Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

EENT > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

Function - Outer Ear

A

Collect sound energy and channel it into head

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

Function - Middle Ear

A

TM captures/transmits sound energy to ossicles

Ossicles converts sound energy to mechanical energy, amplifies it, and transfers it to the oval window of the cochlea

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

Function - Eustachian Tube

A

Pressure adjustments
Drainage
Protection from nasopharyngeal secretions and bacteria

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

Eustachian tube is opened by contraction of what muscle?

A

tensor veli palantini during swallowing/yawning

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

Perilymph

A

Found in the bony labyrinth

High Na, low K (similar to CSF)

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

Endolymph

A

Found in the membranous labyrinth

Low Na, high K

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

Function - Vestibule

A

Proprioception and balance

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

Function - Cochlea

A

Conversion of sound energy into electrical energy

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

How is sound transmitted in the ear?

A

Sound is collected by the outer ear
TM captures sound, transmits to ossicles
Ossicles convert sound energy into mechanical energy, transmits to cochlea
Mechanical energy moves endolymph in membranous labyrinth, causing flow of K+ ions across negatively-charged hairs on Organ of Corti, causing synapse firing
Information is conveyed by CNVIII to auditory area of temporal lobe, where it is interpreted as sound

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

Where is the only vascularized epithelium in the body?

A

inner ear

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

Function - Stria vascularis

A

“back-up battery” for Organ of Corti

Maintains endolymph

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

DDX - Ear pain (outer ear)

A 
Lichen simplex chronicus
Seborrheic dermatitis
Contact dermatitis
Atopic dermatitis
Acute cellulitis
Erysipelas
Infectious chondritis
Relapsing polychondritis
Auricular hematoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tx: Lichen simplex chronicus

A

education, cut nails, soothing lotion

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

What are other common locations to find seborrheic dermatitis?

A

scalp, eyebrows

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

What are other common locations to find atopic dermatitis?

A

flexural folds, ear canal

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

DDX: atopic derm vs. otitis externa

A

AD - sterile, no WBC, not infected

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

Acute cellulitis and erysipelas occur secondary to ___.

A

dermatitis, trauma

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

DDX: cellulitis vs. erysipelas

A

Cellulitis: more superficial, smaller area, usu caused by GABHS

Erysipelas: deeper infection, involves entire auricle, pt will be sicker (fever, chills)

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

Infectious chondritis is usually secondary to ___.

A

erysipelas

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

DDX: Erysipelas vs. Infectious chondritis

A

IC involves cartilage

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

DDX: Relapsing polychondritis vs. Infectious chondritis

A

RP - non-infectious, bilateral, spares lobes, nasal/ocular chondritis or arthritis possible

IC - infectious, involves the lobe, systemic sxs

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

Tx: Auricular hematoma

A

Remove fluid with 18g needle and 10 cc syringe, cover w/ compression dressing for 48 hours

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

DDx - Ear pain (ear canal)

A 
Otitis externa
Malignant otitis externa
Otitis media (acute, serous)
Otic barotrauma
Impacted cerumen
Foreign bodies
Osteoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Risk factors: OE

A

Change in pH from acid to alkaline
Inc. temp/humidity
Mild trauma/freq. cleaning

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

SSx: OE

A

TTP ear canal and auricle, aural fullness, hearing loss, unilateral or b/l

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

Risk factors: MOE

A

Diabetics
Alcoholics
Severe malnourished

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

SSx: MOE

A

Ear pn, purulent d/c, no fever, no swelling, granulation tissue at junction of temporal bone

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

Most important sign of MOE?

A

granulation tissue at junction of temporal bone

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

MC causative agent of MOE?

A

Pseudomonas aeruginosa

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

Complications: MOE

A

Osteomyeltitis, hearing loss, facial nerve paralysis, death

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

Tx: MOE

A

Refer to ENT, anti-pseudomonal agents

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

AOM is usu 2˚ to __.

A

URI

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

SSx: AOM

A

Usu unilateral, begins w/ sensation of blockage/hearing loss (fluid, loss of bony landmarks, red TM, small/distorted light reflex), progression to fever (>99.5˚F), < evening

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

What are the best clues for AOM in infants?

A

insomnia, irritability, anorexia

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

Which sign, if present, can be used to rule in AOM?

A

Bulging TM

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

Which sign, if absent, can be used to rule out AOM?

