Brainscape's Knowledge GenomeTM

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


See full index

EENT > Test 3 > Flashcards

Test 3 Flashcards

1
Q

what are the ddx for dizziness

A
  • Vertigo
    • Acute severe vertigo
    • Recurrent positional vertigo
    • Recurrent spontaneous vertigo
  • Syncope or presyncope
    • Arrhythmia
    • Valvular disease
    • Acute coronary syndrome
    • Brugada syndrome
    • Wolff-Parkinson-White syndrome
    • Carbon monoxide poisoning
    • Orthostasis
    • Subarachnoid hemorrhage
    • Transient ischemic attack
    • Stroke
    • Orthostatic hypotension/POTS
    • Dehydration
  • Disequilibrium
    • Peripheral neuropathy
    • Parkinson’s
    • B12 deficiency
    • Cataracts
    • Lyme
  • Lightheadedness
    • Hypoglycemia
    • Anxiety
    • Encephalopathy
    • Medication side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

shuffling gait, bradykinesia, and wide based ataxic turns

A

parkinson’s disease

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

unsteady gait

A

peripheral neuropathy

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

ataxic gait

A

cerebellar disorder

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

HINTS

A

Head Impulse, Nystagmus, Test of skew

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

what is spontaneous nystagmus

A

movement of the eyes without a cognitive, visual or vestibular stimulus, occurs consistently with fixed central gaze position stationary, upright, and neutral positions

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

Gaze Nystagmus

A

holding off center gaze produces eye movement

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

when assesing nystagmus what do you note?

A

unilateral or bilateral
horizontal, vertical or rotational
suppression

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

Vestibular-ocular reflex, Head-Impulse (or head thrust) test

A

Thrust patients head 20-30 degrees while the patient fixates on the examiner’s nose

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

unidirectional, horizonatal Nystagmus

A

peripheral vertigo

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

bidirectional, rotational or pure vertical Nystagmus

A

central vertigo

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

horizontal with the fast phase beating away from the hypoactive labyrinth

A

Peripheral vertigos

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

Down beat, torsional or true vertical nystagmus

A

central vertigo

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

which nystagmus can be suppressed by visal fixation?

A

Peripheral nystagmus

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

catch-up saccade to re-fixate on the target (your nose) when thrust is in the direction of the lesion (head thrust)

A

peripheral vertigo

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

Test of Skew

A

assessed by asking the patient to look straight ahead, then cover and uncover each eye

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

test of skew +

A

Vertical deviation of the covered eye after uncovering indicative of central vertigo

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

Dix-Hallpike, Nylan-Barany maneuvers, or George’s test

A

Observe patient at rest, test extraocular motions (EOM). Rotate and extend head, lay patient down and hold position for 30 second or patient tolerance

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

Dix-Hallpike, Nylan-Barany maneuvers, or George’s test + means

A

positional vertigos

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

Romberg Tests

A

The patient is asked to remove his shoes and stand with his two feet together. The arms are held next to the body or crossed in front of the body.
The clinician asks the patient to first stand quietly with eyes open, and subsequently with eyes closed. The patient tries to maintain his balance. For safety, it is essential that the observer stand close to the patient to prevent potential injury if the patient were to fall. When the patients closes his eyes, he should not orient himself by light, sense or sound, as this could influence the test result and cause a false positive outcome.
The Romberg test is scored by counting the seconds the patient is able to stand with eyes closed.

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

Sharpened Romberg Tests

A

he patient has to place his feet in heel-to-toe position, with one foot directly in front of the other.
the assessment is performed first with eyes open and then with eyes closed.
The patient crosses his arms over his chest, and the open palm of the hand lies on the opposite shoulder. The patient also distributes his weight over both his feet and holds his chin parallel with the floor

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

Romberg and Sharpened Romberg Tests + eyes open

A

cerebellar disorder

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

Romberg and Sharpened Romberg Tests + eye closed

A

peripheral neuropathy or vestibular disorder

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

Past pointing

A

ask patient to touch your fingers with eyes open, and then eyes closed

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

Past Pointing Dysmetria or dysdiadochokinesia

A

cerebellar lesion

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

fistula test

A

insufflation

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

Fistula Test +

A

opening (perilymphatic fistula) between the TM and the vestibular apparatus, the change in aural pressure will cause symptoms and or nystagmus

