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Holy Grail Docs > Ear Disease > Flashcards

Ear Disease Flashcards

1
Q

can otitis external affect hearing?

A

yes

discharge and increased ear wax can cause blockage causing a temporary conductive hearing loss

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2
Q

investigation of otitis externa?

A

can swab

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3
Q

management of otitis externa?

A

topical aural toilet

topical clotrimazole if fungal

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4
Q

what is ramsey hunt syndrome?

A

shingles of the facial nerve affecting the outer ear

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5
Q

how might ramsey hunt syndrome present?

A

hearing loss
vertigo
facial nerve palsy

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6
Q

how is ramsey hunt syndrome managed?

A

systemic anti-herpetic therapy

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7
Q

signs of otitis media?

A

fullness
bulginess
cloudiness
redness of tympanic membrane

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8
Q

symptoms of otitis media?

A

otalgia
fever
irritability
can get some conductive hearing loss

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9
Q

investigation of otitis media?

A

history
otoscopy
audiometry

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10
Q

management of acute otitis media?

A

80% resolve in 4 days without antibiotics
1st line = amoxicillin
2nd line = erythromycin

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11
Q

describe aetiology of otitis media with effusion (OME)

A

more common in males

more common in children

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12
Q

signs of OME?

A

fluid line present on tympanic membrane
retraction of tympanic membrane
altered motility

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13
Q

symptoms of OME?

A

conductive hearing loss

could have poor performance at school, behavioural issues and speech delay

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14
Q

how is OME investigated?

A

otoscope
audiometry
tympanometry

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15
Q

how is OME managed?

A

watch and wait - most resolve within 3 months

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16
Q

management of OME if not resolving after 3 months?

A

1st occurrence = grommet insertion

2nd occurrence = grommet and adenoidectomy

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17
Q

what is cholesteatoma and what causes it?

A

abnormal production of keratin in the middle ear

idiopathic or result of chronic otitis media and perforated tympanic membrane

18
Q

symptoms of cholesteatoma?

A

hearing loss
discharge
visible keratin in middle ear

19
Q

how is cholesteatoma diagnosed?

A

diffusion weighted MRI

20
Q

how is cholesteatoma managed?

A

surgery

21
Q

what is otosclerosis and what causes it?

A

abnormal thickening of the osicles

idiopathic

22
Q

signs and symptoms of otosclerosis?

A

gradual onset conductive hearing loss

23
Q

how is otosclerosis managed?

A

stepedectomy

24
Q

how is vertigo examined?

A 
otoscopy
neurological
blood pressure including lying/standing
balance system
audiometry
25
Q

what is BPPV and what causes it?

A

benign paroxysmal positional vertigo
calcified otolith becomes dislodged from utricle into semi-circular canal
can be caused by head trauma, ear surgery or can be idiopathic

26
Q

signs/symptoms of BPPV?

A

position triggered vertigo that lasts seconds (e.g looking up, turning in bed)

27
Q

how is BPPV investigated?

A

dix-hallpike manoeuvre

28
Q

how is BPPV managed?

A

epley manoeuvre

brandt daroff manoeuvre

29
Q

what causes menieres?

A

idiopathic

30
Q

signs/symptoms of menieres?

A

history of recurrent, spontaneous, rotational vertigo with at least 2 episodes lasting >20 mins (often hours)
prodromal vomiting
feeling of fullness in affected ear
sensorineural hearing loss - before or during

31
Q

how is menieres investigated?

A

head CT to exclude other causes

32
Q

how is menieres managed?

A

supportive treatment during episodes

grommets or vestibular suppressors if severe or continuous

33
Q

what usually causes vestibular neuritis/labrynthitis?

A

usually viral

34
Q

symptoms of vestibular neuritis/labrynthitis?

A 
vertigo for hours/days
nausea
vomiting
no associated tinnitus or hearing loss in vestibular neuritis
hearing loss is seen in labrynthitis
may have viral prodromal symptoms
35
Q

how is vestibular neuritis/labrynthitis managed?

A 
usually self limiting 
may need further investigation/rehabilitation if prolonged or atypical
rule of 3s:
- in bed 3 days
- off work 3 weeks
- off balance for 3 months
36
Q

what is an acoustic neuroma/vestibular schwannoma?

A

rare benign tumour arising in vestibular portion of vestibulocochlear nerve within the temporal bone

37
Q

describe the tumours in acoustic neuroma/vestibular schwannoma?

A

95% are sporadic and unilateral

38
Q

if a in acoustic neuroma/vestibular schwannoma was bilateral and occurring in a young person, what might this suggest?

A

Neurofibromatosis 2

39
Q

signs/symptoms of in acoustic neuroma/vestibular schwannoma?

A

absent corneal reflex
hearing loss
tinnitus
imbalance

40
Q

how is in acoustic neuroma/vestibular schwannoma diagnosed?

A

MRI

41
Q

noise induced hearing loss has a classical dip at what frequency?

A

5Hz

42
Q

what is prebyscuis?

A

age related hearing loss
usually at high frequency
can treat with hearing aids

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