A

Immobile TM

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

Risk factors: Otic barotrauma

A

air travel

scuba diving

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

SSx: Otic barotrauma

A

Ear pn < yawning, hearing loss, dizziness

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

SSx: Impacted cerumen

A

discomfort to ear pn, hearing loss, dizziness, reflex cough

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

Cerumen impaction is mc in which populations?

A

elderly, pts w/ cognitive impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Tx: impacted cerumen

A

cerumenolytic agents, irrigation, manual removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the main contraindication to ear lavage?

A

Perforated TM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Why should irrigation should not be done with beans?

A

They can swell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are osteomas?

A

Exostoses of the external auditory meatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

SSx: osteoma

A

Usu asx, occasional conductive hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Tx: osteoma

A

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What homeopathic is indicated for osteomas?

A

Hekla lava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

DDx: Referred ear pain (normal otoscopic exam)

A

TMJ dysfunction (MC), molars, head/neck malignancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are red flags for serious occult cause of referred ear pain?

A

Smokers, alcoholics, >50 years old, diabetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

SSx: Serous Otitis Media (OME)

A

Usu painless, plugged feeling, aural fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are the MC causes of OME?

A

Allergies, viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

PE: OME

A 
TM yellow/amber
Bubbles, fluid level
Retraction
Tympanogram flat-type B
Little/no movement of insufflation
Conductive hearing loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Tympanometry: Type A vs B vs C

A

A: Normal
B: early AOM, OME
C: Eustachian tube dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Eosinophilic otitis media mainly occurs in pts with __.

A

bronchial asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

SSx: Infectious Myringitis

A

Red/painful ear, no middle ear involvement, vesicles on TM (if S. pneumoniae)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

SSx: Herpes Zoster Oticus (Ramsay Hunt Syndrome)

A

Otalgia, facial palsy, hearing loss, vertigo, pathognomonic vesicular rash of the pinna, ext. auditory canal, TM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Cause: Herpes Zoster Oticus (Ramsay Hunt Syndrome)

A

Reactivation of VZV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Hearing loss and vertigo in Ramsay Hunt Syndrome is due to ___.

A

movement of virus from CN VIII to CN VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the facial nerve deficit in Herpes Zoster Oticus (Ramsay Hunt Syndrome)?

A

Cannot close eyelid/lift eyebrow/smile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

DDx: Mastoiditis vs. AOM

A

Mastoiditis will have ear pain like AOM, but also have pain behind the ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

SSx: Mastoiditis

A

Otalgia, tender/red mastoid, bulging of TM, protrusion of auricle, spasm of ipsilateral SCM

62
Q

Complications: Mastoiditis

A

Abscess into brain, meningitis, death

63
Q

Etiology: Mastoiditis

A

AOM that spreads to mastoid air cells

64
Q

What is the best way to soften cerumen prior to irrigation?

65
Q

Why is infectious myringitis sometimes called “bullous?

A

If caused by Strep. pneumoniae, there may be vesicles on TM

66
Q

PE: AOM vs. OME

A

AOM - Bulging

OME - Retraction

67
Q

Hx: AOM vs. OME

A

AOM - Pain

OME - Usu painless

68
Q

MC cause of OE?

A

Excessive moisture

69
Q

What population of pts w/ OE are more likely to need systemic tx?

A

Diabetics, those taking systemic corticosteroids

70
Q

OE - Homeopathy

A

Hepar sulph: < heat, < touch

71
Q

What are the most important reasons for treatment to fail in Otitis externa?

A

Failing to clean out the canal, wrong dx (chondritis, MOE), fungal infx, underlying systemic imbalance (dermatitis)

72
Q

MC fungal pathogens in OE?

A

Aspergillus nigra, Candida

73
Q

MC bacterial pathogens in OE?

A

P. aeruginosa, S. aureus

74
Q

Tx: OE d/t Aspergillus nigra

A

Tea tree oil 1:10

75
Q

Complication: OE

76
Q

Risk Factors for OM: Season

A

Fall, Winter (peaks in Feb.)

