Ear diseases Flashcards
1
Q
Name some generalised SYMPTOMS of ear disease
A
Hearing Loss
Tinnitus
Vertigo
Otalgia
Ear Discharge
Facial Weakness
Previous Ear Surgery
Nasal symptoms
Family History
Specific paediatric history
Neurological symptoms
2
Q
What are the types of hearing loss
A
Conductive
Sensorineural
Mixed
3
Q
What are some SIGNS of ear disease?
A
- external scars
- abnormalities of ear canal(discharge, swelling, bleeding)
- masses (Changes in ear drum, swelling over mastoid, facial weakness, hearing loss)
4
Q
Which disease is associated with “glue ear”
A
acute otitis media
5
Q
which group of people does acute otitis media affect
A
children
6
Q
what ear disease is associated with URTI?
A
acute OM
7
Q
Which disease is known as glue ear
A
otitis media with effusion
8
Q
what are the causes of OM with effusion in adults?
A
9
Q
Which anatomical part fo ear is affected in otitis media with effusion
A
10
Q
what is otitis externa
A
11
Q
what are the common causes of otitis externa
A
12
Q
what is the most common cause of perforation
A
13
Q
A
13
Q
what is cholesteatoma
A
14
Q
what are the consequences of cholesteatoma?
A
15
Q
what is the treatment for cholesteatoma
A
16
Q
what are the complications associated with cholesteatoma and acute OM
A
Laterally
- Subperiosteal abscess
Medially
- Sensorineural Hearing Loss /Tinnitus / Vertigo / Facial Palsy
Superiorly
- Brain Abscess / Meningitis
Posteriorly
- Venous Sinus Thrombosis
17
Q
what is otosclerosis
A
18
Q
which group of people is most commonly affected by otosclerosis
A
19
Q
what is the treatment for otosclerosis
A
20
Q
otosclerosis progresses more rapidly during ____?
A
pregnancy
21
Q
presbycusis has to do with ___ frequency and has a highly ____ onset
A
high, variable
22
Q
noise-induced hearing loss has a classical dip at __
A
4 kHz
23
Q
which drugs are known to cause sensorineural hearing loss?
A
Gentamicin and other aminoglycosides
Chemotherapeutic drugs – e.g. Cisplatin, Vincristine
Aspirin and NSAIDs (in overdose)
24
what is a vestibular schwannoma
25
what are the symptoms of vestibular schwannoma
26
what is the diagnostic investigation for vestibular schwannoma
MRI
27
what is the characteristic sign of base of skull fracture
Battle sign
28
what is vertigo
29
how would you differentiate between causes of dizziness based off of symptoms?
CARDIAC--Lightheadedness, syncope, palpitations
NEUROLOGICAL-- Blackouts, visual disturbance, paraesthesia, weakness, speech & swallow problems
VESTIBULAR--Vertigo is a sensation of motion: spinning, falling, being pushed
30
what does duration of episodes about vertigo tell us about the underlying cause?
31
what are the associated symptoms with vertigo
Duration of episodes is the key:
Seconds – BPPV
Hours – Meniere’s
Days – Vestibular neuritis
Variable – migraine associated vertigo
32
what is the commonest cause of vertigo on looking up
33
what are the causes of BPPV
34
what is the underlying pathophysiology of BPPV?
35
what are the key features of vertigo that strongly indicates BPPV?
36
which is the diagnostic examination for BPPV?
Dix-Hallpike manoeuvre
37
what is the treatment of BPPV?
- Epley manoeuvre
- Selmont manoeuvre
- Brandt-Daroff exercises
38
how long does vertigo last for labrynthitis
39
what are the associated symptoms with labyrinthitis?
40
what is the aetiology of vestibular neuronitis/labyrnthitis?
41
what is the management of labyrinthitis
42
what is the rule of 3's in the management of vestibular neuronitis/labyrinthitis
43
what is the underlying pathophysiology of Meniere's disease
endolymphatic hydrops
44
what is the typical history of mèniere's disease
45
what are the symptoms of meniere's disease
46
meniere's disease is associated with typically ___frequency _______ hearing loss
low, sensorineural
47
what is the management for meniere's disease
48
what are some preventative measures for meniere's disease
49
what is the management of meniere's disease
50
what is the most common auditory symptom associated with migraine
51
what are the common symptoms associated with migraine-induced vertigo?
- spontaneous attacks of vertigo and ataxia
- phonophobia
- fluctuating hearing loss and acute permanent hearing loss
- motion sensitivity with bouts of motion sickness (2/3 patients with migraine)
52
what is the treatment for migraine?
(lifestyle and pharmacological?)
53
what are some common triggers associated with migraine?
