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OS 212 ORL > Hearing > Flashcards

Hearing Flashcards

1
Q

foul-smelling ear discharge may indicate

A

necrosis due to bacterial infection e.g. osteonecrosis

cholesteatoma

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2
Q

for family history, ask for TORCHES.

A

TOXoplasmosis
Rubella
CMV
HERpes Simplex

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3
Q

newborn with risk factors (ABCDEFG)

A 
Asphyxia
Bacterial Meningitis
Congenital Perinatal Infection
Defects of head and neck
Elevated bilirubin
Family history
Gram birth weight
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4
Q

ear discharge

clear serous
mucoid
purulent

A

clear serous - from outer ear (no mucous glands)
mucoid - middle ear, mastoid
purulent - infection

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5
Q

conductive HL

tuning fork test (wrs)

A

weber - lateralized to affected ear

rinne - AC < BC

schwabach - diminished in affected ear

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6
Q

otalgia

*tragal, mastoid tenderness

A

if with otalgia, rule out chronic otitis media

tragal - acute otitis externa
mastoid - acute otitis media

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7
Q

aural atresia may be congenital or acquired……

A

congenital - failure of canalization of epithelial plug poriton

acquired - due to chronic otitis externa, or trauma of EAC

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8
Q

EAC stenosis due to

A

chronic infections –> fibrotic thickening of walls

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9
Q

TM embryogenesis

A

ectoderm - squamous layer
mesoderm - fibrous layer
endoderm - mucosal layer

8 wk AOG - ectoderm @ 1st pharyngeal groove thickens, grows toward middle ear
21 wk AOG - concha cavum = outer 1/3 of EAC, forms channel
28 wk AOG! = TM

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10
Q

otitis externa hx

A

ear manipulation with subsequent otalgia/pain on ear manipulation

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11
Q

otitis externa patho, etiology (localized, diffuse)

A

lipid layer removed by moisture or local trauma -> edema, obstruction of glands, fullness, itching… bleh

localized - s. aureus
diffus - pseudomonas

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12
Q

otitis externa treatment

A

neomycin/polymixin with steroids to relieve inflammation
quinolones from G+/-

*ear wick method

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13
Q

otitis externa presentation

A

edema, obstruction of glands, fullness, itching…

erythematous/swollen EAC

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14
Q

otomycosis/externa mycotica etiology (3) + factors (4)

A

aspergillus albicans
aspergillus niger
pitysporum

moisture
high temp
poor hygiene
immunosuppression

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15
Q

otomycosis/externa mycotica treatment (2)

A

1:1 acetic acid + isopropyl alcohol

anti-fungals (e.g. nystatin, clotrimazole)

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16
Q

acute otitis media

duration
etiology (3)

A

< 3 weeks

strep pneumoniae
h influenza
moraxella catarrhalis
*URTI?

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17
Q

acute otitis media presentation (4)

A

pain fever malaise sometimes headache

red bulging TM

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18
Q

stages of acute otitis media (4)

A

hyperemic - URTI reflux; Amoxicillin for G+

exudative - no light reflex

suppurative - perforated TM

resolution/complication

19
Q

mechanical trauma EAC treatment

A

clean with hydrogen peroxide

20
Q

mechanical trauma presentation (4)

A

bleeding, discharge, pain, hearing loss

TM difficult to see

21
Q

barotrauma presentation

A

pain, fullness, dec hearing

retracted TM, blebs, sometimes perforated (give antibiotic)

*may cause hemotympanum, possible rupture

22
Q

neoplasm

exostoses vs osteoma

A

both in bony canal?

exostoses - multiple bilateral
osteoma - single unilateral

23
Q

osteosclerosis

mode of heredity
causes stiffening and fixation of what?
sign?????

A

autosomal dominant
stiffening and fixation of stapes

  • normal PE
  • dizziness, balance probs, tinnitus
  • Schwartze’s sign - in minority of px; hyperemia of promontory
24
Q

OAE: if sensorineural HL is present,

A

it is not > 40db

25
Q

pulsatile tinnitus indicative of?

A

vascular lesion

26
Q

sensorineural HL

tuning fork test

A

weber - lateralize to better hearing ear

rinne - AC > BC

schwabach - examiner > px in poor hearing ear

27
Q

sensorineural HL

congenital genetic disorders that occur ALONE (3) + mode of heredity

A

micheal - AD

mondini - AD

scheibe - AR

28
Q

most common congenital genetic deafness

A

scheibe dysplasia

29
Q

sensorineural HL

congenital genetic disorders that occur ALONE (3) + affected areas

A

micheal - total lack of INNER EAR

mondini - partial aplasia of labyrinth; cochlea only 1 1/2 turns instead of 2 1/2

scheibe - undeveloped PARS INFERIOR (saccule and cochlear duct); HIGH f HL

30
Q

sensorineural HL

congenital genetic disorders occurring with other abnormalities (2)

A

waardenburg’s - AD; weird face…. huhu

pendred’s - R; thyroid enlargement

31
Q

sensorineural HL

most common cause of NON-GENETIC congenital deafness

A

congenital rubella

*congenital cataract, retinitis, CV anomalies, deafness, mental retardation

32
Q

most common cause of unilateral acquired HL

A

mumps

33
Q

most common cause of bilateral HL

A

measles

34
Q

in px na comatosed

A

meningitis, early HL due to ossification of cochlea

infections spread from CSF to perilymph

35
Q

measles vs mumps

when manifested ang HL

A

measles - at time of rash; abrupt

mumps - towards end; profound & permanent

both bilateral

36
Q

drugs inducing hearing loss (3)

A

aminoglycosides (strepto-, gentamycin) - best known; outer hair cells first

loop diuretics (furosemide/Lasix) - ion transport in stria vascularis (doesn’t affect hair cells)

salicylates (aspirin/Aspilet)

37
Q

herpes zoster oticus/ramsay hunt syndrome

presentation

A

pain, vesicles

hearing loss, vertigo, facial nerve paralysis

*reactivation of virus in geniculate ganglion

38
Q

ototoxic chemicals & heavy metals (3)

A

trichloroethylene (auditory nerve)

toluene (cns, hair cell damage)

mercury (early - cochlea; late - neurological)

39
Q

a protective reflex….

A

acoustic reflex - stapedius & tensor tympani contract -> stiffen ossicles

*hsp72 also protective fxn by cellular repair

40
Q

most common INNER EAR TUMOR

A

acoustic neuroma (benign tumor of Schwann cells)

*all unilateral HL must be screened for this

41
Q

presbycusis affects any of these four parts first

A

hair cells
cochlear neurons
stria vascularis
basilar membrane

(HSBC hahahhaa)

42
Q

mixed hearing loss most commonly caused by

A

CSOM

43
Q

temporal bone fracture

CHL, SHL

A

CHL - longitudinal fracture, ossicle disruption

SHL - transverse fracture, vestibulocochlear apparatus

OS 212 ORL (7 decks)

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