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

Hennebert’s sign

A

pushing on tragus and external auditory meatus

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

Hennebert’s sign +

A

few beats of horizontal nystagmus seen under Frenzel glasses without clinical evidence of middle ear or mastoid disease
indicates congenital syphilis and Meniere disease

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

Caloric Testing

A

a specialist has patient is sitting back at 30º and cold water (ice cubes in water for 10 minutes) is instilled into ears

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

Caloric Testing +

A

iced water on the damaged side either does not cause nystagmus, or has no effect on any spontaneous nystagmus indicating a peripheral lesion

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

Headshake test

A

Shake head for 20 seconds at 2 Hz with eyes closed then inspect eyes for nystagmus

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

unilateral nystagmus in the horizontal plane (Headshake test)

A

peripheral vertigo

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

vertical nystagmus (headshake test)

A

central vertigo

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

Videonystagmography (VNG)

A

measures the movements of the eyes directly through infrared cameras
can decipher between a unilateral (one ear) and bilateral (both ears) vestibular loss

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

VNG procedure

A

Ocular Mobility
Optokinetic Nystagmus
Positional Nystagmus
Caloric Testing

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

Ocular Mobility part of VNG

A

The patient is asked to follow objects that jump from place to place, stand still, or move smoothly

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

slowness or inaccuracies in following visual targets (ocular mobility)

A

central or neurological problem, or possibly a problem in the pathway connecting the vestibular system to the brain

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

Optokinetic Nystagmus

A

The patient views a large, continuously moving visual image to see if their eyes can appropriately track these movements

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

Optokinetic Nystagmus + any slowness or inaccuracies in following visual targets

A

central or neurological problem, or possibly a problem in the pathway connecting the vestibular system to the brain

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

Positional Nystagmus

A

technician will move the patients head and body into various positions to make sure that there are no inappropriate eye movements

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

Aconite

A

something bad happens/shock/trauma causing the person to become dissociative, excessive excitability in nervous and vascular system,
lots of anxiety, sudden, fearful
one cheek red, one pale
anxiety with heart sx
sensitive to outside stress
bright red
worse cold
hot

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

Apis

A

busy bee, like having task/jobs, like to organize, jealous
protective and easily turn into an enemy/annoyed
swollen, tight, bursting, dusky redness
drop things
worse from suppressed eruptions, hearing bad news, shock
hot
right-sided

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

Arsenicum album

A

anxious, restless, proper, tense, worried, depressed, perfectionistic
can’t be easily consoled, hypochondriac
restlessness exhausts them
suicidal ideation but fear of death
cold want heat
disgusting discharge
right-sided

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

Belladona

A

intense, delirious, pulsing
deep red, hot, and dry
sudden onset of physical or emotional sx
right-sided
twitching/jerking
dilated pupils

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

Phosphorous

A

open to people, infections,
bubbly
sensitive to other emotions
spacey
discharge easily pours out of them
gas, bloating
left-sided
anxiety about health
bright red blood

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

Vestibular evoked myogenic potential

A

neurophysiological technique used to determine the function of the utricle and saccule of the inner ear

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

obliterates VEMP’s

A

conductive hearing loss

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

does little or nothing to VEMP’s

A

sensorineural hearing loss

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

“Tullio” effect

A

Sound-induced vertigo; disequilibrium or dizziness, nystagmus and oscillopsia triggered by sounds

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

Peripheral vertigo

A

dysfunction somewhere in the middle or inner ear, affecting the vestibular apparatus
Spontaneous nystagmus is unidirectional and horizontal
moderate to severe

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

Central vertigo

A

dysfunction in the CNS brain stem or cerebellum
vertigo mild to severe
N/V less severe
associated with weakness, dysarthria, vision changes, paresthesia, altered mental status, ataxia or other motor/sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

DDX for central vertigo

A

drugs
stroke
Vertebrobasilar insufficiency,
Multiple Sclerosis
Tumors near the cerebellopontine angle (CPA) angle
Wernicke encephalopathy
encephalitis, meningitis
TBI

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

What drugs/substances cause vertigo

A

alcohol
Barbiturate
seizure med: phenobarbital Dilantin, Lamictal and Depokote

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

Head impulse test indicating peripheral

A

corrective saccade

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

head impulse test indicating central

A

normal exam

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

head impulse test indicating central

A

normal exam

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

Suppression of nystagmus with visual fixation

A

peripheral

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

minimal or some suppression of nystagmus with visual fixation

A

central

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

smooth pursuit intact

A

peripheral

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

smooth pursuit broken

A

central

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

Dix-hallpike showing latency, adaptability, fatigability.

A

peripheral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Dix-hallpike showing no latency, no adaptability, no fatigability.

A

central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

diminished hearing, tinnitus indicates which vertigo

A

peripheral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

normal hearing indicates which vertigo

A

central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

abnormal caloric testing indicates which vertigo

A

peipheral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

normal caloric test indicates which vertigo

A

central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

nystagmus and vertigo after a loud noise (Tulio’s phenomena) indicates which vertigo

A

peripheral

68
Q

no nystagmus and vertigo after a loud noise (Tulio’s phenomena) indicates which vertigo

A

central

69
Q

Vestibular neuritis cause

A

hypoactive vestibular apparatus due to viral infection (URI)

70
Q

Vestibular neuritis sx

A

bell’s palsy
sudden severe, frequent to constant, spontaneous, and worse with movement vertigo/imbalance with N/V

71
Q

vestibular neuritis PE

A

spontaneous horizontal-torsional nystagmus beating away from the lesion side
head impulse test +
caloric test +
decreased VEMPs
unsteadiness with a falling tendency toward the lesion side

72
Q

vestibular neruritis Tx/management

A

resolve days to weeks
supportive care
IV hydration

73
Q

Labyrinthitis cause

A

inflammation of the labyrinth
Autoimmune cause bilateral labyrinthitis
Ototoxic drugs (gentamicin, streptomycin or neomycin, phenytoin (Dilantin), antihypertensive, diuretics, nitroglycerine, quinine, salicylates, sedative/hypnotics)), TB treatment
Herpes viruses, influenza, measles, rubella, mumps, polio, hepatitis, and Epstein-Barr.
Herpes zoster oticus cause severe labyrinthitis
AOM or OME

74
Q

Viral labyrinthitis Sx

A

sudden, unliteral vertigo serve and incapacitating with N/V
hearing loss

75
Q

Viral labyrinthitis PE

A

spontaneous nystagmus away from the affected side
absent caloric responses in the affected ear
head impulse test is positive
hearing loss is usually mild to moderate and typically evident in the higher frequencies (>2000 Hz),

76
Q

Serous labyrinthitis cause

A

of chronic, untreated middle ear infections (serous otitis media aka OME)

77
Q

Serous labyrinthitis sx

A

unliteral vertigo with N/V
hearing loss

78
Q

CNS stroke Sx

A

focal weakness
slurred speech

79
Q

Rothrock criteria

A

Patient > 60 years, new onset focal neurologic deficit, headache with vomiting, or altered mental status

80
Q

RF for CNS stroke

A

older age, hypertension, and diabetes

81
Q

CNS stroke PE

A

head impulse test will be normal

82
Q

Benign Paroxysmal Positional Vertigo sx

A

Brief episodes (1 minute) of vertigo that are triggered by positional changes

83
Q

Benign Paroxysmal Positional Vertigo cause

A

Development of otolith (calcium carbonate precipitates in endolymph) roll across hairs when head moves and sends aberrant signals to brain causing vertigo
secondary to head trauma, dental surgery, middle ear infection (AOM), and Labyrinthitis

84
Q

Benign Paroxysmal Positional Vertigo PE

A

Dix-Hallpike + a transient burst of upbeat nystagmus is seen, Nystagmus fatigues on repeat examination

85
Q

types of BPPV

A

anterior canal BPPV (AC-BPPV) (3rd)
posterior canal BPPV (PC-BPPV) (most common)
horizontal canal BPPV (HC-BPPV) (2nd)

86
Q

Treatment for BPPV

A

Epley maneuvers

87
Q

Horizontal SCC BPPV

A

experience severe vertigo when lying supine and rotating the head

88
Q

Anterior (SCC) BPPV TX/DX

A

Dix-Hallpike
Variants of the Dix-Hallpike maneuver may also treat anterior canal BPPV

89
Q

Central Positional Vertigo cause

A

lesion in the cerebellum or brainstem

90
Q

Central Positional Vertigo PE

A

downbeat or pure torsional nystagmus on Dix-Hallpike

91
Q

Meniere disease cause

A

Blockage of endolymphatic sac or duct
autoimmune mechanisms
genetic predisposition
Herpes (Varicella zoster, HSV), CMV
Vascular etiology
edema within the endolymphatic space

