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Clinical medicine HEENT > quiz 3 part 2 (ear) > Flashcards

quiz 3 part 2 (ear) Flashcards

1
Q

what is an auricle hematoma?

A

collection of blood in the cartilaginous auricle/ outer ear

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2
Q

complications of auricle hematoma

A

cauliflower ear and conductive hearing loss, otitis and periosteum damage, must fully drain

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3
Q

what is mastoiditis

A

bacterial infection of the mastoid air cells
-this is an AOM complication

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4
Q

what bacteria is linked to mastoiditis

A

pneumococcus

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5
Q

S+S of mastoiditis

A

fever, postauricle pain, otorrhea, swelling, tenderness, pinna displacement, edema of the external canal, destruction of bony septa, lump pushing the ear forward (pinna displacement0

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6
Q

mastoiditis x ray

A

air cells will coalesce and destory the bony septa

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7
Q

mastoiditis treat

A

iv ceftriaxone
-myringotomy to remove the TM fluid to releive the pressure
-mastoidectomy
*emergency

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8
Q

complications of mastoiditis

A

infection can decompress through the TM and go to lateral mastoid cortex forming a superiosteal abscess
-rare: extends centrally causing Temporal lobe abscess or spetic thrombosis of the lateral sinus

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9
Q

what is a possible complication of AOM

A

cholesteatoma
-only if it was there for a long time

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10
Q

trauma or euschian tube dysfunction can also cause?

A

cholesteatoma

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11
Q

why is cholesteatoma bad

A

it erodes the ear and needs to be cleared out
-can also cause vertigo
-extends from the TM and possible to the bone

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12
Q

how can we treat cholesteatoma

A

-get a ct to see the extent of the spread,
-audiogram to asses conductive and possible sensorineural hearing loss
-surgery to remove the membrane so it does not come back
-ear drop
-antibiotics (questionable)

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13
Q

complications of cholesteatoma untreated

A

bone destruction, deafness, facial nerve paralysis, dizziness, abscess, systemic infection, death

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14
Q

neuralgia can affect what?

A

trigeminal, glossopharyngeal, genticulate or sphenopalatine
-causes ear ache

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15
Q

cerumen impaction

A

-common cause of conductive hearing loss

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16
Q

cerumen impaction S+S

A

-vague pain with hearing loss
-NO OTHER symptoms

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17
Q

treatment for cerumen impaction

A

-clean it out with cerumol or hydrogen peroxide (sometimes dissolves it)
-dont flush TM could be perforated and water would damage

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18
Q

what is bullous myringitis

A

blood filled ball
-caused by herpes or mycoplasma pneumoniae

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19
Q

bullous myringitis S+S

A

balls on TM< sudden pain, fluidy bulging TM, herpetic lessions near the tragus

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20
Q

malignant external otitis

A

persistant otitis externa

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21
Q

what bacteria causes malignant external otitis

A

pseudomonas auregenosa

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22
Q

S+S of malignant otitis externa

A

fouls smelling discharge, granulations in ear canal, deep otalgia, palsies of nerves 6,7,10,11,12

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23
Q

what scan should we do for malignant OE

A

ct scan to look for osseous erosion

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24
Q

how are we treating malignant OE

A

antipseudomonal antibiotics long term (cipro)
-start with an IV bc this is a severe infection then go to oral

25
Q

complications of malignant otitis externa

A

spread to bone: osteomyelitis
-risky especially in immunocomp
-can hit the base of the skull

26
Q

otitis externa

A

-swimmers ear, can be from a lack of hygiene, kocalized to the canal not the TM, not properly drying ears

27
Q

likley bacterial causes of otitis externa

A

pseudomonas, proteus, aspergillus

28
Q

what are risk factors of otitis externa

A

seborrhatic dermatitis and mechanical trauma

29
Q

otitis externa S+S

A

swelling that can cause ear occlusion and hearing loss, pain, no relief from pulling on the ear, erythematous and edematous ear canal, tenderness with tragus movement, thick white purulent otorrhea, insufflation of TM (-): there should BE movement unless there is also an otitis media at the same time

30
Q

what does not causes relief of otitis externa

A

pulling on the ear

31
Q

how to diagnose OE

A

-culture if there is no improvement and otorrhea
-clinical diagnosis

32
Q

how to treat OE

A

-keep the ear dry, cipro drops if pseudomonas, insert a wick if there is severe edema (not possible if too painful), oral fluroquinolones

33
Q

why can you not give oral fluroquinoloes to under 18yrs

A

it can cause their tendons to rupture

34
Q

who is at risk to get OE

A

swimmers and diabetics

35
Q

when does otalgia become chronic

A

2-3 weeks

36
Q

what else can cause otalgia

A

refered pain: nasopharynx, tonsils and upt

37
Q

otalgia presents in older pt

A

suspect tumor

38
Q

differential dx for otalgia

A

-serous otitis media, otitis media w effusion, otitis externa, barotrauma, fb, dental infection, mastoiditis, TMJ, herpes, chickenpox

39
Q

chronic om vs externa

A

-externa causes pain
-chronic can decrease hearing

40
Q

central hearing loss

A

-issue is at the cortex/brainstem, ascending auditory pathway (CNS

41
Q

common cause of central hearing loss

A

vestibular schwanoma/ acoustic neuroma
-8th cranial nerve schwanoma are the most common intracranial tumors
-the tumor grows from the myelin

42
Q

MRI for vestibular schwanoma

A

to look for how far the tumor spread

43
Q

malingering hearing loss

A

faking it for attention

44
Q

psycogenic hearing loss

A

you are unaware that it is fake

45
Q

nonorganic hearing loss

A

equal hearing loss at all frequencies and no reponse to pure tones in one or both ears

46
Q

conductive hearing loss results

A

rinnie: (-) bc they will not be able to hear once it has been moved off the mastoif
websters: sound goes to the bad ear because the bone conduction is better

47
Q

causes of congenital:

A

cholesteatoma, secretory otitis media, euschian tube dysfunction, congenital atresia (narrowing), external otits, TM perforation, ossicular fixation, ossicular disarticulation

48
Q

what can people not hear with congenital

A

low or flat frequencies
-deficit of loudness

49
Q

ossicular disarticulation

A

ossicles/ middle ear bones are not alignes
-from trauma

50
Q

ossicular fixation

A

-otosclerosis/ age and joint changes
-bones can not move properly

51
Q

where does the webster sound go on conductive loss

A

to the bad ear

52
Q

how do ppl with conductive speak

A

maintain their soft voice, can hear speech when it is loud, equal loss for all frequencies, can not hear consonants, background noise helps

53
Q

sensorineural loss is

A

progressive, preventable, permanent and painless

54
Q

how does a sensorineural person speak

A

shouting

55
Q

sensorineural test results

A

rinni(+): AC louder than BC
webster: sound goes to the good ear

56
Q

what does a sensorineural person hear

A

sounds are jumbled, background noise makes it worse, high frequency loss

57
Q

what are potential causes of sensorineural

A

-measles, mumps, meningitis, cmv
-menier disease, acoustic neroma, hair cell destruction

58
Q

how does sensorineural speak

A

yelling, they might have tinnitus

Clinical medicine HEENT (10 decks)

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