77
Q

Risk Factors for OM: Age

A

Peaks 6-18 mos and 5 yrs

78
Q

Risk Factors for OM: Food

A

Dairy at early age
Early intro of solid foods/reliance on formula
Breast feeding <6 mos
Food allergy

79
Q

Risk Factors for OM: Feeding position

80
Q

Toynbee phenomenon

A

Supine bottle feeding causing aspiration into Eustachian tube

81
Q

Risk Factors for OM: Sleep position

82
Q

Risk Factors for OM: Environmental

A 
2nd/3rd hand smoke
"Sick" buildings
Sibling with URI
Daycare attendance
Pacifier use
83
Q

Risk Factors for OM: Nutritional deficiencies

A

Vit A, Vit D, Zinc

84
Q

Risk Factors for OM: Race

A

Eskimo, Native American

85
Q

Risk Factors for OM: Structural

A

Fetal alcohol syndrome, Down’s syndrome, cleft palate

86
Q

Risk Factors for OM: Conditions

A

GERD
Overweight
Genetics

87
Q

Risk Factors for OM: Drugs

A

Early antibiotic use

88
Q

Twins studies for AOM showed higher rates for (monozygotic/dizygotic) twins.

A

monozygotic

89
Q

How are children’s ears different than an adults, and how does that make them more at risk for Otitis media?

A

Shorter, narrower, and horizontal compared to adults

90
Q

__% of aspirates for AOM are viral.

91
Q

MC bacterial pathogens: AOM

A

Strep. pneumonia, H. influenza, Moraxella catarhalis

92
Q

Homeopathy for AOM: Aconite

A

Early stage, non-suppurative, violent pain, after exposure to cold, < warm applications

93
Q

Homeopathy for AOM: Belladonna

A

Throbbing pain, red/flushed dry face, thirstless, deranged mind

94
Q

Homeopathy for AOM: Calc carb

A

Red/hot/throbbing high fever, moist head/face, sensitive to cold, mucus in chest/nose

95
Q

Homeopathy for AOM: Chamomile

A

Painful ear, otitis w/ dentition capricious, intolerant, irritable, one cheek red/other white, desires to be carried

96
Q

Homeopathy for AOM: Hepar sulph

A

Sensitive to touch/cold, < drafts, irritable, wants to be wrapped

97
Q

Homeopathy for AOM: Medorrhinum

A

thick/green d/c, eardrums will perforate

98
Q

Homeopathy for AOM: Lycopodium

A

R-sided otitis, eczema behind the auricle, irritable, < 4-8pm, > warm drinks

99
Q

Homeopathy for AOM: Mercurius

A

bloody d/c, abscessed ears. mastoiditis, profuse salivation, indented tongue, child smells sick, < temp. extremes

100
Q

Homeopathy for AOM: Pulsatilla

A

OE/OM, thick/yellow d/c, thirstless, mild, > open air, > sympathy, >being carried

101
Q

Homeopathy for AOM: Ferrum Phos

A

High fever, red TM, R-sided, vague sxs, thirst for cold drinks, red spots on cheeks

102
Q

Homeopathy for AOM: Kali sulph

A

More irritable puls.

103
Q

Clark’s rule for dosing in children

A

Wt. of child / 150 x Adult dose

104
Q

NNT for antibiotics in AOM in children

105
Q

When are antibiotics most beneficial for AOM?

A

Children <2 yo w/ bl AOM, children with both AOM/otorrhea, reducing risk of mastoiditis in populations where it is mc

106
Q

Risks: Antibiotics for AOM

A

D, stomach pain/rash, increase resistance to antibiotics, inc. rate of recurrence in OME

S/E: D, abd. pain, rash

107
Q

What are the advantages of breast-feeding in preventing otitis media?

A

Provides sIgA, prostaglandins, better feeding position, develops musculature of the face/nasopharynx, no need for dairy/soy (common allergens), ideal mix of nutrients

108
Q

Complications: AOM

A

Mastoiditis, Meningitis, TM perforation, Cholesteatoma, Chronic Suppurative Otitis Media

109
Q

MC bacteria: CSOM

A

P. aeruginosa, S. aureus

110
Q

NNT: AOM w/ otorrhea

111
Q

Best antibiotic choice for empiric treatment of AOM?

A

Augmentin (Amoxicillin + clavulanate)

112
Q

Supplement options: AOM

A

Vitamins A/C/D, Fish oil, Zinc picolinate, probiotics

113
Q

DDx: Patulous Eustachian Tube

A

Superior semicircular dehiscence syndrome, perilymphatic fistula

114
Q

What type of dizziness might pts describe as “being on a merry-go-round or on a boat”?

115
Q

What is difficult about diagnosing CO poisoning?

