Pathology

Question 1

What does KITTENS stand for?

Answer 1

K - (K) congenital e.g. enzyme defects not resulting in HL at birth but predisposition earlier
I - Inflammation, including Immune and Infection
- Idiopathic (of unknown cause)
T - Trauma
T - Toxic, including drugs and degeneration/ageing
E - Endocrine (diabetes, thyroid disease)
N - Neurological, brain, nerves
- Neoplasia/tumours
S - Systemic something else is going on in the body

Question 2

Describe Symptoms and SIgns

Answer 2

Symptoms = what the patient/parent tells you
Signs = what you see on examination

Question 3

Name 6 top causes of acquired HL?

Answer 3

• Noise exposure
• Age
• Acoustic Neuroma
• Injury
• Ototoxicity
• Genetic

Question 4

Cochlea relies on what systems to function normally?

Answer 4

• vasculature (the blood vessels)
  * haematology (the blood cells)
  * metabolism. (e.g. diabetes)
• endocrine function (e.g. thyroid)

Question 5

hereditary factors play a role in presbyacusis T or F

Answer 5

True - and susceptibility to noise induced HL

Question 6

What occurs in labyrinthitis ossificans?

Answer 6

Ossification and bony deposits in the IE

Question 7

HL from chemotherapeutic drugs is usually…

Answer 7

SNHL is initially:
• worse at high frequencies
• bilateral, Drugs intravenous hence bilateral
• usually irreversible

▪ It may be accompanied by tinnitus or vertigo
▪ The degree of hearing loss is usually dose-related  Rarely, severe loss may occur after a single dose

Question 8

what are the two types of HL from noise exposure?

Answer 8

NIHL is caused by repeated exposure to sound that is:
• too intense
• too long in duration
Acoustic trauma is a single exposure to a hazardous level of noise resulting in PTS without a preceding TTS

Question 9

what are the most at risk frequencies for NIHL

Answer 9

3-6kHz - greatest loss at 4kHz

Progresses most rapidly during the first 10-15 years of exposure then slows. Stabilises once the noise exposure ceases

Question 10

What is a good measure to assess ears which might be overstimulated by sound?

Answer 10

OAEs

because of the well-recognised sensitivity of the OHC

Question 11

List 3 roles of an audiologist in early identification and prevention of NIHL

Answer 11

Prevention!

• promote safe listening behavioirs
• noise cancelling headphones etc
• identify those at risk of NIHL

Question 12

The prognosis for SSNHL is affected by 4 variables, they are:

Answer 12

1. Severity the more severe, the less the chances of recovery, especially for profound losses.
   Initial speech discrimination is not a useful prognostic variable, but is useful diagnostic variable
   
   2. The audiogram shape: up sloping and midfrequency shapes have a better prognosis than down sloping and flat losses
   3. The presence of vertigo especially with a down sloping loss there is a poor prognosis
   4. The age of the patient worse for: children, and adults older than 40 years
      **A delay in treatment (more than one week) is also associated with poor recovery.

Question 13

Difference between necrotising Ototis externa and Otitis exerns?

Answer 13

Necrotising is malignant - see granulations

- common in elderly diabetics or immune compromised individual’s such as

Question 14

three layers of TM

Answer 14

1. Outer epithelial layer is continuous with the skin of the EAC
   
   2. Middle fibrous layer (connective tissue)
      Inner mucosal layer is continuous with the mucosa of the middle ear

Question 15

List common ME diseases - 6

Answer 15

□ Acute otitis media (Inflammation of the middle ear)
□ Chronic otitis media with effusion
□ Atelectasis and adhesive otitis media
□ Tympanosclerosis
□ Chronic tympanic membrane (TM) perforations
Chronic suppurative otitis media (CSOM) with or without cholesteatoma

Question 16

What are some mechanisms for acquired cholesteatoma?

Answer 16

poor ET function
The normal migratory pattern of the TM epithelium is altered and keratin accumulates
The sac enlarges and fills the epitympanum/attic and surrounds the ossicle