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ENT > Ear pathology > Flashcards

Ear pathology Flashcards

1
Q

What should you look for when examining the outer ear?

A 
Discharge
Swelling
Bleeding
Masses
Scars
Changes in ear drum
Swelling over mastoid
Facial weakness
hearing loss
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2
Q

What can affect the outer ear?

A

Trauma

Otitis externa

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3
Q

What is otitis externa?

A

Inflammation of the skin of the ear canal

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4
Q

What can cause otitis externa?

A

Bacteria

Fungal- aspergillus

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5
Q

What is disease of the middle ear called?

A

Otitis media

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6
Q

What can cause otitis media?

A

Virus

bacteria

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7
Q

What bacteria can cause otitis media?

A

Strep pneumonia
H. Influenza
Staph A
Pseudomonas

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8
Q

What two forms of otitis media are there?

A

Acute

Chronic

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9
Q

What are some of the symptoms of acute otitis media?

A

Recurrent URTI
TM retraction
Reduced TM movement and altered colour
CHL

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10
Q

How do you treat acute otitis media?

A

Watch and wait:
60% resolve in 1/12
90% resolve in 3/12

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11
Q

When should you refer acute otitis media?

A

if lasts longer than 3/12
Bilateral OME
CHL >25dB
Speech/language problems

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12
Q

What three conditions does chronic otitis media cover?

A

Perforation
Chronic otitis media with effusion
Cholesteatoma

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13
Q

What can cause perforation of the TM?

A

Trauma

Otitis media

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14
Q

How do you treat perforation of the TM?

A

Keep infection free
Self-resolves
Surgery if not

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15
Q

What is the common name for Chronic otitis media with effusion?

A

Glue ear

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16
Q

What is glue ear?

A

Otitis media with effusion

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17
Q

What can cause Otitis media with effusion?

A

Rhinosinusitis

Nasopharyngeal carcinoma/lymphoma

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18
Q

How does Otitis media with effusion present?

A

CHL
Abnormal cone of light
Sucked in TM so can see incus

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19
Q

How do you treat Otitis media with effusion?

A

Grommets

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20
Q

What is cholesteatoma?

A

Chronic otitis media with perforated tympanic membrane.

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21
Q

What causes cholesteatoma?

A

Abnormal stratified epithelium in middle ear with high turnover producing lots of keratin

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22
Q

What is cholesteatoma associated with?

A

Inflammation

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23
Q

What are some symptoms of cholesteatoma?

A

Hearing loss

Discharge

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24
Q

What are some of the complications of cholesteatoma?

A

Erodes surrounding bone
Damage facial nerve
Brain abscess
Venous sinus thrombosis

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25
Q

How do you treat cholesteatoma?

A

Surgical excision

Reconstruction

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26
Q

What pathology can affect the vestibulocochlear nerve?

A

Vestibular Schwannoma

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27
Q

What is a Vestibular Schwannoma?

A

Benign tumour of Schwann cells of vestibular part of CNVIII. Arises in IAM
Generally unilateral

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28
Q

What does a Vestibular Schwannoma look like?

A

Tan/white/yellow mass

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29
Q

What are some symptoms of a Vestibular Schwannoma?

A

Hearing loss
Tinnitus
Vertigo

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30
Q

How do you diagnose Vestibular Schwannoma?

A

MRI

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31
Q

What are two of the major symptoms of inner ear disease?

A

Dizziness

Hering loss

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32
Q

What categories of things can cause dizziness?

A 
Visual
CVD
Proprioceptive
Vestibular
Central pathways
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33
Q

What things can cause central dizziness?

A

Stress
Migraines
MS

34
Q

What things can cause visual dizziness?

A

Cataracts

DM

35
Q

What things can cause CVD dizziness?

A

Arrhythmias

Postural Hypotension

36
Q

What things can cause Proprioceptive dizziness?

A

DM
Arthritis
Neurological

37
Q

What things can cause vestibular dizziness?

A

Benign Postural Paroxysmal Vertigo
Meniere’s
Vestibular neuronitis
Labyrinthitis

38
Q

What is the most common cause of vestibular dizziness?

A

Benign Postural Paroxysmal Vertigo

39
Q

What is the pathology of Benign Postural Paroxysmal Vertigo?

A

Otolith migrates from utricle into semicircular canal- normally posterior

40
Q

What can cause Benign Postural Paroxysmal Vertigo?

