Otology

Question 1

Sound not transmitted through outer/middle ear

Answer 1

Conductive hearing loss

Question 2

Sound not interpreted by inner ear

Answer 2

Sensorineural hearing loss

Question 3

Test comparing bone conduction to air conduction. A negative result is suggestive of conductive hearing loss. A positive result does not rule out sensorineural hearing loss

Answer 3

Rinne’s tuning fork test

Question 4

Test for hearing lateralisation. With sensorineural hearing loss, sound will lateralise to the opposite side. With conductive the sound will lateralise to the same side as the hearing loss

Answer 4

Weber’s test

Question 5

Hearing test used to identify hearing threshold levels of an individual, aiding in the determination of the degree, type and configuration of a hearing

Answer 5

Pure tone audiogram

Question 6

An examination used to test the condition of the middle ear and mobility of the eardrum by creating variations of air pressure in the ear canal

Answer 6

Tympanogram

Question 7

Blood collection in ear tissue. If left unresolved leads to damage of cartilage causing cauliflower ear appearance

Answer 7

Auricular haematoma

Question 8

Inflammation of external ear

Answer 8

Otitis externa(steroidal treatment => antimicrobial ear drops)

Question 9

Osteomyelitis of temporal bone seen in elderly diabetic patients with pain in ear, usually pseudomonas infection

Answer 9

Malignant otitis externa (treat with antibiotics)

Question 10

(a) Fluid secretion into middle ear lumen causing a build up of non-infectious fluid in middle ear cavity
(b) treatment for this condition

Answer 10

(a)Otitis media with effusion (glue ear)
(b) Grommets
In children is caused by eustacian tube not being fully developed. In adults need to thick of pathology blocking the eustacian tube

Question 11

Bacterial infection of the middle ear, can lead to tympanic membrane rupture

Answer 11

Acute otitis media, most episodes will recover without antibiotics, only treat if persistent

Question 12

Eustacian tube dysfunction causing tympanic membrane retraction and build up of skin around it. Will have persistant smelly discharge from the ear

Answer 12

Cholestaetoma, should have a referral to ENT. Treatment is mastoidectomy to remove the excess skin

Question 13

Chronic inflammation of middle ear and mastoid cavity

Answer 13

Chronic suppurative otitis media, complications include facial nerve weakness and brain abscess

Question 14

Deposits of calcium in the tympanic membrane

Answer 14

Tympanosclerosis, causes no symptoms and requires no treatment

Question 15

Stapes begins to fuse with the surrounding bone, eventually becoming fixed so it can’t move => sound is no longer transmitted into the inner ear efficiently

Answer 15

Otosclerosis

Question 16

High frequency sensorineural hearing loss. Gradually occurs in most individuals as they grow older

Answer 16

Presbycusis

Question 17

Ototoxic medication that can cause hearing loss

Answer 17

Gentamycin

Question 18

Unilateral sensorineural hearing loss requires which investigation for suspicion of which condition?

Answer 18

MRI for vestibular schwannoma

Question 19

What are the 5 main diagnoses for vertigo

Answer 19

Benign positional vertigo, menieres disease, vestibular neuritis, labyrinthitis, migraine

Question 20

Vertigo will be precipited by specific changes in head position. The investigation for this is (a)……….. the treatment is (b)…………… the condition is called (c)……………..

Answer 20

(a) Dix-Hallpike test
(b) Epley manoeuvre
(c) Benign positional vertigo

Question 21

Two conditions cause spontaneous vertigo where dizziness can last for days, typically patient has a few episodes. Motion can provoke vertigo if vestibular canals are damaged by the infection.

(a) has no other associated symptoms
(b) associated with unilateral hearing loss

Answer 21

(a) vestibular neuritis
(b) Labyrinthitis

Acute treatment would be vestibular sedatives, vertigo persists then vestibular rehabilitation

Question 22

Spontaneous vertigo with unilateral hearing loss, lasts a few hours and happens every few days/weeks/months. Hearing loss is fluctuating and progressive

Answer 22

Meniere’s disease

Question 23

The four drugs that can be used to treat Meniere’s disease are:

Answer 23

1. betahistine
2. bendrofluazide
   3 intratympanic dexamethasone
3. intratympanic gentamicin

Question 24

Not as characteristic a presentation as other forms of vertigo but will have other migraine symptoms, although these do not have to occur at the same time as the vertigo

Answer 24

Migraine related vertigo.

Advise to avoid possible migraine triggers, and possible use of prophylactic treatment

Question 25

Lower motor neuron facial weakness

Answer 25

Facial palsy- if excluded any causative disease process => Bell’s palsy