Ear disorders

Question 1

Sense of fullness, popping/crackling, retraction of tympanic membrane

Answer 1

Eustachian Tube Dysfunction

Question 2

Fluid in the middle ear space following AOM, TM retracted and nonmobile

Answer 2

Otitis media with Effusion (OME)

Question 3

Dysfunction resulting from negative pressure in the middle ear space

Answer 3

Eustachian Tube Diseases

Question 4

Family HO HL, skipped generations, “cookie-bite” form

Answer 4

Hereditary SNHL

Question 5

Bilateral fluctuating hearing loss

Answer 5

Autoimmune SNHL

Question 6

Decrease in hearing, pain, child playing with beads

Answer 6

Foreign Body

Question 7

Recurrent painful erythema/edema affecting cartilage of ear and tracheobronchial

Answer 7

Relapsing polychondritis

Question 8

Sudden pain, quickly relieved, temporary hearing loss

Answer 8

Tympanic Membrane Perforation

Question 9

Pain, decrease in hearing, dizziness, q-tip and earplug use

Answer 9

Cerumen impaction

Question 10

Tenderness on mastoid/temporal bone, forward displacement of Pinna

Answer 10

Mastoiditis

Question 11

Extreme itching of external auditory canal

Answer 11

Pruritus

Question 12

Rapid shifts in barometric pressure, ear pain, dizzy, feeling of fullness

Answer 12

Barotrauma

Question 13

Age-related, symmetric high-frequency SNHL, tinnitus, loss of clarity (background noise), normal exam

Answer 13

Presbycusis

Question 14

Prolonged exposure to sounds exceeding 85 dB, loss of high frequency

Answer 14

Noise Trauma SNHL

Question 15

Bony overgrowths in ear canal, exposure to cold water from surfing

Answer 15

Exostoses

Question 16

A problem or obstruction conducting sound waves anywhere along the route through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles)

Answer 16

Conductive Hearing Loss

Question 17

Ringing, buzzing, sounds with hearing loss, worse in quiet environments, hyperacusis (super sensitive to sounds)

Answer 17

Tinnitus

Question 18

Water exposure, otalgia, pruritus, purulent discharge, pain during manual manipulation of auricle, red TM

Answer 18

Otitis Externa

Question 19

Young bottle-fed child in daycare, flu season, ear pain, fever, fussy, red tympanic, MIDDLE EAR EFFUSION (fluid)

Answer 19

Acute otitis media (AOM)

Question 20

Congenital Auricle Malformations

Answer 20

REFER Early! Associated with kidney abnormalities

Question 21

Adult caucasian with FH, progressive bilateral asymmetric CHL, + Weber and Rinne on affected side

Answer 21

Ostosclerosis

Question 22

Dysfxn of sensory or neural components of auditory system

Answer 22

Sensorineural Hearing Loss

Question 23

Rapid onset HL upon awakening, following viral infection, tinnitus, dizzy, normal exam

Answer 23

Sudden SNHL - REFER

Question 24

An 18-month-old toddler presents with 1 week of rhinorrhea, cough, and congestion. Her parents report she is irritable, sleeping restlessly, and not eating well. Overnight she developed a fever. She attends day care and both parents smoke. On examination signs are found consistent with a viral respiratory infection including rhinorrhea and congestion. The toddler appears irritable and apprehensive and has a fever. Otoscopy reveals a bulging, erythematous tympanic membrane and absent landmarks.

Answer 24

Otitis Media

Question 25

A 35-year-old man presents with a 2-day history of rapid-onset severe ear pain and fullness. The patient complains of otorrhea and mild decreased hearing. He reports that his symptoms started after swimming. No fever is reported. On physical exam the external ear canal is diffusely swollen and erythematous. He has tenderness of the tragus and pain with movement of the auricle. The tympanic membrane was partially visualized due to the swelling. The concha and the pinna look normal. Neck exam fails to reveal any lymphadenopathy.

Answer 25

Otitis Externa

Question 26

A 3-year-old girl presents with recurrent acute otitis media, refractory to antibiotics. She has been noted to have a mild conductive hearing loss and flat tympanograms on audiometric assessment. A serous effusion is present bilaterally on otoscopic exam.

Answer 26

Eustachian Tube Dysfxn

Question 27

A 40-year-old woman presents with a 1-year history of recurrent episodes of vertigo. The vertigo spells are described as a sensation of the room spinning that lasts from 20 minutes to a few hours and may be associated with nausea and vomiting. The spells are incapacitating and are accompanied by dizziness, vertigo, and disequilibrium, which may last for days. No loss of consciousness is reported. The patient also reports aural fullness, tinnitus, and hearing loss in the right ear that is more pronounced around the time of her vertigo spells. Physical exam of the head and neck is normal. A horizontal nystagmus is noted. She is unable to maintain her position during Romberg testing or Fukuda stepping test. She turns toward the right side and she is unable to walk tandem. Her cerebellar function tests are normal.

Answer 27

Meniere’s Disease