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Year 2- Head and Neck > Otology > Flashcards

Otology Flashcards

1
Q

List the components of the external ear.

A

Pinna
Ear canal

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2
Q

List the components of the middle ear.

A

Tympanic membrane
Ear ossicles

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3
Q

List the components of the inner ear.

A

Semi-circular canals
Cochlea

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4
Q

Name the three ossicles of the middle ear.

A

Malleus
Incus
Stapes

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5
Q

Otalgia?

A

Ear pain

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6
Q

What should be asked about hearing loss?

A

Gradual or sudden
Unilateral bilateral

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7
Q

What should be asked about tinnitus?

A

Type of noise e.g. whooshing, ringing, buzzing.

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8
Q

What can otalgia be associated with?

A

Fever
Infection
Earache

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9
Q

Do chronic or acute conditions usually cause earache?

A

Acute

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10
Q

Which type of cancer could cause earache?

A

Tonsillar cancer

->especially something to be aware of if an elderly patient presents with earache.

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11
Q

Which skin condition can cause ear infections?

A

Eczema

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12
Q

Which instrument is used to examine the ear?

A

Otoscope

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13
Q

What would you see in a normal tympanic membrane?

A

Light reflection

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14
Q

In people with normal hearing, what is better- air conduction or bone conduction?

A

Air conduction

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15
Q

Name a situation where bone conduction may be better than air conduction

A

If there has been a perforation

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16
Q

If a patient has wax in the ear, what should be done?

A

If causing symptoms, it can be removed.
If not, will clear on it’s own.

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17
Q

If a patient is going to get wax removed, what can be done first?

A

Olive oil/almond oil ear drops to thin the wax

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18
Q

What can be done if there is no improvement of ear wax after using ear drops?

A

Ear Irrigation

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19
Q

If a patient has bleeding in the ear after trauma, e.g. RTA, what may be the cause?

A

Base line fracture of skull

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20
Q

Name some inorganic foreign bodies.

A

Beads, plastic material

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21
Q

Name some organic foreign bodies.

A

Cotton buds
Nuts

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22
Q

Which type of foreign body can cause more damage?

A

Organic foreign bodies-> can cause excoriation of skin and lead to otitis media in some cases.

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23
Q

What should be done in the cases of foreign bodies?

A

Should be removed, quicker if organic FB

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24
Q

What should be done in the cases of penetrating trauma to ear?

A

Do not prod, leave it and review in six weeks

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25
Q

What is the treatment for acute otitis externa?

A

Topical antibiotics
NO WATER IN EAR

-Sofradex
-Gentisone HC ear drops
Otomize spray

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26
Q

If patient has history of ear infections, which medication should not be given and why?

A

Aminoglycosides as can cause sensory neural hearing loss

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27
Q

What should be used in the treatment of acute otitis externa if the tympanic membrane is perforated or not visible?

A

Cilodex- combo of Ciprofloxacin and dexamethasone

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28
Q

Your patient with otitis externa ignores advice and goes swimming.
The ear becomes swollen so you can hardly see the ear canal and secretions cannot come out of the ear, causing a lot of pain.

What can be done?

A

Use a Pope Wick, a small tampon, to put through the small slit and add drops to keep the ear canal open and stop it collapsing. ALso can put ear drops using this Pope Wick

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29
Q

What may happen is otitis externa gets even worse after the ear canal has closed?

A

May develop into cellulitis

30
Q

What should be done with someone with cellulitis of the ear?

A

Admit to hospital
IV antibiotics
Topic antibiotics

31
Q

A patient presents with itchy ears after coming back from holiday. The patient swam a lot on this holiday.

What is the likely problem?

A

Fungal infection of ear

32
Q

Therefore, which patients are more likely to get fungal infections in their ear?

A

Those with chronically wet ears

33
Q

What is the treatment for fungal otitis externa?

A

Keep ears dry
Topical clopizadrole or nystatin ear drops

34
Q

A 65yr old patient presents with six weeks of ear ache and ear discharge. His GP prescribed topical antibiotics which have not helped.

What may be the cause?

A

Malignancy- necrotising otitis externa

35
Q

In which patients may necrotising otitis externa be seen?

A

Elderly, immunosuppressed, diabetic

36
Q

What else may a patient with necrotising otitis externa present with?

A

Facial nerve palsies

37
Q

Which organism commonly causes necrotising otitis externa?

A

Pseudomonas

38
Q

What is the drug of choice to treat against Pseudomonas?

A

Ciprofloxacin

39
Q

Which tests should be done in someone with suspected necrotising otitis externa?

A

Swab
Fasting blood sugar- diabetic patients
CRP

40
Q

What is the management for someone with necrotising otitis externa?

A

Immediate referral to ENT
Systemic anti-pseudomonas antibiotics
Control of diabetes
Possibly surgery

41
Q

What are exostoses?

A

Multiple swellings of the ear due to body overgrowths in the ear canal

42
Q

What is the management for exostoses?

A

If doesn’t affect hearing, nothing.
Some people have surgery to widen ear canal or remove the exostoses.

43
Q

What is an ear osteoma?

A

Benign wound tumour, bony lesion

44
Q

What is the treatment of an osteoma?

A

Nothing, can leave it in most cases

45
Q

What would be done if you suspect otitis media with effusion (glue ear)?

A

Audiogram to confirm diagnosis

46
Q

What is the treatment for otitis media with effusion if it doesn’t go away on it’s own?

A

Grommet insertion

47
Q

A patient comes in with recurring discharge in the ear. He has had previous grommet insertions and upon examination, the eardrum is not intact. There has been perforation of the tympanic membrane.
What could this be?

A

Chronic otitis media with perforation in active state

48
Q

Which drug would be given in treatment of tympanic membrane perforation?

A

Cilodex

49
Q

After 2 weeks on Cilodex, and a patient still has discharge, what would you do?

A

Refer to ENT

50
Q

What may be done if ear discharge persists?

A

Myringoplasty, a type of surgery

51
Q

What may occur if a patient has had previous grommet insertions and has no symptoms but upon examination, the ear looks abnormal?

A

Tympanosclerosis- scarring of the ear drum…nothing needs to be done

52
Q

What is cholesteatoma?

A

Abnormal collection of skin cells within the ear

53
Q

What can happen in those with chronic otitis media with cholesteatoma?

A

Can eat away at the ossicles and cause balance issues.

54
Q

What is the treatment for those with chronic otitis media with cholesteatoma?

A

Temporal mastoid surgery

55
Q

If a patient had retraction of the tympanic membrane, which structure of the ear is altered?

A

Eustachian tube problems

56
Q

A child is referred to you from the GP. The GP says she has swelling over the mastoid bone, severe pain and fever.
What could this be?

A

Acute mastoiditis

57
Q

What happens if acute mastoiditis is not treated?

A

Will form brain abscess.

58
Q

Which imagery investigation is done to confirm acute mastoiditis?

A

CT

59
Q

Which vitamin deficiency can cause BPPV (benign paroxysmal positional vertigo).

A

Vitamin D deficiency

60
Q

What is the treatment for BPPV?

A

Epley manoeuvre

61
Q

How is BPPV diagnosed?

A

Using Dix-Hallpike manoeuvre

62
Q

A 45yr F has had 7 episodes of vertigo lasting 20m-1hr. Has tinnitus and h/o migraine. She difficulty using the phone on the right side (struggles to hear).
What is the diagnosis?

A

Meniere’s disease

63
Q

What is the treatment for Meniere’s Disease?

A

Betahistine (type of vasodilator)
Stemetil (anti-emetic)

64
Q

What is the difference between the presentation of Meniere’s Disease and a migraine?

A

Migraine has no associated hearing loss
Migraine does cause vertigo and tinnitus.

65
Q

Okay so…recap.

Which vertigo related condition lasts:
1. a few seconds
2. a few hours
3. a few days
?

A
  1. BPPV
  2. Meniere’s disease
  3. Vestibular neuritis
66
Q

What are anti-emetic drugs?

A

Drugs used to treat nausea and vomiting

67
Q

What is the treatment for Bell’s Palsy?

A

Steroids

68
Q

What causes Ramsay-Hunt syndrome?

A

Herpes zoster virus (varicella zoster)

69
Q

What can cause Bell’s Palsy?

A

Herpes simplex virus

70
Q

Which condition would need antiviral medication; Ramsey-Hunt syndrome or Bell’s Palsy?

A

Ramsay-Hunt syndrome

71
Q
A

Year 2- Head and Neck (13 decks)

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