A

Head trauma
Ear surgery
idiopathic

41
Q

What are the symptoms of Benign Postural Paroxysmal Vertigo?

A

Vertigo on looking up, bending forwards, moving in bed, getting up etc

42
Q

How do you diagnose Benign Postural Paroxysmal Vertigo?

A

Dix Hallpike test:
Sit then lie down
Turn head quickly

43
Q

What is a differential for Benign Postural Paroxysmal Vertigo?

A

Vertebrobasilar insufficiency

44
Q

How does Vertebrobasilar insufficiency differ from Benign Postural Paroxysmal Vertigo?

A

Vertebrobasilar insufficiency has:
Visual disturbances
Weakness
Numbness

45
Q

How can you treat Benign Postural Paroxysmal Vertigo?

A

Epley maneuver

Brandt-Daroff exercise

46
Q

How long does Benign Postural Paroxysmal Vertigo last for?

A

Seconds

47
Q

What is a good diagnostic question for Benign Postural Paroxysmal Vertigo?

A

‘Do you get dizzy when turning over in bed?’

48
Q

What causes Meniere’s?

A

Unknown

49
Q

What is the pathology of Meniere’s?

A

Mixing of peri and endo lymph

50
Q

What are the symptoms of Meniere’s?

A

hearing loss with episodes
Feeling of pressure in ear
Spontaneous vertigo
hearing loss in one ear

51
Q

How do you treat Meniere’s?

A 
Supportive
Hearing aids
Avoid: NaCL, beta histamines, Caffeine, Alcohol, stress
Grommets
Steroid injections
Gentamicin 
Surgery
52
Q

How long does Meniere’s last?

A

Hours

53
Q

What is a good diagnostic question for Meniere’s?

A

‘Does one ear feel full/ do you get hearing loss during episodes?’

54
Q

What is vestibular neuronitis?

A

Inflammation of superior vestibular nerve

55
Q

What causes vestibular neuronitis?

A

Viral infection

56
Q

What are some of the symptoms of vestibular neuronitis?

A

Vertigo for days

No tinnitus or hearing loss

57
Q

How do you treat vestibular neuronitis?

A

Support
Self-limiting
Bed for 3 days, off work for 3 weeks, off balance for 3 months.

58
Q

How longs does vestibular neuritis last for?

A

Days

59
Q

What is a good question to ask in vestibular neuronitis?

A

‘Was it severe, lasting days with N&V?’

60
Q

What is labrynthitis?

A

Inflammation of the labyrinths

61
Q

What can cause labrynthitis?

A

Viral infection

62
Q

What are some of the symptoms of labrynthitis?

A

Vertigo for days

Tinnitus and hearing loss

63
Q

What associated symptoms is it important to ask about with dizziness?

A 
Lightheadedness, Syncope, palpitations
Blackouts
Visual disturbances
Weakness
Speech and swallowing problems
64
Q

What is a good question to ask to diagnose migraine associated dizziness?

A

‘Do you get light sensitive?’

65
Q

What is otalgia?

A

Ear pain

66
Q

What is hemotympanum?

A

Blood in the inner ear

67
Q

What two types of hearing loss are there?

A

Conductive

Sensory

68
Q

Describe conductive hearing loss

A

Cochlea works but can’t get sound to it

69
Q

Describe sensory hearing loss

A

Cochlea doesn’t work

70
Q

What is a major cause of conductive hearing loss?

A

Otosclerosis

71
Q

What is otosclerosis?

A

Fixation of the stapes footplate

72
Q

What are some symptoms of otosclerosis?

A

Gradual hearing loss

Rapid progression in pregnancy

73
Q

Is otosclerosis more common in men or women?

A

Women

74
Q

How do you treat otosclerosis?

A

Surgery

75
Q

Name three causes of sensory hearing loss

A

Presbycusis
Noise induced
Drug induced

76
Q

What is presbycusis?

A

Olg age hearing loss

77
Q

What is a symptom of presbycusis?

A

Loss of high frequency

78
Q

What is a symptom of noise induced hearing loss?

A

Dip at 4kH

79
Q

What drugs can cause hearing loss?

A

Gentamicin
Aspirin OD
Chemo

80
Q

What is myringitis?

A

Inflammation of the ear drum

81
Q

What 4 Ts can refer pain to the ear?

A

Teeth, TMJ, THyroid and Tongue

ENT (10 decks)

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