Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Otorhinolaryngology > Otology > Flashcards

Otology Flashcards

1
Q

What frequency of tuning forks should one use to peroform Rinnes and Webers tests?

A

512Hz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does a Weber’s test lateralising to the right mean?

A

A conductive hearing loss in the R ear

Or

A sensorineural hearing loss in the L ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If you get a senorineural loss in the L ear where will Webers test lateralise to?

A

The pt will have better hearing in the R ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If Rinne’s test is positive then is BC>AC or is AC

A

AC it better than (>) BC.

This is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If Rinne’s test is negative what does this mean?

A

That BC is better than AC.

This is abnormal and indicates a conductive hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes a false negative Rinne’s test?

A

The ear you are testing has profound sensorineural hearing loss (i.e. its dead)

So when testing BC the other ear picks up the sound giving the picture that BC>AC however BC and AC from that ear will not actually occur as it is dead.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Do pure tone audiograms test BC or AC?

A

They test both.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How are the L and R ears BC and AC noted down on a pure tone audiogram?

A

R - AC –> O RED
R - BC –> [ RED
L - AC –> X BLUE
L - BC –> ] BLUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Under what volume should normal pt be able to hear and at what frequencies

A

Normal hearing is to be able to hear:

All frequencies

At at least 20dB or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What indicates normal age-related hearing loss (presbycusis)?

A

A sloping off of hearing above 4000hz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does tympanometry measure?

A

The compliance/stiffness of the eardrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is tympanometry also known as?

A

Impedance audiometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In tympanometry the probe has a number of channels, what are these?

A

A speaker to send the sound wave

A microphone to receive the sound wave

A device to vary the pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a Type B tympanogram?

A

A flat line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a Type C tympanogram?

A

A normal shape graph BUT further towards the Y-axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does a Type C tympanogram indicate?

A

The drum is retracted, as there is a negative pressure in the middle ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does a Type B tympanogram indicate?

A

There is fluid in the middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can an excessively tall peak on a tympanogram indicate?

A

A hyper mobile drum

such as in ossicular discontinuration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is presbyacusis?

A

the degenerative loss of hearing in old age (>50yrs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the characteristics of presbyacusis?

A

Bilateral high frequency hearing loss

With or without tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is presbyacusis treated?

A

Hearing aids

to help with hearing loss and mask tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What causes presbyacusis?

A

Atrophy of the outer hair cells in the cochlea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a cholesteatoma?

A

a cyst or sac

of keratinizing squamous epithelium

in the middle ear and/or mastoid process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where do cholesteatomas most commonly occur?

A

in the attic aka epitympanic part of the middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the sings and symptoms of cholesteatoma?

A

foul smelling discharge (if CSOM)

a conductive hearing loss

attic aural polyps (a proliferation of chronic inflammatory cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What bacteria is thought to cause cholesteatoma?

A

Pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are thought to predispose a pt to cholesteatoma?

A

genes i.e. congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the risks of cholesteatoma?

A

It can essentially erode anything including: (it takes years)

ossicles - 50db conductive hearing loss

lateral semicircular canal - vertigo

CN7 - facial palsy

cochlea - sensorineural heaing loss

roof of middle ear into brain - sepsis

sigmoid sinus - thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How is cholesteatoma treated?

A

Surgical removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the types of otitis media?

A

Otitis media with effusion (sterile fluid aka glue ear)

Acute (suppurative) otitis media (has a suppurative fluid and is due to infection)

Chronic suppurative otitis media (CSOM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What occurs if there are repeated attacks of acute otitis media?

A

The repeated attacks weaken the tympanic membrane.

This eventually causes perforation

which does not heal

This is now chronic suppurative otitis media (CSOM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which demographic commonly get otitis media?

A

Children with URTI (these track up and cause OME)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does the infection cause in acute otits media?

A

The infection in the middle ear causes pus accumulation

This leads to pressure on the tympanic membrane, thus pain.

This can then rupture causing otorrhoea and reduction in otalgia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the symptoms of AOM?

A

Otalgia
Otorrhoea (one perforated)
Conductive hearing loss
Pyrexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the treatment for AOM?

A

antibiotics (amoxycillin + clavulanic acid = Augmentin)

analgesia

Myringotomy (tiny incision is created in the eardrum) if condition fails to resolve or is having serious side-effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How must a perforated ear be managed?

