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Respiratory > Ear Disorders > Flashcards

Ear Disorders Flashcards

1
Q

What is conductive hearing loss?

A

Sound not transmitted to inner ear

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2
Q

What is sensorineural hearing loss?

A

Damage to inner ear

Damage to nerve pathways

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3
Q

What are the assessments for hearing loss?

A

Weber test
Rinne Test
Otoscopy
Audiometry

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4
Q

What is the presentation of conductive hearing loss on assessment?

A 
Weber test: vibrations heard in bad ear
Rinne test (-): BC > AC
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5
Q

What is the presentation of sensorineural hearing loss on assessment?

A

Weber test: vibrations heard in good ear
Rinne test (+): AC > BC (lesser degree)
Tinnitus +
Normal otoscopy

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6
Q

What are causes of sensorineural hearing loss?

A

Auditory insults

Infections

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7
Q

What is the treatment for sensorineural hearing loss?

A

Abx
Corticosteroids
Hearing aids
Cochlear implants

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8
Q

What nerve does the cochlear implant attach to?

A

Cranial nerve VIII

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9
Q

What are the causes of conductive hearing loss?

A

Obstruction
Infection
Trauma

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10
Q

What is the prevention of conductive hearing loss?

A

Treat infections early
Avoid trauma from physical object/pressure/noise
Avoid flying/scuba diving if you have sinus infection or URT infection
Protect ears from loud activities

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11
Q

What is mixed hearing loss?

A

Damage to middle or outer ear and inner ear

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12
Q

What is dizziness?

A

One’s altered orientation to spatial relationships

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13
Q

What are the components of dizziness?

A

Imbalance
Lightheadedness
Vertigo

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14
Q

What is vertigo?

A

Sensation of disorientation in space

Illusion of motion (rotational)

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15
Q

What are the types of vertigo?

A

Peripheral

Central

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16
Q

What is peripheral vertigo?

A

Whole vestibular apparatus involved
+ Hearing loss
+ Ear fullness
+ Tinnitus

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17
Q

How long does peripheral vertigo last?

A

Spells lasting sec/min/hours

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18
Q

What is ventral vertigo?

A

CNS
+ Neurological findings
+/- Hearing loss
+/- Tinnitus

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19
Q

How long does vertigo last?

A

Days/months

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20
Q

What are the s/sx of vertigo?

A

N/V
Diaphoresis
Nystagmus
Hearing loss/tinnitus

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21
Q

What are the peripheral sources of vertigo?

A

Benign positional vertigo
Meniere’s disease
Vestibular neuritis
Bacterial Labyrinthitis

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22
Q

What is the presentation of BPPV?

A

Severe verigo episodes < 60 seconds
Occurs with certain head positions
+/- N/V
No hearing loss/tinnitus

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23
Q

What are the causes of BPPV?

A

Calcium deposits in semicircular canal

From trauma, degeneration, infection

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24
Q

How can BPPV be treated?

A

Epley maneuver

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25
Q

What is the presentation of Meniere’s disease?

A 
Severe vertigo episodes 2-3 hours (less than 24 hours)
Episodes are recurrent
Sense of fullness (affected ear)
\+ Hearing loss
\+ Tinnitus
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26
Q

What are the causes of Meniere’s disease?

A

Imbalance of fluids in inner ear

Increased production and/or decreased absorption

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27
Q

What are preventative means for Meniere’s disease?

A

Sodium restriction

Diuretics

28
Q

What is the treatment for Meniere’s disease?

A

Sx tx

Antinausea/antivertigo

29
Q

What is the treatment for Meniere’s disease after treatment failure?

A

Corticosteroids (intratympanic)
Vestibular neurectomy
Intratympanic AGs

30
Q

What is vestibular neuritis?

A

Inflammation of vestibular nerve only

Cochlea not involved

31
Q

What is the presentation of vestibular neuritis?

A

Sudden vertigo episodes 7-10 days
Single episode or several attacks
No hearing loss/tinnitus
+ Nystagmus

32
Q

What are the causes of vestibular neuritis?

A

Inflammation of vestibular nerve

Likely viral

33
Q

What is the treatment of vestibular neuritis?

A

Self-limiting
Antivertigo/antiemetics
Corticosteroids

34
Q

How long should corticosteroids be given in vestibular neuritis?

