ear disorders Flashcards
What is the primary cause of otitis media with effusion (OME)?
A) Viral infection
B) Incomplete resolution of acute otitis media (AOM)
C) Fungal infection
D) Bacterial conjunctivitis
B) Incomplete resolution of acute otitis media (AOM)
Otitis Media with Effusion (OME)
Causes
Incomplete resolution of acute otitis media (AOM)
Recent or concurrent upper respiratory infection (URI) such as RSV or influenza
Eustachian tube dysfunction
Allergies
Sinusitis/rhinitis
Pharyngitis
Which symptom is NOT commonly associated with OME?
A) Pain
B) Stuffiness and fullness in the ear
C) Loss of auditory acuity
D) Popping, crackling, or gurgling sound
A) Pain
What is the characteristic appearance of the tympanic membrane (TM) in OME?
A) Clear and transparent
B) Dull with decreased mobility
C) Red and swollen
D) Perforated
B) Dull with decreased mobility
When should antibiotics be considered for OME?
A) Immediately upon diagnosis
B) If effusion persists past 12 weeks
C) After 24 hours of symptoms
D) Only if there is severe pain
B) If effusion persists past 12 weeks
When should antibiotics be considered for OME?
A) Immediately upon diagnosis
B) If effusion persists past 12 weeks
C) After 24 hours of symptoms
D) Only if there is severe pain
B) If effusion persists past 12 weeks
When should a patient with OME be referred to an ENT specialist?
A) If symptoms improve within 4 weeks
B) If hearing loss occurs
C) If effusion resolves spontaneously
D) For mild ear discomfort
B) If hearing loss occurs
What is the role of decongestants in the treatment of OME?
A) Highly recommended
B) Effective in drying up effusion
C) Not supported by evidence
D) First-line treatment
C) Not supported by evidence
What should patients with OME avoid to prevent tympanic membrane perforation?
A) Loud noises
B) Sharp objects in the ear
C) Swimming
D) Flying
B) Sharp objects in the ear
What should be done if a patient with AOM has significant hearing loss?
A) Refer to an ENT specialist
B) Increase the antibiotic dosage
C) Stop all medications
D) Apply warm compresses
A) Refer to an ENT specialist
What is a common cause of acute otitis media (AOM)?
A) Fungal infection
B) Microbial (bacteria or virus)
C) Allergies
D) Trauma
B) Microbial (bacteria or virus)
Which condition is a differential diagnosis for AOM?
A) Sinusitis
B) Otitis externa
C) Glaucoma
D) Cataracts
B) Otitis externa
Which symptom is commonly associated with AOM?
A) Severe headache
B) Double vision
C) Deep ear pain
D) Persistent cough
C) Deep ear pain
Which diagnostic test is used to assess TM mobility in AOM?
A) MRI
B) CT scan
C) Pneumatic otoscopy
D) Ultrasound
C) Pneumatic otoscopy
What comfort measure can be used for AOM?
A) Cold compresses
B) Local heat
C) Antihistamines
D) Decongestants
B) Local heat
Which symptom indicates a possible complication of AOM requiring an emergency referral?
A) Mild ear discomfort
B) Severe headache
C) Slight dizziness
D) Low-grade fever
B) Severe headache
To confirm a diagnosis of AOM, which of the following must be observed?
A) Acute onset of symptoms, presence of middle ear effusion, and ear pain
B) Chronic ear drainage and a history of ear infections
C) Clear TM and normal hearing
D) Presence of nasal congestion and sore throa
A) Acute onset of symptoms, presence of middle ear effusion, and ear pain
Which of the following is a required criterion for diagnosing acute otitis media (AOM)?
A) Chronic ear discharge
B) Acute onset of symptoms
C) Presence of nasal congestion
D) History of ear infections
B) Acute onset of symptoms
What indicates the presence of middle ear effusion, a criterion for diagnosing AOM?
A) Clear TM with normal mobility
B) Bulging TM and limited TM mobility
C) Redness of the outer ear
D) Fluid drainage from the outer ear
B) Bulging TM and limited TM mobility
What is the recommended management for mild cases of AOM in older children and adults without severe symptoms?