92
Q

Meniere disease sx

A

episodic attacks (2-24 hrs. between episodes) of vertigo that is severe too violent with nausea and vomiting
aural fullness worse w/ downward fluctuations in hearing
tinnitus can be loud and roaring
fluctuating sensorineural hearing loss often affecting the lower frequencies
unilateral

93
Q

Meniere disease onset

A

affects middle-aged women,

94
Q

Meniere disease PE

A

head impulse test will lateralize vestibular dysfunction to the symptomatic ear.
audiology: low frequency or combined low- and high-frequency sensory loss with normal hearing in the mid frequencies

95
Q
  1. Two or more spontaneous episodes of vertigo with each lasting 20 minutes to 12 hours
  2. Audiometrically documented low- to medium- frequency sensorineural hearing loss in one ear, defining and locating to the affected ear on in at least one instance prior, during or after one of the episodes of vertigo
  3. Fluctuating aural symptoms (fullness, hearing, tinnitus) located in the affected ear
  4. Not better accounted for by any other vestibular diagnosis
A

Meniere disease dx

96
Q

Transient Ischemic Attack SX

A

sudden and short episodes of vertigo and hearing loss that get worse in a crescendo pattern
focal neurologic deficits

97
Q

Transient Ischemic Attack RF

A

hypertension, diabetes, hyperlipidemia

98
Q

Bilateral vestibular failure cause

A

aminoglycoside toxicity Gentamicin and streptomycin

99
Q

Acoustic Neuroma SX

A

Slowly progressive unilateral hearing loss in high frequencies
50% vertigo
tinnitus
vague dizziness or vertigo
facial weakness later in disease

100
Q

Acoustic Neuroma DX

A

Refer to ENT for audiology (retrocochlear deficit pattern)
Auditory brainstem response (ABR)
MRI of the interior auditory canal with gadolinium contrast

101
Q

Perilymphatic Fistula cause

A

Breach between the middle and inner ear. Secondary to trauma from a direct blow or sudden barotraumas, occasionally heavy weight bearing or straining.

101
Q

Perilymphatic Fistula SX

A

symptoms worse by insufflation
vertigo and mixed sensorineural hearing loss

102
Q

Superior canal dehiscence cause

A

bone overlying the superior aspect of the superior semicircular canal becomes thin or even absent, thereby allowing pressure to be transmitted to the inner ear
secondary to trauma, or barotrauma

103
Q

Superior canal dehiscence sx

A

Coughing, sneezing, and loud noises (Tulllio phenomenon) can provoke vertigo
oscillopsia (objects in the visual field appear to oscillate) and autophony
hyperacusis

104
Q

Superior canal dehiscence dx

A

clicked vestibular evoked myogenic potential c(VEMP)
MRI or high-resolution CT of the temporal bone.

105
Q

Migrainous Vertigo sx

A

Episodic moderate dizziness
stimuli such as light, sound, or motion, can trigger or aggravate symptoms

106
Q

Migrainous Vertigo DX

A

based on the symptoms, degree, frequency, and duration of the vestibular episodes, a history of migraine, and the temporal association of migraine, ruling out what may be due to other reasons
The head impulse test will be normal

107
Q

Neuhauser Criteria for Migrainous Vertigo

A

Episodic vestibular symptoms of at least moderate severity Vertigo; positional dizziness and head motion intolerance

Migraine according to the International Headache Criteria

One or more of the following features during at least two vertigo attacks
Migrainous headache
photophobia
phonophobia
migraine aura

Other diagnoses excluded by appropriate tests

108
Q

Cervicogenic Vertigo sx

A

Vague dizziness

109
Q

Cervicogenic Vertigo cause

A

triggered by somatosensory input (position sense) in the cervical joints from head and neck movement neck injury (whiplash),

110
Q

Cervicogenic Vertigo TX

A

physical therapy and manipulation

111
Q

Hearing loss PE

A

Webber
Rinne
whispered voice test

112
Q

Webber

A

measures bone conduction
use 512 Hz tuning fork
Lateralize to bad ear = conductive hearing loss
Lateralizes to good ear = sensorineural hearing loss

113
Q

Rinne

A

AC > BC = Normal
BC > AC= Conductive hearing loss
AC > BC, (both diminished)= Sensorineural hearing loss

114
Q

pure tone audiology

A

test air conduction and bone conductio

115
Q

Air conduction

A

measured with earphones and tests the entire auditory system.