A

It should be kept dry until healed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is otitis media with effusion colloquially known as?

A

Glue ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the essential cause of otitis media with effusion (Glue ear)

A

Poor ventilation of the middle ear due to narrowing of the eustachian tube.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How common is glue ear and what is the normal prognosis?

A

75% of children will have it at some point

most resolve spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How long can chronic otitis media with effusion last?

A

months or even years.

41
Q

What are the issues with long term glue ear?

A

can cause a hearing loss of ~25dB which can affect

schooling/development

It can predispose to acute supperative otitis media

42
Q

What is the consistancy of the liquid in otitis media with effusion?

A

Thick and sticky (however it is NOT purulent)

43
Q

What are the possible causes of eustachian tube narrowing (that leads to glue ear)?

A

infection or allergy of middle ear mucosa

eustachian tube dysfunction

as a sequale of acute supperative otitis media

44
Q

What is the treatment for glue ear?

A

50% resolve spontaneously in 3 months (so wait 3mnths 1st)

after which if not resolving treatment is indicated:

grommets
OR
hearing aid

for a few years as kids tend to grow out of it

45
Q

What degree of hearing loss can be expected in CSOM?

A

15dB normally

60dB if the ossicles are disrupted

46
Q

What is the treatment for CSOM?

A

aural toilet

and

antibiotic + steroid drops

Myringoplasty may help

47
Q

What is otosclerosis?

A

Spongy bone formation around the oval window and as it grows it fuses with the stapes

48
Q

What is the mechanism by which otosclerosis causes sensorineural hearing loss?

A

the compact bone (of the otic capsule/bony labyrinth) is replaced by spongy bone

which produces toxins

which destroy the cochlear

causing senirneural hearing loss

49
Q

What is the mechanism by which otosclerosis causes conductive hearing loss?

A

more commonly

the bony overgrowth affects the footplate of the stapes

which results in its fixation

and leads to conductive hearing loss

50
Q

What increases your risk of developing otosclerosis?

A

family history

51
Q

How common is otosclerosis?

A

1/100 but very few are symptomatic

52
Q

What are the symptoms/signs of otosclerosis?

A

Bilateral hearing loss
Paracusis willisii (background hearing is better)
Tinnitus
Positional vertigo

53
Q

What is the usual age otosclerosis become symptomatic?

A

30

54
Q

How is otosclerosis diagnosed?

A

Clinically: normal ear drum w/

conductive hearing loss

Definitively:

surgical examination of the stapes footplate (fixation being the most common cause of deafness in otosclerosis)

55
Q

What is the treatment for otosclerosis?

A

hearing aid (if required)

if severe then surgically replace the stapes with a Teflon piston (small risk of sensorineural deafness)

56
Q

What are the classical signs of noise induced hearing loss?

A

Tinnitus is very common

Classical 4 or 6kHz dip on audiogram

Genuine Hx of noise exposure

57
Q

What is the treatment for noise induced hearing loss?

A

Councelling for tinnitus

and provision of a hearing aid

58
Q

What is the usual cause of tinnitus?

A

Sensorineural hearing loss

59
Q

What is the classical presentation of Meniere’s disease?

A

Typically 45y/o with the triad:

1) Severe recurrent attacks of vertigo lasting from 10 minutes to 24 hours
2) Tinnitus
3) Fluctuating but deteriorating sensorineural hearing loss

60
Q

Is Meniere’s disease bi or unilateral?

A

unilateral but can progress to be bilateral

61
Q

What is the character of the hearing loss in Meniere’s disease?

A

initially affects the lower frequencies

Recovers but does eventually permanently deteriorate

62
Q

How often do attacks occur in Meniere’s disease?

A

In clusters or may only occur very occasionally.

63
Q

How is Meniere’s disease treated?

A

Acutely:

-> vestibular sedative (e.g. prochlorperazine)

Long term:

  • > betahistine (a vasodilator)
  • > diuretics
  • > avoidance of caffeine and salt

If severe:
-> Surgery - e.g. destroying the labyrinth or cutting 8th nerve.

64
Q

Is otitis externa acute or chronic?

A

It can be both

65
Q

What is otitis externa?