A) Immediate surgical intervention
B) High-dose steroids
C) Observation protocol
D) Hospitalization
C) Observation protocol
Which management step is recommended for mild cases of AOM in older children and adults?
A) Immediate surgical intervention
B) Observation protocol
C) High-dose steroids
D) Hospitalization
B) Observation protocol
Which sign is necessary to diagnose middle ear inflammation in AOM?
A) Mild ear itching
B) Clear TM
C) Distinct erythema of TM and ear pain
D) Normal ear appearance
C) Distinct erythema of TM and ear pain
Which antibiotic is recommended if the first-line treatment for AOM fails or if there is a history of recent antibiotic use?
A) Azithromycin
B) Augmentin (Amoxicillin/clavulanate)
C) Cephalexin
D) Erythromycin
B) Augmentin (Amoxicillin/clavulanate)
Which combination of symptoms and signs is required for the diagnosis of AOM?
A) Chronic ear pain, normal TM appearance, and fever
B) Acute onset of symptoms, bulging TM, and distinct erythema of TM
C) Acute onset of symptoms, clear TM, and no ear pain
D) History of allergies, ear itching, and mild ear discomfort
B) Acute onset of symptoms, bulging TM, and distinct erythema of TM
What is the first-line antibiotic treatment for acute otitis media (AOM)?
A) Azithromycin
B) Amoxicillin
C) Ciprofloxacin
D) Doxycycline
B) Amoxicillin
Which comfort measures can be used to alleviate symptoms of AOM?
A) Cold compresses and antihistamines
B) Warm compresses and analgesics
C) Decongestants and nasal sprays
D) Antihistamines and antifungals
B) Warm compresses and analgesics
Which type of drainage is indicative of cholesteatoma in COM?
A) Clear and watery discharge
B) Chronic, grayish-yellow suppuration
C) Bloody discharge
D) Greenish pus
B) Chronic, grayish-yellow suppuration
Which diagnostic test is used to demonstrate decreased or absent tympanic membrane (TM) mobility in COM?
A) MRI
B) CT scan
C) Pneumatic otoscopy
D) Ultrasound
C) Pneumatic otoscopy
What is the first-line topical antibiotic treatment for COM?
A) Amoxicillin
B) Ciprofloxacin or Ofloxacin
C) Azithromycin
D) Erythromycin
B) Ciprofloxacin or Ofloxacin
What is a common sign of chronic otitis media (COM)?
A) Acute ear pain
B) Intermittent or continuous otorrhea lasting for more than three months
C) Sudden onset of dizziness
D) Temporary hearing loss after swimming
B) Intermittent or continuous otorrhea lasting for more than three months
What should be included in the patient education for managing COM?
A) Use earplugs at all times
B) Insert small objects to clean the ear
C) Avoid inserting objects into the ear
D) Avoid washing the ear
C) Avoid inserting objects into the ear
When should a patient with COM be referred to an ENT specialist?
A) Immediately upon diagnosis
B) For persistent hearing loss six weeks after treatment
C) If there is any ear discomfort
D) For routine check-up
B) For persistent hearing loss six weeks after treatment
What is a key risk factor to assess in patients with COM?
A) Tobacco smoke in the home
B) Recent eye infection
C) High blood pressure
D) Family history of diabetes
A) Tobacco smoke in the home
What management step is essential for keeping the ear canals clean in COM?
A) Use of Q-tips
B) Aural toilet
C) Use of ear candles
D) Regular application of cold compresses
B) Aural toilet
What is a common objective finding on the examination of a patient with chronic otitis media?
A) Clear tympanic membrane
B) Perforated, draining tympanic membrane
C) Normal ear canal appearance
D) No evidence of fluid in the middle ear
B) Perforated, draining tympanic membrane
Which bacteria is a common cause of otitis externa?
A) Escherichia coli
B) Staphylococcus
C) Mycobacterium
D) Clostridium
B) Staphylococcus
Which symptom is commonly associated with otitis externa?