116
Q

mild hearing loss

A

26–40 dB, difficulty with faint or distant speech

117
Q

moderate hearing loss

A

41–55 dB

118
Q

moderate to severe hearing loss

A

56–70 dB, speech must be loud; difficulty with group conversation

119
Q

severe hearing loss

A

71–90 dB, difficulty with loud speech; understands only shouted or amplified speech

120
Q

profound hearling loss

A

91+ dB, may not understand amplified speech

121
Q

Speech audiometry

A

measures the threshold that speech can be accurately heard

122
Q

Tympanometry

A

measure of tympanic membrane mobility (Static admittance, or Compliance (TM mobility) and an indirect measure of middle ear pressure.

123
Q

Electrocohleography

A

method for recording the electrical potentials of the cochlea

124
Q

Auditory Brainstem Response

A

time taken for an impulse to get from the cochlea to the brainstem is measured.

125
Q

Otosclerosis population

A

early 20s, 40-50s peak incidence, females, Caucasians,

126
Q

Otosclerosis sx

A

Progressive conductive hearing loss, usually with preserved speech discrimination or sensorineural hearing loss with cochlear involvement

127
Q

Otosclerosis PE/Dx

A

Carhart’s notch: A dip in bone conductive threshold at 2000 Hz. on audiometric testing
Schwartze’s sign: Pinkish/blue hue on promontory upon otoscopic examination
Tympanogram will indicate lower impedance (Type AS Stiff)
CT scan

128
Q

Traumatic hearing loss cause

A

ears boxed, barotrauma, and explosions

129
Q

Cholesteatomas sx

A

profound conductive hearing loss
recurrent vertigo

130
Q

Sensorineural hearing loss

A

hearing loss for problems with the cochlea and problems with CN 8 or CNS

131
Q

Sensorineural hearing loss cause

A

viral/bacterial: measles, syphilis, VRI, rubella, strep AOM infection
brain injury
granulomas, meningioma’s, and acoustic neuroma
metabolic/vascular: DM, hypothyroidism, hyperlipidemia, hypercholsterolemia
Ototoxicity: aspirin, quinine, aminoglycoside, erythromycin, loop diuretics, thiazide diuretics, platinum-based chemotherapeutics, carbon monoxide, nicotine, alcohol, heavy metals, interferon a

132
Q

Sudden Sensorineural Hearing Loss

A

Defined as a loss > 30 dB in three contiguous frequencies in a period of < 3 days

133
Q

Sudden Sensorineural Hearing Loss dx

A

Diagnosis of exclusion
audiology and refer to ENT
assess hearing loss with whispered voice test and tuning fork test
hearing loss the sound will lateralize to the “good” ear

134
Q

Sudden Sensorineural Hearing Loss cause

A

viral: Mumps, measles, herpes zoster, Zika and infectious mononucleosis
vascular: partial or complete occlusion of the cochlear vasculature
membrane rupture: rupture of the delicate inner ear membrane and fistulae of the round and/or oval window due to pressures from within (cerebrospinal pressure) or without (middle ear pressure) suddenly increases causing breaks in the cochlear membrane

135
Q

Sudden Sensorineural Hearing Loss management

A

Refer these patients to an ENT for audiology and work up.
Glucocorticoid therapy

136
Q

Prebyacusis

A

age related hearing loss

137
Q

Prebyacusis cause

A

Loss of hair cells at the organ of Corti, later loss of cochlear neurons, the stria vascularis degenerates and shrinks and the ossicles and tympanic membrane becomes more rigid

138
Q

Prebyacusis sx

A

hearing loss is, most often symmetric and gradual in onset causing loss of the high frequencies

139
Q

Prebyacusis RF

A

male sex
white race
family history
older
service/blue-collar occupation
exposure to loud noises
lower education level
cognitive impairment
smoking
high serum homocysteine levels
low folic acid intake
hypertension
diabetes

140
Q

Otoacoustic Emissions

A
  • distortion tones
  • test only way up to the cochlea and not the brain
  • background noise interfere
141
Q

Auditory Brainstem Response Testing

A

goes up to the brain
background noise doesn’t interfere

142
Q

Automated ABR

A

screening method used

35dBnHL click stimulus

143
Q

Threshold ABR

A

introduce a louder click

determining hearing level in patients who cannot be tested using traditional method

144
Q

Neurodiagnositc ABR

A

retro-cochlear pathology, MS
adults who have hearing loss that sounds distorted on one side

145
Q

Behavioral Hearing testing

A

visual reinforcement audiology
conditional play audiometry
conventional audiometry

146
Q

conventional audiometry

A

patient raises a hand, presses a button, or verbally indicates that they hear a sound

147
Q

conditional play audiometry

A

put block in bucket when they hear the noise

148
Q

visual reinforcement audiology

A

patient turns when a sound is played through a speaker, reinforced by showing a toy or video

149
Q

Mild hearing loss tx

A
  • communication strategies
    • speak louder
    • look at them when talking
    • be in the same room
    • reduce background noise
    • slow down speech
    • lighting
  • Low-gain hearing aid
150
Q

Moderate to Severe/Profound TX

A
  • hearing aids
  • listening systems
151
Q

Profound hearing with unusable hearing tx

A
  • cochlear implant
  • manual communication
152
Q

Vestibulo-ocular reflex

A

the sensory signals encoding head movements are transformed into motor commands that generate compensatory eye movements in the opposite direction of the head movement, thus ensuring stable vision

153
Q

Vestibulo-spinal reflex

A

composed of several tracts that connect the vestibular nuclei to the muscles of the neck, trunk, and extremities

need cerebellum input to maintain smooth movement

provides necessary compensatory movement to maintain head position, maintain postural stability, and prevent falls

154
Q

Vestibulocollic reflex

A

stabilize head while moving

155
Q

RF for falling

A

older age

women have higher rate of fracture

males have higher rate of death

Caucasians

156
Q

video nystagmography

A

test for positional vertigo
HSCC function
oculomotor
gaze
positional: supine, head and body positions
Dix-Hallpike
Calorics

157
Q

video head-impulse testing

A

utricular and saccular function/symmetry

VOR and VSR

158
Q

post-urography

A

standing balance function

159
Q

rotational chair

A

HSCC function

160
Q

minutes to seconds dizziness tx

A

canalith repositioning procedure

161
Q

hours to days dizziness Tx

A

dietary changes, VBRT

162
Q

Persistent postural-perceptual dizziness

A

chronic functional disorder presenting with the complaints of dizziness and unsteadiness

163
Q

Persistent postural-perceptual dizziness dx

A

One or more symptoms of dizziness, unsteadiness or non-spinning vertigo on most days for at least 3months.
1. Symptoms last for prolonged (hours-long) periods of time, but may wax and wane in severity.
2. Symptoms need not be present continuously throughout the entire day.

B. Persistent symptoms occur without specific provocation, but are exacerbated by three factors: upright posture, active or passive motion without regard to direction or position, and exposure to moving visual stimuli or complex visual patterns.

C. The disorder is triggered by events that cause vertigo, unsteadiness, dizziness, or problems with balance, including acute, episodic or chronic vestibular syndromes, other neurological or medical illnesses, and psychological distress.
1. When triggered by an acute or episodic precipitant, symptoms settle into the pattern of criterion A as the precipitant resolves, but may occur intermittently at first, and then consolidate into a persistent course.
2. When triggered by a chronic precipitant, symptoms may develop slowly at first and worsen gradually.

D. Symptoms cause significant distress or functional impairment.

E. Symptoms are not better accounted for by another disease or disorder.

164
Q

Persistent postural-perceptual dizziness TX

A

vertigo rehabilitation exercises and medication, with cognitive-behavioral therapy for associated psychological morbidity, and can lead to a good outcome

165
Q

causes of tinnitus

A

hearing loss, cholesteatoma, meniere disease, vestibular schwannoma, meds, temporomandibular joint dysfunction, head or neck injury, cerumen removal, MS, spontaenous intracrainial hypotension, type I Chiari malformation, idiopathic intracranial hypertension, vestibular migraine, viral, bacterial, fungal, hyperlipdemia, DM, Vit B12 deficiency, patulous eustachian tube, arterial bruit, venous hum, arteriovenous malformation, vascular tumors, carotid atherosclerosis, dissection, tortuosity, paget disease, palatal myoclonous, idiopathic stapedial, tensor tympani muscle spasm

166
Q

Dx of tinnitus

A

pure tone audiometry with assessment of air and bone conduction, speech discrimination testing, tympanometry, auditory brainstem response, contrast-enhanced MRI, electronystagmography, CT angiography, carotid doppler ultrasonography, neck computed tomography angiography, MRI angiography, MRI venography, lumbar puncture

EENT (7 decks)

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