ENT Disease and Audiometry

Question 1

what is the name of the test that involved placing a tuning fork on behind and next to the ear to compare which area hears its sound best?

Answer 1

rinne’s test

Question 2

what part of the bone is the tuning fork placed on in rennie’s test?

Answer 2

mastoid process

Question 3

what does webers test involve?

Answer 3

placing tuning fork in the midline of the forehead and asking the patient if they feel the vibration more in the forehead or an ear

Question 4

what does the “x” stand for on an audiogram?

Answer 4

left ear

right is never wrong

Question 5

what does ] stand for on an audiogram?

Answer 5

bone conduction

Question 6

what does a tympanogram measure?

Answer 6

pressure

tests if the TM is mobile

Question 7

name the 6 components of the D principle

Answer 7

deafness
discomfort
discharge
dizziness
din din (tinnitus)
defective facial movement

Question 8

what nerves can cause earache?

Answer 8

V
VII
IX
X
C2
C3

Question 9

name 3 conditions that can cause ear discharge?

Answer 9

acute otitis media
chronic otitis media
csf leak

Question 10

what is otorrhoea?

Answer 10

ear discharge

Question 11

what kind of ENT pain can refer to the ear and why?

Answer 11

tonsil/laryngeal pain

is in the path of the glossopharyngeal nerve

Question 12

if ear discharge is clear what is it suspected to be and what would confirm this?

Answer 12

csf

glucose test

Question 13

how could you tell if the cochlea was involved in vertigo?

Answer 13

if there was hearing loss too

Question 14

presentation of defective facial movement in ear disease?

Answer 14

lower motor neurone problems

facial palsy

Question 15

how is pain presented in otitis media?

Answer 15

worse when pus is retained

gets better when it is out

Question 16

another word for “otitis media with effusion”

Answer 16

glue ear

Question 17

pathophysiology of glue ear?

Answer 17

fluid present behind eardrum -> causes blocked eustachian tube -> middle ear can’t equalise pressure -> transudate collects

Question 18

Tx of glue ear?

Answer 18

nothing for 3 months

insert grommet or hearing aid for 6 months if not settling

Question 19

why is there significant hearing loss in chronic otitis media?

Answer 19

TM is destroyed

Question 20

where do cholesteatomas present on the TM?

Answer 20

upper part

Question 21

key hearing test used to determine hearing thresholds of patients?

Answer 21

pure tone audiometry

Question 22

what does the O stand for on an audiogram?

Answer 22

air conduction of the right ear

Question 23

what does the X stand for on an audiogram

Answer 23

air conduction of the left ear

Question 24

what does the triangle stand for on an audiogram?

Answer 24

bone conduction of the left and right ear

Question 25

what does masking do?

Answer 25

plays a narrow band noise to distract the ear that isnt being tested so you can get a true measurement of the tested ear

Question 26

sensorineural hearing loss is reversible T or F

Answer 26

F

Question 27

causes of sensorineural hearing loss?

Answer 27

``` regular, prolonged exposure to loud sounds ototoxic drugs rubella neuroma schwannoma ```

Question 28

how does the air and bone conduction compare in sensorineural hearing loss?

Answer 28

are the same

Question 29

how does the air and bone conduction compare in sensorineural hearing loss?

Answer 29

bone is better -> within normal limits

Question 30

cause of conductive hearing loss?

Answer 30

anything causing sound to not pass freely into the inner ear eg outer/middle ear problem: glue ear ear infection perforated ear drums

Question 31

what audiogram feature would make you consider otosclerosis as the diagnosis?

Answer 31

carharts notch at 2000Hz (big dip in bone conduction)

Question 32

tympanometry is helpful in making the diagnosis of...

Answer 32

TM perforation | otitis media

Question 33

name the red flag symptoms of head and neck cancer?

Answer 33

``` odynophagia neck lumps hoarseness stridor sore throat dysphagia unilateral ear pain ```

Question 34

how long should ENT symptoms have lasted to be classed as a red flag symptom

Answer 34

3 weeks

Question 35

most common type of head and neck cancer?

Answer 35

squamous

Question 36

major lifestyle risk factors for head and neck cancer?

Answer 36

alcohol | tobacco

Question 37

what is the size of the tumour and nodes in an HPV head and neck cancer?

Answer 37

small tumour | big nodes

Question 38

1st line analgesia for pain from a cancer?

Answer 38

non opiod | + adjuvant

Question 39

2nd line analgesia for pain from a cancer?

Answer 39

opioid for mild-mod pain non-opioid adjuvant

Question 40

what is an adjuvant analgesic?

Answer 40

painkillers whose primary indication is for something other than pain eg antidepressants

Question 41

what anticonvulsants are used in pain management?

Answer 41

gabapentin | pregabalin