A

Vital signs are not helpful

116
Q

DDx: dizziness d/t hypovolemia vs. autonomic dysfxn

A

Hypovolemia = drop in SBP 15-20 mmHg w/ increased pulse rate

Autonomic = drop in SBP 15-20 mmHg w/ low pulse rate

117
Q

MC neurologic causes of syncope or pre-syncope

A

SAH, stroke, TIA

118
Q

Impaired balance when walking

A

Disequilibrium

119
Q

What is the MC cause of disequilibrium?

A

Multiple Sensory Deficit

120
Q

Why is it so important to recognize Multiple Sensory Deficit?

A

Common in geriatrics, inc. risk of falls

121
Q

What type of dizziness might pts describe as “in my legs, not my head”?

A

Disequilibrium

122
Q

Imaging when stroke needs to be ruled out?

A

MRI (CT too insensitive)

123
Q

Lab testing identifies the cause of vertigo in __% of cases.

A

less than 1%

124
Q

Location of problem: Peripheral vs. central vertigo

A

Peripheral: middle/inner ear

Central: CNS (brain stem, cerebellum)

125
Q

DDx (Peripheral vs. Central vertigo): Vestibular Ocular reflex

A

P: Corrective saccade if 40% vestibular fxn difference between ears

C: Intact

126
Q

How is the Vestibular Ocular relex elicited?

A

Rapid head impulse test

127
Q

DDx (Peripheral vs. Central vertigo): Spontaneous nystagmus direction

A

P: Unidirectional, primarily horizontal, slow phase in direction of defunct labyrinth

C: Bidirectional, rotational/downbeat/pure vertical

128
Q

DDx (Peripheral vs. Central vertigo): Spontaneous nystagmus suppressed w/ visual fixation

A

P: Yes

C: No

129
Q

DDx (Peripheral vs. Central vertigo): Smooth pursuit on EOM

A

P: Intact

C: Broken

130
Q

DDx (Peripheral vs. Central vertigo): Dix-Hallpike

A

P: Latency, Adaptability, Fatiguability

C: None of the above

131
Q

How long can the latency be in BPPV before nystagmus occurs in Dix-Hallpike test?

A

20 seconds

132
Q

DDx (Peripheral vs. Central vertigo): Diminished hearing, tinnitus

A

P: Common

C: Rare

133
Q

DDx (Peripheral vs. Central vertigo): Caloric test

A

P: Abnormal

C: Normal

134
Q

DDx (Peripheral vs. Central vertigo): Tullio’s phenomena

A

P: Abnormal

C: Normal

135
Q

What is Tullio’s phenomena?

A

Nystagmus and vertigo after a loud noise

136
Q

What are the MC causes of vertigo?

A

BPPV, Meniere’s disease, vestibular neuritis

137
Q

Normal findings: Caloric testing

A

Unilateral nystagmus w/ fast component away from cold water and slowly back, dizziness

138
Q

Abnormal findings: Caloric testing

A

In peripheral lesions, lack of nystagmus or no effect on spontaneous nystagmus

139
Q

Hennebert’s sign

A

Vertigo after pushing on tragus and external auditory meatus

+ in perilymphatic fistula

140
Q

If symptoms and/or nystagmus are elicited by insufflation, this is a sign of ___.

A

perilymphatic fistula

141
Q

Inability to complete past pointing exam suggests ___.

A

cerebellar lesion

142
Q

If Romberg test is positive with eyes open, suspect ___.

A

cerebellar disorder

143
Q

If Romberg test is positive with eyes closed, suspect ___.

A

peripheral neuropathy or vestibular disorder

144
Q

DDx (Peripheral vs. Central vertigo): Type of nystagmus elicited by Dix-Hallpike

A

P: upbeat (BPPV)

C: downbeat

145
Q

What three things should be noted with spontaneous nystagmus?

A

direction, plane, ability to suppress

146
Q

What tool can be used to prevent visual fixation?

A

Frenzel lens

147
Q

What other way can visual fixation be eliminated other than Frenzel lens?

A

Blank sheet of paper

148
Q

If valsalva causes pre-syncope, suspect ___.

A

cardiovascular reason instead of vestibular

149
Q

Red flags for stroke with vertigo

A

Hyperacute onset vertigo, occipital HA, gait ataxia

150
Q

DDx (VEMPs): sensorineural vs. conductive hearing loss

A

Conductive: obliterates VEMPs

Sensorineural: No change in VEMPs

151
Q

What is the only test to differentiate unilateral and bilateral hearing loss?

A

Caloric testing (as part of VNG)

152
Q

What is the gold standard for testing inner ear function?

A

Videonystagmography

EENT (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions