Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENT Review > ENT > Flashcards

ENT Flashcards

1
Q

a down sloping, symmetric, sensorineural hearing loss

A

age-related hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

progressive and asymmetric sensorineural hearing loss

A

worse in the high frequencies
indicates pathology in the 8th cranial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you evaluate asymmetric hearing loss?

A

MRI of internal auditory canals without contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is asymmetric sensorineural hearing loss defined

A

10dB difference between ears in 3 contiguous frequencies, 15dB in 2 contiguous frequencies, or 25dB in one frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the typical location for the cholesteotoma?

A

Pars Flaccida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who qualifies for the Navy’s Hearing Conservation Program?

A

All Naval Aviation personnel meet HCP criteria and are monitored annually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Significant Threshold Shift (STS)

A

“resetting the baseline”

>10dB change at 2000, 3000, 4,000 Hz compred to a reference audiogram.

*Prior to confirming a baseline shift, the audiogram must be repeated to ensure at least 14 hour rest from hazardous noise environments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fitness for Duty/270 Rule

A

Any individual with a sum of their hearing loss at the frequencies of 3000, 4000, and 6000 Hz in both ears equals or exceeds a sum total of 270 dB

OR

has their baseline re-established three times will not be assigned to duties involving exposure to hazardous noise w/o medical qualifying evaluation and clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is asymmetric hearing loss, on its own, disqualifying if hearing remains within standards?

A

Nope.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do you do if there is any suspicion or concern for sudden sensorineural hearing loss?

A

urgent formal audiogram

urgent ENT consult

start prednisone (60-80mg PO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When do you refer to ENT for:

barotrauma?

unilateral middle ear effusion?

A

Recurring barotrauma episodes or any unilateral middle ear effusion persisting for more than 8 weeks.

ENT should evaluate the Eustachian tubes with endoscope and r/o a nasopharyngeal mass as a cause of unilateral ETD in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are signs of Eustachian Tube Dysfunction in adults?

A

recurring barotrauma or unilateral middle ear effusion persisting for more than 8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Just remember that most acute and chronic middle ear pathologies are due to ETD

A

ETD is the cause of most acute and chronic MIDDLE ear pathologies

Allergic rhinitis, URI, acute (or chronic) sinusitis, nasal polyps, enlarged adenoids, nasopharyngeal neoplasms are some exacerbating conditions for ETD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

TM Perforation

Treatment

A

TM perforation is NCD on its own.

Treatment: counsel on dry ear precautions

re-examine ear at 4-6 weeks

**DO NOT USE CORTISPORIN DROPS (NEOMYCIN/POLYMIXIN/HYDROCORTISONE)

Aminoglycosides are ototoxic and can cause SENSORINEURAL hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TM Perforation

Aeromedical disposition

A

down status for ~2-3 days

The perforation does not need to be healed to return to flight if asymptomatic

If the perforation was due to middle ear barotrauma, ensure the patient can equalize the contralateral ear before returning to flight and any exacerbating factors are resolved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cholesteatoma

Most common early symptom?

A

The most common early symptom of Cholesteatoma is recurring, painless ear drainage

17
Q

Barotrauma most commonly occurs during __________

A

Ear barotraumas occur most commonly on descent.

Failure of the Eustachian tube to open and allow ambient air to equalize the negative pressure in the middle ear space leads to mucosal engorgement, middle ear effusion, hemotympanum, or a TM perforation

18
Q

S/S of barotrauma in the ear

A
  1. middle ear effusion (serous or bloody) resulting in conductive hearing loss
  2. pain or discomfort acutely

There is usually no vertigo or sensorineural hearing loss. Symptoms resolve and effusion clears in days (or weeks) w/o treatment

19
Q

When do you consult ENT for barotrauma?

A

Consult ENT for recurring barotrauma episodes or any unilateral middle ear effusion persisting for more than 8 weeks.

The ENT should visualized the Eustachian tubes with endoscopy and a nasopharyngeal mass should be ruled out as a cause of unilateral ETD in adults

20
Q

Inner ear barotrauma

Signs and Symptoms

A

Inner Ear Barotrauma

  1. sensorineural hearing loss (may also be mixed)
  2. vertigo

*Patient’s with a perilymphatic fistula will experience fluctuating vertigo and hearing loss persisting after the initial barotraumatic presentation. Episodes of vertigo occur with straining or valsalva and they can be reproduced by “pumping” the patient’s tragus on exam

21
Q

Inner Ear Barotrauma

So you think someone has it…. what do you do?

A
22
Q

PLF:

treatment

A

PLF Treatment:

  1. bedrest
  2. steroids for sensorineural hearing loss
  3. vestibular suppressants for vertigo (PRN)
  4. antiemetic (PRN)
  5. Stool softeners (remember vertigo occurred with straining)

*recompression treatment is contraindicated for inner ear barotrauma

23
Q

Barotrauma that occurs on ascent

2 causes

A
  1. Alternobaric vertigo- self limiting. Vertigo is brief and mild
  2. Inner ear decompression sickness (DCS) very rare in flight. S/S include vertigo, hearing loss, and other neurologic signs and symptoms from DCS.
24
Q

The Ostio-meatal complex is the common drainage pathway for ?

A

OCM is the common drainage pathway for the

frontal

anterior ethmoid

maxillary sinuses

25
Q

What sinus is the most commonly affected by barotrauma?

A

The frontal sinus is most commonly affected by sinus barotrauma

it has a longer, narrower and tortuous outflow tract

26
Q

When is allergic rhinitis NCD?

A

Uncomplicated allergic rhinitis is NCD if:

symptoms controlled with aviation-approved medicaitons

no diagnosis of chronic sinusitis

no nasal polyps

no allergy immunotherapy

27
Q

Does Allergy Immunotherapy (AIT) require a waiver?

A

AIT is CD.

you may request a waiver once on maintenance dose, symptms are controlled, and no complicating factors like sinusitis, ETD, or asthma.

28
Q

What are the diagnostic criteria for Acute Bacterial Sinusitis

A

Symptoms lasting >10 days

MUST HAVE:

  1. nasal congestion +/- purulent nasal discharge
  2. +/- pain/pressure/fullness/fever

“Double worsening” after initial URI symptoms

29
Q

Chronic Sinusitis: with or w/o nasal polyps

diagnostic criteria

A

Chronic Sinusitis

  1. >12 weeks of symptoms (nasal congestion > rhinorrhea > hyposmia > facial pressure)
  2. Evidence of inflammation (exam, endoscopy, or imaging)
30
Q

Chronic Sinusitis: with or w/o nasal polyps

Treatment

A

topical nasal steroids

and

sinus saline rinces

31
Q

Chronic Sinusitis: with or w/o nasal polyps

Aeromedical Dispo

A

Because it is a risk factor for sinus barotrauma, chronic sinusitis is CD and a waiver is required for all patients

32
Q

Chronic Sinusitis: with or w/o nasal polyps

Waiver Requirements

A

Waiver Requirements

  1. If sinus surgery:
    1. cleared to fly by surgeon (endoscopic exam)
    2. aviation approved meds for maintenance
    3. barofunction check (back seat ride, hyper/hypobaric chamber, pool dive test
  2. If medically managed:
    1. resolved symptoms on stable treatment
    2. Post-treatment CT with patent OMC and frontal outflow tracts
    3. barofunction check (same as above)

*A barofunction check is not required after the initial waiver if the patient has been asymptomatic during flight during the same period

ENT Review (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions