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PANCE Lightning Round > EENT Ears > Flashcards

EENT Ears Flashcards

1
Q

On Weber testing, what will be present with cerumen impaction?

A

Lateralization to affected ear (bone conduction > air conduction

-Conductive hearing loss

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2
Q

Name two solvents that work to soften the cerumen in an impaction.

A

Hydrogen peroxide

Carbamide peroxide

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3
Q

What else can be done if softening the cerumen does not work to solve the problem?

A

Irrigation, curette, suction

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4
Q

MCC of otitis externa

A

Pseudomonas aeruginosa

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5
Q

Symptoms of otitis externa

A
  • Pain
  • Pruritus
  • Pain with movement of tragus or auricle
  • Purulent auricular discharge
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6
Q

Topical ABX for otitis externa

A

-Ciprofloxacin-dexamethasone
-Ofloxacin
For about 7 days

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7
Q

What is osteomyelitis of the temporal bone called and who does it normally occur in?

A

Malignant Otitis Externa

Immunocompromised states; elderly diabetes MC, high dose glucocorticoid therapy, chemo, HIV

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8
Q

What cranial nerve palsies can malignant otitis externa lead to?

A

Cranial Nerves 6, 7, 10, 11, 12

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9
Q

Treatment for malignant otitis externa

A

Admission + IV Ciprofloxacin

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10
Q

Diagnostic for malignant otitis externa

A

CT or MRI

But, biopsy is most accurate

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11
Q

Cauliflower ear is a result of _________

A

Blunt trauma that creates a hematoma. The hematoma creates avascular necrosis of the ear. Happens in wrestlers that do not wear helmets.

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12
Q

MCC of acute otitis media

A

Staph Pneumoniae

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13
Q

Symptoms and exam findings of a patient with acute otitis media

A
  • Preceded by viral URI
  • Otalgia
  • Bulging and erythematous TM with effusion
  • Decreased TM mobility (most sensitive)
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14
Q

Risk factors for AOM

A
  • Bottle feeding or pacifier
  • Second hand smoke
  • 6-18 months old
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15
Q

Treatment for AOM

A
  • Pain killers (Ibuprofen or Tylenol)
  • Amoxicillin first line for 10 days
  • Second line: Amoxicillin-Clavulanic acid, Cefdinir, Cefpodoxime
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16
Q

If the patient has a penicillin allergy, what is the treatment for AOM?

A

-Azithromycin, Clarithromycin, Bactrim

17
Q

What is chronic otitis media?

A

-Recurrent infection of middle ear in presence of TM perforation > 6 weeks

18
Q

MCC of Chronic otitis media

A

Pseudomonas

-Staph A, Mycoplasma

19
Q

Symptoms of chronic otitis media

A

-Recurrent purulent otorrhea (painless)

20
Q

Treatment for chronic otitis media

A

-Removal of infected debris + Ofloxacin/Ciprofloxacin

21
Q

What is a cholesteatoma?

A

Abnormal keratinized collection of desquamated squamous epithelium in the middle ear that can lead to bony erosion of the mastoid

22
Q

Symptoms of a cholesteatoma

A

-Painless otorrhea (brown or yellow with a strong odor)

23
Q

Treatment for cholesteatoma

A

Surgical excision of debris and reconstruction of ossicles

24
Q

What two things should you avoid if you suspect a TM rupture?

A 
Topical aminoglycosides (Gentamicin, Tobramycin, Amikacin)
Water
25
Q

What is an acoustic neuroma/vestibular schwannoma?

A

Benign tumor involving Schwann cells, which produce myelin sheath

  • Arises in the cerebellopontine angle and can compress cranial nerves 5, 7, 8
  • MC intracranial tumors
26
Q

Symptoms of acoustic neuroma

A
  • Sudden onset of unilateral sensorineural hearing loss (partial) that slowly worsens
  • Tinnitus, facial numbness (5), facial paresis (7)
27
Q

How do you confirm an acoustic neuroma with imaging? What do you perform for the laboratory of choice for this?

A

MRI

Audiometry

28
Q

Treatment for barotrauma

A
  • Prevention
  • Do not fly with a cold
  • Autoinsufflation: swallowing, yawning, chewing gum, decongestants
29
Q

Symptoms of narrowed Eustachian Tubes

A
  • Fullness in the ears
  • Retraction of TM or decreased mobility
  • Popping or cracking with yawning or swallowing
  • Decreased hearing
30
Q

Treatment for narrowed Eustachian Tubes

A

Decongestants (Pseudoephedrine, Oxymetazoline)

Surgical insertion of T tube

31
Q

Symptoms of overly patent Eustachian Tubes

A
  • Exaggerated ability to hear yourself breathe or speak

- Feel better during a URI

PANCE Lightning Round (2 decks)

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