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PT I Exam I > Otic & Vestibular Disorders > Flashcards

Otic & Vestibular Disorders Flashcards

1
Q

Clinical Thresholds that are a sign you need to refer the patient:

A
  1. Fever > 103
  2. Sys BP < 100
  3. RR >25
  4. Unintentional weight loss
  5. Foreign object in ear
  6. N/V for > 24 hours
  7. Sudden Hearing loss
  8. Blood from ear canal
  9. Fall caused by dizziness
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2
Q

T/F: You can recommend a OTC drop to relieve ear pain

A

FALSE; may use systemic pain relievers

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3
Q

What are common ear symptoms patients report?

A

Pain: aching, throbbing, stabbing

Fullness, heaviness, clogged feeling, pressure

Itching, burning

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4
Q

What is the role of cerumen?

A

Cerumen = ear wax

  1. Lubricates and keeps skin soft
  2. Traps or slows foreign objects
  3. Hydrophobic barrier
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5
Q

T/F: You should clean your ear canal with a washcloth instead of a Q-tip.

A

False! Only clean pinna and outer ear with washcloth.

Never insert anything into ear canal
- “Nothing smaller than your own elbow”

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6
Q

Why do patients feel pressure in their ears?

A
  1. Excessive ear wax
  2. Atmosphere changes
  3. Impacted ear wax
  4. Water in the ear
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7
Q

How can you reduce the amount of ear wax in the ear?

A

Warm water irrigation

Ceruminolytics:

  1. Carbamide peroxide or hydrogen peroxide and rinsing after
    a) Warn patient of bubbling/fizzing for hours after use
  2. Sweet oil - aka olive oil
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8
Q

How can you combat ear pressure issues when flying or scuba diving?

A

Topical decongestant

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9
Q

A patient complains that their excessive sweating while running results in ear pressure. What can you recommend to help?

A
  1. Swim-Ear OTC to help dry out ear

2. Isopropy alcohol + glycerin to dry out and protect skin

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10
Q

T/F: The best treatment for Swimmer’s Ear is the OTC product Swim-Ear!

A

FALSE; do not use as Swimmer’s ear is an infection of the ear, not just water causing pressure

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11
Q

Which household ingredients do people often use to help dry out their ears? Is there any concern?

A
  1. White Vinegar = safe but may burn broken skin

2. Borax solutions = TOXIC to kiddos and not safe in humans

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12
Q

List 4 ways to avoid getting water in the ear that causes pressure issues.

A
  1. Gravity
  2. “Palm vacuum”
  3. Ear plugs
  4. Blow dryer on lowest setting
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13
Q

What is Swimmer’s Ear and how do you treat it?

A

It is a bacterial infection of the skin in the outer ear
- Treat with Antibiotics + Steroid ear drops

No OTC product available

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14
Q

What are possible causes of Swimmer’s Ear?

A
  1. Sticking objects in ear
  2. Frequent H20 exposure causing softening or breaking down of skin (maceration)
  3. Swimming in poor quality water with infectious agents
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15
Q

A mom brings her 10 year old into the pharmacy asking what she can use to help her son’s itchy, painful ear. He recently came back from summer camp where they did a lot of swimming, hiking and biking.

What can you recommend?

A

Most likely = Swimmer’s Ear

Patient should take be taken to the PCP for antibiotics and steroid ear drops

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16
Q

Discuss treatment for dermatologic conditions of the ear

A

Treat like other skin issues

  1. Wet a dry lesion
  2. Dry a wet lesion
  3. Use Crisco to moisten/protect skin
17
Q

An older gentleman comes into your pharmacy asking about lipoflavonoids.

What is he likely going to use this for and what can you tell him about the product? What else could you recommend?

A

Used for tinnitus: Ringing in the ears

Product has not been proven to be effective, but is fairly safe to use (Expensive though!).

May recommend:

  1. White noise creator
  2. looking over his drug profile to see if it is a side effect of one of his medications
  3. Treating hearing loss - hearing aids
18
Q

What two medications may be prescribed to alleviate tinnitus for patients?

A

gabapentin or dexamethasone

19
Q

What is Meniere’s Disease? Signs and Symptoms?

A

Too much fluid is located in the cochlea resulting in over stimulation

  1. Vertigo
  2. Hearing loss - Lowest pitch 1 (different from age-related)
  3. Pressure or fullness
  4. Tinnitus
20
Q

What is Vertigo?

A

A feeling of spinning when you are sitting down

- Motion sickness

21
Q

How do patients describe motion sickness?

A
  1. Unsteadiness or disequilibrium - sense of imbalance
  2. Lightheadedness - feeling as if you are about to faint
  3. Dizziness - Any of the above
  4. Vertigo = feeling of spinning when you are sitting down
22
Q

What are possible causes of vertigo?

A

Migraine
Ischemic Stroke
Multiple Sclerolsis
Drugs-induce: alcohol, lithium, anti-HTNs, sedatives, anticonvulsants, aminoglycosides

23
Q

Who is most likely to experience vertigo?

A

Children age 2 to 12, pregnant females or those who suffer from migraines

24
Q

What are Pharmcological therapies used to treat or prevent vertigo?

A
  1. Acupressure: Sea bands = Prophylaxis
  2. Antihistamines = Prophylaxis
  3. Scopolamine patch = Prophylaxis
  4. Phenothiazines “Antipsychotics” - Treat vomiting only
  5. Metoclopramide = N/V treatment
  6. Cannabinoids = nausea treatment
25
Q

What is the concern of using Compazine for vertigo treatment?

A

Extrapyramidal side effects, although less likely with compazine than phenergan

26
Q

What is the proper way to place ear drops?

A

< 3 y.o. = Pull ear down and back
3+ y.o. = Pull ear UP and BACK

Do not touch dropper to ear
Stay in position for 2 minutes to allow absorption for each ear!

27
Q

List possible causes of hearing loss

A
  1. Noise Exposure
  2. Trauma/Infection
  3. Aging
  4. Meniere’s Disease
  5. Congential - structural or maternal infection
28
Q

Which drugs are associated with hearing loss?

A

Aminoglycosides
- Genta > Tobra > Amikacin > Neomycin

Cancer Chemotherapy

Asprin > 6 gm/day = tinnitus symptom

Vancomycin, tetracycline & erythromycin

29
Q

How can we treat hearing loss?

A
  1. Get rid of drug causing the problem
  2. Cochlear Implants
  3. Hearing Aids
30
Q

Which health precautions should patients take if they have a cochlear implant?

A
  1. Pneumococcal pneumonia vaccine
  2. Meningococcal vaccine
  3. Haemophilus Influenzae vaccine
  4. Influenza vaccine - NOT FLUMIST

PT I Exam I (9 decks)

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