35
Q

Why viral infection is not a cause of vestibular neuritis?

36
Q

What is the presentation of bacterial labyrinthitis?

A

Severe vertigo episodes
Profound hearing loss
Profound ataxia/nausea/vomiting

37
Q

What is the cause of bacterial labyrinthitis?

A

Bacteria infection of inner ear (vestibular/cochlear)

Complication of bacterial meningitis or otitis media

38
Q

What are the treatments for bacterial labyrinthitis?

A

Abx
Vertigo sx
Corticosteroids for prevention of hearing loss

39
Q

What do the cerumen glands contain?

A

Lysozymes: provide acid coat and antimicrobial

40
Q

What can cause cerumen loss?

A

Excess water (swimming/sweating)

41
Q

What is the pathology of OE?

A

Cerumen retention d/t:
Foreign bodies
Mechanical
Diseases (High cell turnover)

42
Q

What diseases cause high cell turnover?

A

Acne
Eczema
Psoriasis
Seborrhea dermatitis

43
Q

What are sx of OE?

A

Otalgia
Otorrhea
Conductive hearing loss
+/- fever, pariauricular edema (PAE)

44
Q

What are the bacteria that can cause OE?

A

P aeruginosa
S aureus
S epidermitis

45
Q

What fungi can cause OE?

A

Candida albicans

Aspergillus

46
Q

What are the abx treatments for OE?

A

Topical neo/poly/HC

Topical cipro HC or Ofloxacin

47
Q

When is cipro HC/ofloxacin used over neo/poly/HC?

A

TM perforation

48
Q

When are oral abx used in OE?

A 
Persistent OE
PAE or erythema
Pain 7+
Otitis media present (Temp > 101)
Immunocompromised
49
Q

What are preventative measures for OE?

A

Swimmers ear:
Ear plugs
Mixture of rubbing alcohol/vinegar
Ear syringe

50
Q

What drugs cause DI ototoxicity?

A

AGs
Vanc/minocycline
Diuretics
Cisplatin (and carboplatin)

51
Q

What are the irreversible DI ototoxicities?

A

AGs

Cisplatin (carboplatin

52
Q

What is the onset of AG ototoxicity?

A

2-5 days from initiation

53
Q

What is the presentation of AG ototoxicity?

A 
Bilateral
HA, N/V, oscullopsia***
\+ Imbalance
\+ Nystagmus
\+ Tinnitus
\+ Fullness
54
Q

What are RFs for AG ototoxicity?

A 
Cumulative dose
Serum drug concentration
Duration of therapy
Concurrent ototoxic meds
Age
Hearing problems
Noise exposure before and after***
Dehydration/renal failure
Bacteremia/Fever
55
Q

How do we prevent AG ototoxicity?

A

Identify high risk patients (2+ RFs)
Monitor for RFs
Monitor sx
Avoid noisy environment for 6 months***

56
Q

What is a SE of vesitibular AG ototoxicity?

A

Oscillopsia***

57
Q

How does vancomycin affect the ear?

A

Vestibular and cochlear toxicity

58
Q

What are RFs for vancomycin ototoxicity?

A

Age
Concomitant ototoxic meds
Renal failure
Correlation with SDC uncertain

59
Q

How does minocycline affect the ear?

A

Only vestibular

60
Q

What are the AEs of minocycline ototoxicity?

A

Dizziness, ataxia, N/V

May impair driving***

61
Q

What is the presentation of loop diuretic ototoxicity?

A

Rapid onset (w/in minutes) bilateral hearing loss
+/- Tinnitus
+/- Vestibular sx

62
Q

What are loop diuretic RF for ototoxicity?

A

IV loops
Infusion rate faster than 4mg/min with greater than 40mg
Renal failure
Concomitant ototoxic meds

63
Q

What is the prevention of diuretic ototoxicity?

A

Lowest possible dose
Avoid IV push
Watch for renal failure/concomitant ototoxins

64
Q

What is the most common cause of cisplatin induced ototoxicity?

65
Q

What is the presentation of cisplatin induced ototoxicity

A

Hearing loss

+ Tinnitus

66
Q

What are RFs for cisplatin induced ototoxicity?

A

Cumulative dose
Age (Elderly/children)
Other concurrent ototoxins and cranial radiation
Dehydration

Respiratory (8 decks)

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