk factors for glue ear

A

smoking household, premature, recurrent URTI

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19
Q

what age and gender is most commonly affected by glue ear

A

boys age 2-7

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20
Q

what is the cause of glue ear

A

chronic otitis media or recurrent AOM

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21
Q

what is the pathology of glue ear

A

eustachian tube dysfunction causes -ve pressure vacuum retracts TM, effusion behind membrane

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22
Q

what is seen on otoscopy in glue ear

A

retracted or bulging grey drum, air fluid level behind membrane, bubbles

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23
Q

when to refer glue ear from primary care

A

> 3 months

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24
Q

what type of hearing loss does glue ear cause

A

mild conductive loss (20-30)

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25
Q

what is the presentation of glue ear

A

midl hearing loss, URTIs +- speech delay, no pyrexia no pain, no discharge

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26
Q

what tests are done after referral for glue ear

A

tympanogram + PTA

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27
Q

what is the initial management of glue ear

A

wait, review after 3 months

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28
Q

what is the treatment of glue ear and when is it indicated

A

if persisted >3month and CHL >25 and bilateral grommets + amoxicillin

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29
Q

what is the management of unilateral glue ear

A

do nothing

30
Q

what is the management of a recurrence of glue ear

A

grommets plus adenoidectomy

31
Q

what is the presentation of benign positional paroxysmal vertigo

A

when moving head/looking up 30sec-1min episodes of vertigo (room spinning)

32
Q

what is the pathology of benign positional paroxsymal vertigo

A

Ca crystals detach from urticle, moving stimulates posterior semicircular canal

33
Q

what test is diagnostic of BPPV and what is a positive result

A

dix-hallpike test, nystagmus

34
Q

what is the management of BPPV

A

epley maneuver

35
Q

what are the 4 types of hearing loss

A

conductive
sensorineural
mixed
central

36
Q

what is the pathology of conductive hearing loss

A

effusion/blood/CSF/wax/foreign body obstruct middle ear

37
Q

what scan is useful in conductive hearing loss

A

CT

38
Q

which type of hearing loss is Rinne’s positive in

A

sensorineural

39
Q

what is otosclerosis

A

stapes fixation in round window, conductive hearing loss

40
Q

is bone or air conduction affected by conductive hearing loss

A

air conduction

41
Q

what causes a sensory hearing loss

A

hair cell damage

42
Q

is bone or air conduction affected by sensorineural hearing loss

A

bone and air conduction the same

43
Q

what type of hearing loss is presbycusis

A

sensorineural

44
Q

what type of hearing loss is noised induced hearing loss

A

sensorineural

45
Q

what scan is useful in sensorineural hearing loss

A

MRI

46
Q

what is the cause of acute otitis media

A

viral URTI +- secondary bacterial infection spreads via eustachian tube

47
Q

what bacteria can cause AOM

A

s. pneumoniae, h. influenzae, s. pyogenes, Moraxella

48
Q

what bacteria can cause chronic otitis media

A

pseudomonas

49
Q

what is seen on otoscopy in acute otitis media

A

opaque/bulging TM +- TM perforation

50
Q

what ages are affected by AOM

A

child/infant

51
Q

what is the presentation of AOM

A

otalgia, discharge, fever, lethargy, +- decreased hearing

52
Q

what causes relief of symptoms in AOM

A

TM perforates

53
Q

what is the management of AOM

A

most self limiting

54
Q

when are ABx indicated in AOM

A

less than 2y.o or severe

55
Q

what ABx are used for AOM

A

1st PO amoxicillin, 2nd erythromycin

56
Q

why is amoxicillin used over penicillin in AOM

A

better oral absorption

57
Q

what are the common infecting organisms in otitis externa

A

fungal: Aspergillus/ candida
bacterial: s. aureus/ pseudomonas

58
Q

what is the general presentation of otitis externa

A

red, swelling, itch, pain, discharge, >ear wax, +- hearing loss

59
Q

what is the management of fungal otitis externa

A

clean + TOP clotrimazole

60
Q

what is the management of bacterial otitis externa

A

acetic acid ABx and TOP aural toilet. gentamicin if severe

61
Q

what is the cause of vestibular neuritis

A

viral infection

62
Q

what is the presentation of vestibular neuritis

A

sudden onset vertigo for days, no tinnitus or hearing loss

63
Q

what is the management of vestibular neuritis

A

vestibular sedative, self-limiting

64
Q

what is the cause of labyrinthitis

A

viral infection

65
Q

what is the presentation of labyrinthitis

A

sudden onset vertigo for days, tinnitus, hearing loss

66
Q

what is the management of labyrinthitis

A

vestibular sedative, self-limiting

67
Q

what is a vestibular schwannoma

A

benign vestibular nerve tumour in temporal bone

68
Q

what is seen on histology of a vestibular schwannoma

A

spindle cells

69
Q

what condition are you suspicious of in bilateral vestibular schwannoma in a young patient

A

neurofibromatosis type 2

70
Q

what is cauliflower ear

A

pinna haematoma (sub-perichondral haematoma)

71
Q

what is the management of cauliflower ear

A

aspirate blood, pressure dressing

72
Q

give an example of an ototoxic drug

A

gentamicin

Y2 ENT (12 decks)

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