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AY ENT > Ear disease > Flashcards

Ear disease Flashcards

1
Q

What are the 6 symptoms of ear disease?

A 
Deafness 
Discomfort 
Discharge 
Dizziness
Din Din (tinnitus) 
Defective movement of face
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2
Q

What is conductive hearing loss?

A

Issue with ear canala. drum or middle ear where sound is just not getting in

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3
Q

Examples of causes of conductive deafness

A 
Ear wax 
Otitis media 
Otitis Externa 
Barotrauma 
Otosclerosis 
Cholesteatoma
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4
Q

What is sensorineural hearing loss?

A

Can be sensory (cochlear) or neural (acoutstic nerve) - sound is getting in but not being sensed

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5
Q

What is central deafness?

A

If all ear function are working well deafness an be caused by brain issues e.g. stroke

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6
Q

What is the most common reason for earache in adults?

A

Referred pain

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7
Q

What nerves can cause ear ache?

A

CN V, VII, IX, X

C2, C3

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8
Q

What is otorrhoea?

A

Discharge from the ear

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9
Q

How is the pain described in AOM?

A

Crescendo pain

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10
Q

Causes of otorrhoea?

A

AOM
COM
CSF

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11
Q

How is tinnitus first line treated?

A

Adaptation therapy

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12
Q

Which condition is often seen in keen swimmers?

A

Otitis Externa

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13
Q

What are the most common bacterial causes of OE?

A

Haem influenzae

Stre penumonaie

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14
Q

What are the 2 most common causes of fungal OE?

A

Aspergillus

Candida

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15
Q

What is the treatment of otitis externa?

A

Suction cleaning

Antifungals (clotrimoxazole)

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16
Q

First line antibiotic in OM

A

Amoxicillin (clarythromycin)

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17
Q

What is a rare but serious complication of AOM?

A

Intracranial complications

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18
Q

What is glue ear?

A

Fluid behind intact ear drum in the abscence of overt infection

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19
Q

Management of OME

A

Watch for up to 3 months if not put in ventilation tube to drain

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20
Q

What is chronic OM?

A

Perforation that hasn’t healed

21
Q

Treatment of chronic OM

A

Treat with antibiotics to dry up then operate to close it

22
Q

What is a cholesteatoma?

A

Squamous epithelium in middle ear

23
Q

Causes of cholesteatoma?

A

Can go through perforation

Ear drum retracted back

24
Q

What is the most common investigation of the ear?

A

CT scan of temporal bone

25
Q

What is vertigo?

A

A sensation of movement, usually spinning

26
Q

What is the clinical relevance of the VOR?

A

Nystagmus will be observed in vestibular pathologies

Drection of nystagmus will depend on involved structures

27
Q

What are important to ask in a history of a dizzy patient?

A 
Triggers?
Time course?
Associated symptoms?
Precipitators?
Alleviating factors?
Medication?
Alcohol?
28
Q

Examination of dizzy patients?

A 
Otoscopy 
Buerological (esp. eye movements) 
BP including lying/standing 
Balance system 
Audiometry
29
Q

Common nto ear related causes of dizziness

A

Postural dizziness
Side effect of medication
Psychogenic & interaction with imbalance

30
Q

What is the commonest cause of vertigo on looking up?

A

BPPV

31
Q

Causes of BPPV

A

Head trauma
Ear surgery
Idiopathic

32
Q

Pathophysiology of BPPV?

A

Otolith matieral from utricle is displaced into semicircular canals

33
Q

Which SSC is BPPV most common in?

A

Posterior SSC

34
Q

What can BPPV be confused with?

A

Vertebrobasilar insufficieny

35
Q

How is VBI diagnosed?

A

Other symptoms of impaired circulation in posterior brain associated with the vertigo (e.g. visual disturbance, weakness, numbness)

36
Q

Clinical presentation of BPPV

A

Vertigo on:
- looking up
- turning in bed (often worse to one side)
- First lying down in bed at night
- on first getting out of bed in the morning
- bending forward
- rising from bending
- moving head quickly (often only in one direction)
Brief episodes
No associated tinnitus, hearing loss, aural fullness

37
Q

How is BPPV evaluated clinically?

A

Hallpike’s test

38
Q

Management of BPPV

A

Epley manoeuvre

Brandt-Daroff exercises

39
Q

What is Hallpikes test?

A

Lie patient back with head off end of bed as quickly as possible
Tell patient to keep eyes open and look for nystagmus

40
Q

How long does a patient have to wait in each position of the epley manouevre?

A

30 secs - 1 min

41
Q

Clinical presentation of vestibular neuronitis

A

Prolonged vertigo (days)
No associated tinnitus or hearing loss
Probable viral aetiology
May be viral prodomal symptoms

42
Q

What is vestibular neuronitis?

A

Inflammation of vestibular nerve

43
Q

Clinical features of labrynthitis

A

Prolonged vertigo (days )
May be asociated tinnitus or hearing loss
Probable viral aetiology
Mat be viral prodromal symptoms

44
Q

Treatment of vestibular neuronitis & labbyrinthitis

A

Supportive management

45
Q

Features of Menieres disease

A

History of recurrent, spontaneous, rotational vertigo with at least 2 episodes

46
Q

Management of Meniere’s disease

A 
Supportive treatment during episodes 
Tinnitus therapy 
Hearing aids 
Grommet insertion 
Intratympanic gentamicin/steroids
47
Q

What percentage of migraine sufferers have spontaneous attacks of vertigo & ataxia?

A

25%

48
Q

How is definite migranoius vertigo diagnosed?

A

Episodic vestibular symptoms of at leat moderate severity (interfere but not impede daily activities)
Migraine according to the international headache society criteria
Other causes ruled out

49
Q

What is otosclerosis?

A

Inherited disorder causing progressive deafness due to gradual ossification of the inner ear

AY ENT (11 decks)

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