Otolaryngology Key Points

Question 1

What is the most important clinical approach in diagnosing patient’s with hearing loss?

Answer 1

HISTORY! History! History!

• Duration of loss
• Unilateral vs. Bilateral
• Sudden vs. Progressive
• Related exposures, noise-induced, acoustic trauma, ototoxic meds (includes chemo)
• Past Med Hx, related trauma
• Associated symptoms (otalgia, imbalance, tinnitus, otorrhea, vertigo, URI Sx, or other neurologic symptoms.

Question 2

What is the most common peripheral vertigo?

Answer 2

Benign Paroxysmal Positional Vertigo

Question 3

What is the caus of BPPV?

Answer 3

Post-trauma, Post-viral infection

Question 4

What are the symptoms of BPPV?

Answer 4

• Brief, recurrent positional vertigo
• Latancy (time needed for motion of canalithiasis)
• Fatigability (type of nystagmus)

Question 5

What two components are enough to diagnose BPPV?

Answer 5

HISTORY!

&

Dix-Hallpike maneuver

Question 6

What is the time range of an acute middle ear space infection?

Answer 6

< 3weeks

Question 7

What is the second most common disease in children behing URI?

Answer 7

Acute Otitis Media

Question 8

What is the pathophysiology behind Acute Otitis Media?

Answer 8

Eustachian tube dysfunction causes negative middle ear pressure —>

Results in transudative fluid collection in middle ear space –>

subsequent infection!

Question 9

What is the treatment for Serous Otitis Media?

Answer 9

No treatment.

(unless they want myringotomy)

Question 10

How should you manage acute otitis media?

Answer 10

• Nothing –> usually spontaneously resolve in 24-72 hrs
• Oral antibiotics (usually Amoxicillin)
• Topical antibiotic otic drops if TM is perforated
• Pain relief, decongestants, antipyretics
• Prophylactic antibiotics if recurrent
• Myringotomy for severe otalgia or toxic patients

Question 11

What are the three surgical options for management of Otitis Media?

Answer 11

• Myringotomy and tubes (PE)
• Adenoidectomy
• Mastoidectomy (if complication of AOM)

Question 12

What type of immune response if Allergic Rhinitis?

Answer 12

IgE-mediated hypersensitivity

(to foreign substances)

Question 13

Allergic rhinitis most commonly affects what age?

Answer 13

> 2 yoa

Question 14

What age is allergic rhinitis almost always present?

Answer 14

20 yoa

Question 15

How is allergic rhinitis diagnosed?

Answer 15

HISTORY of: sneezing, rhinorrhea, nasal congestion, and lacrimation, pruritus highly suggestive of allergy, post nasal drip, eustachian tube dysfunction

(also physical exam)

Question 16

How is allergic rhinitis treated?

Answer 16

• avoidance of allergen
• intranasal steroids
• antihistamines
• decongestants