A) Chronic ear pain
B) Itching of the external ear canal
C) Blurred vision
D) Nasal congestion
B) Itching of the external ear canal
Bacterial causes of otitis external
- Pseudomonas
- Staph
- Strep
What is the layman’s term for otitis externa?
A) Middle ear infection
B) Swimmer’s ear
C) Sinus infection
D) Inner ear infection
B) Swimmer’s ear
Fungal causes of otitis externa
- Aspergillus
- Candida albicans
What should be avoided to prevent otitis externa?
A) Using ear plugs during swimming
B) Prolonged exposure to warm, humid conditions
C) Wearing hats in cold weather
D) Using a humidifier at home
B) Prolonged exposure to warm, humid conditions
Which treatment is appropriate for severe otitis externa with significant swelling?
A) Oral antibiotics alone
B) Antibacterial drops with a steroid
C) Antifungal cream
D) Antiviral medication
B) Antibacterial drops with a steroid
When should a patient with otitis externa call their healthcare provider?
A) If symptoms improve within 24 hours
B) If no improvement within 48 hours
C) If the ear feels dry
D) If there is mild itching
B) If no improvement within 48 hours
What is a key preventive measure for otitis externa after swimming?
A) Using hair dryers to dry the ears
B) Inserting cotton balls into the ears
C) Drying the ears with a clean, dry towel
D) Applying moisturizer to the ears
C) Drying the ears with a clean, dry towel
Which subjective symptom is often reported by patients with otitis externa?
A) Dizziness
B) Feeling of fullness in the ear
C) Severe headaches
D) Visual disturbance
B) Feeling of fullness in the ear
What environmental condition increases the likelihood of developing otitis externa?
A) Cold and dry weather
B) Warm and humid weather
C) High altitudes
D) Low humidity
B) Warm and humid weather
Which population is more at risk for otitis externa?
A) People who wear hearing aids
B) People who wear glasses
C) People who are immunocompromised
D) People who frequently use nasal sprays
C) People who are immunocompromised
Which antibiotic drop is commonly used for treating otitis externa?
A) Ciprofloxacin and dexamethasone (Ciprodex)
B) Amoxicillin
C) Azithromycin
D) Erythromycin
A) Ciprofloxacin and dexamethasone (Ciprodex)
What is the primary goal of inserting a wick into the ear canal for otitis externa?
A) To block further infection
B) To facilitate medication administration
C) To dry out the ear canal
D) To reduce hearing loss
B) To facilitate medication administration
What type of discharge is commonly seen in otitis externa?
A) Clear fluid
B) Bloody discharge
C) Purulent discharge
D) Watery discharge
C) Purulent discharge
Which condition is a differential diagnosis for otitis externa?
A) Conjunctivitis
B) TMJ
C) Glaucoma
D) Asthma
B) TMJ
What is the recommended duration for using Ciprodex drops in otitis externa treatment?
A) Three days
B) Five days
C) Seven days
D) Ten days
C) Seven days
which substance is commonly used in prophylactic otic drops to prevent otitis externa?
A) Hydrogen peroxide
B) 2% acetic acid
C) Saline solution
D) Olive oil
B) 2% acetic acid
Which preventive measure is recommended to avoid otitis externa after swimming?
A) Using earplugs during swimming
B) Wearing hats in cold weather
C) Using cotton swabs to clean the ears
D) Applying ear drops before swimming
A) Using earplugs during swimming
How often should prophylactic otic drops be used after water exposure to prevent otitis externa?
A) Once a week
B) Twice daily
C) Every hour
D) After each contact with water
D) After each contact with water
What is a key component of patient education for preventing otitis externa?
A) Use of cold compresses daily
B) Avoiding the use of ear drops
C) Keeping the ears dry after swimming or showering
D) Frequent ear candling
C) Keeping the ears dry after swimming or showering
Which of the following is a common reversible cause of tinnitus?
A) Gentamicin
B) Vancomycin
C) Alcohol
D) Streptomycin
C) Alcohol
Which diagnostic test is NOT commonly used for tinnitus evaluation?
A) CBC
B) Thyroid function tests
C) Liver function tests
D) Tympanometry
C) Liver function tests
What is the most important first step in managing a patient with tinnitus?
A) Start vitamin supplementation
B) Eliminate possible offending medications
C) Prescribe oral antidepressants
D) Refer to audiology
B) Eliminate possible offending medications
Which of the following medications is considered ototoxic and can cause irreversible tinnitus?
A) Salicylates (aspirin)
B) Quinine
C) NSAIDs
D) Gentamicin
D) Gentamicin
Causes of reversible tinnitus
salicylates, quinine, alcohol, and endomethasone
Which symptom is NOT part of the Meniere’s disease triad?
A) Vertigo
B) Conductive hearing loss
C) Tinnitus
D) Aural fullness
B) Conductive hearing loss
causes of irreversible tinnitus
medications with ototoxicity with irreversible effects include streptomycin, gentamicin, and vancomycin
Which medication is used for symptom management in Meniere’s disease and is also a vestibulo-suppressive antihistamine?
A) Meclizine
B) Dramamine
C) Scopolamine
D) Glycopyrrolate
A) Meclizine
What is the first-line dietary modification for managing Meniere’s disease?
A) High protein diet
B) Low salt diet
C) High carbohydrate diet
D) Low fat diet
B) Low salt diet
What is the AAOHNS criteria for diagnosing Meniere’s disease?
A) One episode of vertigo and hearing loss
B) Two distinct episodes of rotational vertigo lasting at least 20 minutes with sensorineural hearing loss and tinnitus or aural fullness
C) Persistent tinnitus and hearing loss
D) Continuous vertigo and aural fullness
B) Two distinct episodes of rotational vertigo lasting at least 20 minutes with sensorineural hearing loss and tinnitus or aural fullness
Which of the following lifestyle changes is NOT recommended for managing tinnitus?
A) Playing background music
B) Increasing salt intake
C) Reducing caffeine consumption
D) Avoiding smoking
B) Increasing salt intake
What is a common cause of tinnitus that is often related to occupational exposure?
A) Aging
B) Chronic noise exposure
C) Head trauma
D) Hypertension
B) Chronic noise exposure
Which supplement may be beneficial for patients coping with tinnitus?
A) Vitamin D
B) Vitamin A
C) Vitamin K
D) Folic acid
B) Vitamin A
Which of the following is a symptom of Meniere’s disease?
A) Continuous headache
B) Pulsatile tinnitus
C) Episodic incapacitating vertigo
D) Persistent cough
C) Episodic incapacitating vertigo
What is the first-line medication for reducing endolymphatic volume in Meniere’s disease?
A) Diuretics
B) Beta-blockers
C) Antidepressants
D) Antihistamines
A) Diuretics
Which of the following is a differential diagnosis for Meniere’s disease?
A) Acute anxiety
B) TMJ disorder
C) Otitis externa
D) Vestibular neuritis
D) Vestibular neuritis
Causes of Meniere’s disease
- Stress
- Allergies
- High salt, caffeine, and alcohol
intake - Hormonal changes
- Changes in barometric pressure
- Exposure to high levels of noise
over a long period of time
Which symptom is NOT part of the Meniere’s disease triad?
A) Sensorineural hearing loss
B) Episodic incapacitating vertigo
C) Persistent headaches
D) Tinnitus
C) Persistent headaches
Which lifestyle factor can contribute to Meniere’s disease?
A) High levels of physical activity
B) Low salt diet
C) High levels of noise exposure over a long period of time
D) Frequent napping
C) High levels of noise exposure over a long period of time
How long do acute episodes of Meniere’s disease typically last?
A) 5 to 10 minutes
B) 10 to 15 minutes
C) 20 minutes to three hours
D) Four to five hours
C) 20 minutes to three hours
Which environmental factor is a known cause of Meniere’s disease?
A) High humidity
B) Changes in barometric pressure
C) Exposure to cold temperatures
D) Low oxygen levels
B) Changes in barometric pressure
Which of the following is a common cause of Meniere’s disease?
A) Low salt intake
B) Sedentary lifestyle
C) High salt, caffeine, and alcohol intake
D) Dehydration
C) High salt, caffeine, and alcohol intake