54
what are the symptoms associated with vestibular schwannoma
55
which disease is associated with asymmetric hearing loss and how is it diagnosed
56
what constitutes chronic otitis media
Otitis media with effusion (Glue Ear)
Cholesteatoma
Perforation
57
what might be the causes of OME in adults
58
what is acute mastoiditis
59
what are the clinical features of acute mastoiditis
60
how do you investigate mastoiditis?
61
what is the management of mastoiditis
62
what is the complication associated with mastoiditis?
63
what type of hearing loss is associated with trauma to the ear?
conductive
sensorineural
mixed
64
What bacteria are associated otitis externa (most likely -> least likely)
65
What are the fungi responsible for otitis externa?
66
Name some common trigger for otitis externa
67
What are the clinical features of otitis externa
68
What is the first-line management for otitis externa?
Topical aural toilet
69
What is the treatment for fungal otitis externa?
70
What is the treatment for bacterial otitis externa?
71
What is the treatment for eczematous otitis externa?
72
What is acute otitis media?
73
Which ear pathology is commonly associated with URTIs?
74
What are the most likely microorganisms causing acute otitis media?
75
How does infection spread from throat to the ear?
76
What are the symptoms of acute otitis media?
77
What does it mean when pain subsides and there is discharge in acute otitis media?
78
What do these clinical signs indicate?
Inflamed ear, bulging opaque tympanic membrane, pain fever?
79
What is the diagnostic investigation for acute otitis media?
80
In which circumstances would you prescribe oral ABx in acute otitis media?
81
Which is the first and second line ABx in acute otitis media?
82
What are the complications of acute otitis media?
83
What is otitis media with effusion?
84
Which ear pathology has an association with eustachian tube dysfunction or obstruction?
85
What are the most common organisms associated with glue ear?
86
What are the risk factors for OM with effusion?
87
What disease do these clinical signs indicate?
- visible fluid/bubbles
- Altered TM colour
- TM retraction
- Impaired tympanic membrane mobility
88
What does a flat tracing in tympanogram indicate?
89
What type of hearing loss would you find in OM with effusion?
90
What is the management of OM with effusion?
91
When is surgery considered for OM with effusion?
92
What is the surgical management options for OME <3years?
93
What is the surgical management options for OME >3years?
94
What is the surgical management options for OME <3years + nasal symptoms?
95
Acute mastoiditis is a complication of which two diseases?
96
Where does OM spread that causes Acute mastoiditis?
97
Which are the most likely-causing microorganisms of Acute mastoiditis?
98
What are the clinical features of Acute mastoiditis?
99
Which is the first-line investigation for Acute mastoiditis?
100
What is the management of Acute mastoiditis?
101
What is a possible complication of Acute mastoiditis?
102
What do these clinical signs indicate?
Sudden severe pain
bleeding from the ear
hearing loss
tinnitus
103
What is the management of a perforated tympanic membrane?
104
History of frequent ear surgery is a key risk factor for which ear disease?
105
What are the most common acquired causes of cholesteatoma?
106
What are the congenital causes of cholesteatoma?
107
What is the pathophysiology of of cholesteatoma?
108
What does a histology slide look like for cholesteatoma?
109
What do these clinical signs indicate?
Unilateral persistent or recurrent discharge, often FOUL-SMELLING
110
What does retraction of TM and cheesy white material on otoscopy indicate?
110
What complications are associated with progression of cholesteatoma?
111
What is the management of cholesteatoma?
112
Which type of tumours account for majority of tumours of the ear?
SCC
113
What causes SCC of the ear?
114
How does SCC tumour of ear present clinically?
115
Carhart's notch is a classical feature of which condition?
116
Name the classical feature of otosclerosis
117
At what kHz is Carhart's notch?
118
What are the features of audiometry typically seen in otosclerosis?
119
What is the management of otosclerosis?
120
What is presbycusis?
121
Presbycusis is typically seen in what people
122
What are the causes/pathophysiology of presbycusis?
123
What type of hearing loss is seen in presbycusis?
124
What is the management of presbycusis?
125
Presbycusis has a ______ slope on audiometry
downward
126
Which part of ear does noise-induced hearing loss affect?
cochlea
127
What type of hearing loss is associated with noise exposure?
128
Which drugs can cause hearing loss?
129
The cause of vestibular schwannomas is associated with what??
130
What is the gross appearance of a vestibular schwannoma?
131
Describe the histology of vestibular schwannoma
132
Palisading nuclei is characteristic of which disease?
133
What type of hearing loss is associated with vestibular schwannoma?
134
What is the definitive management for vestibular schwannomas?
135
What is malignant (necrotising) otitis externa?
136
What is the most common microorganism causing malignant (necrotising) otitis externa?
Pseudomonas aeruginosa
137
What are the risk factors for for malignant (necrotising) otitis externa?
138
What are the signs and symptoms of malignant (necrotising) otitis externa?
139
What are the investigations for malignant (necrotising) otitis externa?
140
What is the management of malignant (necrotising) otitis externa?
141
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