A

generalised inflammation of the external ear canal and ear

thus causing swollen + narrowed EAM

66
Q

What can predispose to otitis externa?

A

Eczema

local trauma

commonly otitis media (this should be checked for once you can see down the ear canal)

67
Q

What are the signs/symptoms of otitis externa?

A

Swollen ear + canal (thus causes conductive hearing loss) this can extend to the face

Tender ear + canal

Itchy ear + canal

otorrhoea

Cracking/crusting skin (can allow fungus to enter)

if chronic skin maybe thickened or fissured

Permanently moist

68
Q

What is the treatment for otitis externa?

A

aural toilet (dry mopping or suction)

antibiotic (sytemic if severe) and/or steroid ear drops

antifungals (if indicated)

glycerine (to withdraw moisture from the ear)

69
Q

Is swimming with grommets harmful?

A

No

70
Q

How long does it take for the ear drum to heal after rupture after due to ASOM?

A

4-5 days

71
Q

What is commonly misdiagnosed as ASOM?

A

Viral acute otitis media

72
Q

What is a retraction pocket?

A

An indrawing of the tympanic membrane and is self cleansing (when not self cleansing = cholestiatoma)

73
Q

What is the treatment of retraction pockets?

A

Just ENT follow-up

74
Q

What is typanosclerosis and what are the symptoms?

A

Scaring of the tympanic membrane

can have no symptoms or

total obliteration of the middle ear - 50db conductive hearing loss

75
Q

What is a “safe” ear infection?

A

There is no such thing, all are potentially dangerous

76
Q

What should be done with asymptomatic perforations?

A

Nothing, just leave alone

77
Q

Will fractured or disrupted ossicles repair themselves?

A

No

78
Q

What should be done with intracranial sepsis of unknown cause?

A

ENT Hx and Ex

79
Q

What are the classic ENT presentations of intracranial sepsis?

A

Ear sepsis or sinusitis

who develop headache, malaise and loss of concentration

80
Q

What is the issue regarding unilateral presbycusis?

A

It doesn’t really occur so this acoustic neuroma

81
Q

What is an acoustic neuroma?

A

Benign tumour of the auditory nerve.

82
Q

What are the early signs of acoustic neuroma?

A

Hearing loss or

tinnitus

83
Q

Who should always be screened for acoustic neuroma?

A

Patients with unilateral or asymmetrical

sensorineural hearing loss

84
Q

What should you do with patients who have had sudden sensorineural hearing loss?

A

Urgent ENT referral (its a medical emergancy)

85
Q

How can non-organic hearing loss be diagnosed?

A

Electric response audiometry

86
Q

What should you suspect if a pt has a discharging ear and a VII nerve palsy?

A

Medical emergency - suspect cholestiatoma

87
Q

What are the frequencies of the different types of temporal bone fracture and which has a worse prognosis?

A

Longitudinal (80%)

Transverse (20%) - worse prognosis

88
Q

What are the three types of otitis externa?

A

diffuse

furuncle

malignant

89
Q

What is diffuse otitis externa?

A

Normal generalised otitis externa

90
Q

What must you suspect if there is otitis externa with mucus?

A

THIS MUST BE COMING FROM THE MIDDLE EAR via a perforation

as there are not mucus secreting glands in the ear canal

91
Q

What is furuncle otitis externa?

A

Infection of the hair follicles in the outer 1/3 of the ear canal by staphylococcus, usually after a hair has been plucked

92
Q

What is malignant otitis externa?

A

Agressive otitis externa NOT CANCEROUS

due to pseudomonas aeruginosa

93
Q

Who is malignant otitis externa most commo in?

A

Immunocompromised

Diabetics

94
Q

What is the most common cause of acute otitis media?

A

50% viral

The rest are bacterial causes

95
Q

What is a common complication of AOM?

A

acute mastoiditis

96
Q

What is the dangerous with acute mastoiditis?

A

The bacterial in the purulent fluid in the mastoid air cells start to erode surrounding bone

97
Q

What is a worrying sign associated with acute mastoiditis?

A

unilateral headache as it is a sign of intracranial complications

98
Q

When can the need for a nasal fracture be properly assessed?

A

Immediately after or 5-10 days later once the inflammation has reduced

Otorhinolaryngology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions