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HENT > Ear Disorders > Flashcards

Ear Disorders Flashcards

1
Q

What are some defenses of the ear?

A
  • ear flap/tragus
  • hair follicles
  • cerumen
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2
Q

How does cerumen protect the ear?

A
  • “washes” the ear

- creates acidic environment

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3
Q

What is perichondritis?

A

infection of the ear CARTILAGE
-serious
(usually unilateral)

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4
Q

What is perichondritis caused by?

A
  • usually secondary to trauma

- usually caused by pseudomonas

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5
Q

Why is perichondritis difficult to cure?

A

poor vascularity

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6
Q

What is a big difference between cellulitis and perichondritis?

A
  • cellulitis is an infection of the SKIN

- might see lobe involvement with cellulitis

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7
Q

What is relapsing polychondritis?

A
  • relapsing
  • bilateral
  • probably autoimmune
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8
Q

What is Otitis Externa?

A

Generic term for generic disorders of the EAR CANAL

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9
Q

Culprits/causes of otitis externa

A
  • pseudomonas
  • fungus
  • staph aureus
  • seborrheic dermatitis
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10
Q

How does Hadley describe swimmer’s ear?

A

dishwasher’s hands of the ear

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11
Q

What otitis external might you see in DM?

A

malignant external otitis

-requires referral!

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12
Q

If an otitis external is vesicular, what should you consider?

A

consider a herpes zoster outbreak

*ENT emergency

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13
Q

sx of otitis externa

A
  • otalgia
  • pruritis
  • discharge
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14
Q

exam findings on otitis externa

A
  • erythema
  • edema
  • pain tugging on pain
  • can’t really see TM
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15
Q

Tx of otitis externa

A
  • for the most part treated topically, not oral abs usually
  • otic drops (usually steroidal for swelling)
  • abx if bacterial (vs. purulent)
  • isopropyl alcohol for drying (swimmer’s ear)
  • acetic acid for fungal or pseudomonal
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16
Q

How can you get drops deeper?

A

wick left in for a few days

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17
Q

If you prescribe abs for otitis external what should you consider?

A
  • bacterial

- must cover for pseudomonas (cipro or cortisporin)

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18
Q

What could you use to treat fungal or pseudomonal otitis external?

A

2% HAc (acetic acid/half strength vinegar)

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19
Q

What is creaminess?

A
  • excess, accumulation of cerumen

- clogs ear and affects hearing

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20
Q

Tx of ceruminosis

A
  • gently irrigate/ ear lavage

- cerumenex to soften wax before irrigation

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21
Q

What is acute otitis media

A

-bacterial infection of the middle ear

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22
Q

What are the bacterial causes of acute otitis media?

A
  • *S. pneumo
  • M. cat
  • H. flu
23
Q

What is acute otitis media usually precipitated by?

A

a URI which causes cascade of congestion which obstructs ET drainage

24
Q

What is the single best predictor of acute otitis media?

second best?

A
  • TM immobility

- “cloudiness”

25
Q

AAP update for acute otitis media

notes about what should be present/ what you should see

A
  • moderate to severe TM bulge
  • Mild TM bulge AND ear pain or intense TM erythema
  • no effusion, no AOM
26
Q

According to the AAP, what 3 things does a dx of AOM require?

A
  • hx of acute onset s/s
  • presence of MEE (middle ear effusion = fluid)
  • s/s middle ear inflammation
27
Q

Is Acute otitis media more common in children or adults? and why?

A

children

-because of angle of eustachian tube

28
Q

sx of acute otitis media

A
  • otalgia
  • fever
  • cough
  • runny nose
  • decreased hearing
29
Q

Exam findings of AOM

A
  • bulging TM
  • decreased, distorted, or absent light reflex
  • redness
  • DOCUMENTED EVIDENCE OF TYMPANIC IMMOBILITY (AAP guideline)
30
Q

Normal TM looks/findings

A
  • translucent/transparent
  • gray or pink color
  • neutral position
  • fully mobile with pneumatic otoscope
  • no effusion
31
Q

What is tympanometry

A
  • distinguishes between retracted and distended TM

- can help distinguish b/t AOM and OME

32
Q

TM characteristics of AOM

A
  • opaque
  • red, yellow, white color
  • BULGING or full position
  • reduced mobility but may respond to POS press on pneumatic otoscope
  • effusion present
33
Q

TM characteristics of Otitis Media with Effusion (OME)

A
  • transluscent or opaque
  • gray or pink color
  • neutral or RETRACTED position
  • reduced mobility which responded to NEG press on pneumatic otoscope
  • effusion present
34
Q

Tx goals of AOM

A

-decrease pain and fever

35
Q

Tx of AOM

A
  • tx pain with tylenol/ibuprofen (because it’s an inflammatory problem)
  • auralgan (antipyrine, benzocaine, dehydrated glycerin)
36
Q

abs treatment of AOM

A
  • amoxicilin first line

- Augmentin second line (amox-clav)

37
Q

Should see improvement in _____ (with AOM abx)

A

in 72 hrs

  • if not, change antibiotic
  • effusion can persist for 12 wks
38
Q

when do you recommend tubes?

A

more than 3 in 6 months

39
Q

What had led to a pathogen shift from pneumococcus to H flu?

A

pneumococcal conjugate vaccine

40
Q

55% of H. flu from children with AOM that doesn’t resolve from oral abx are________ producers

A

B-lactamase

41
Q

Otitis Media with Effusion (OME)

A
  • effusion w/o acute sx
  • no infection!!
  • fluid in middle ear without s/s of acute ear infection
42
Q

concerns of OME

A

hearing loss, effects on speech, language, learning

43
Q

what is the preferred initial procedure for persistent OME

A

tympanostomy tube insertion

44
Q

______ testing should be conducted for children who have hearing loss

A

language testing

45
Q

dix-hallpike maneuver

A

to localize labyrinthine dysfunction

46
Q

epley maneuver

A

to reposition otoliths

-habituate vertigo by performing movements that reproduce sx

47
Q

classic triad of meniere disease?

A
  • hearing loss
  • vertigo
  • tennitus
48
Q

Meniere disease s/s

A
  • hearing loss
  • vertigo
  • tinnitus
  • usually unilateral
  • intermittent attacks
49
Q

What distinguishes Meniere disease from BBPV

A

-hearing loss

no hearing loss in BBPV

50
Q

cause of miner disease

A
  • buildup of endolymph pressure

- idiopathic

51
Q

meniere disease treatment

A

scopolamine, diuretics, meclizine/antivert

52
Q

vestibular neuronitis

A
  • sudden onset vertigo
  • due to imbalance in vestibular syst
  • may involve latent herp v1
53
Q

labyrinthitis

A
  • inflammatory disorder of INNER ear/labyrinth
  • hearing loss always present
  • does NOT tend to recur (unlike vestibular neuronitis)
54
Q

What is a variant of labyrinthitis?

A
  • Herpes zoster Oticus (Ramsay-hunt syndrome)
  • reactivation of latent varicella zoster
  • initial sx deep burning auricular pain followed by vesicular rash in external canal

HENT (7 decks)

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