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MRCS med school > Vertigo, Hearing Loss, Tinnitus and Larynx > Flashcards

Vertigo, Hearing Loss, Tinnitus and Larynx Flashcards

1
Q

Definition of vertigo

A

Illusion of movement

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2
Q

Causes of vertigo

A

IMBALANCE

Infection

Meniere’s disease

BPPV

Arterial

Lymph

Aminoglycosides

Nerve

Central lesion

Epilepsy

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3
Q

Ototoxic drugs which can cause vertigo

A

Gentamicin
Loop diuretics
Metronidazole
Co-trimoxazole

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4
Q

Ix for vertigo

A

Hearing
CNs
Romberg’s test
Dix-Hallpike manouvre
Audiometry

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5
Q

Romberg’s test interpretation

A

+ve = vestibular or proprioception dysfunction

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6
Q

Pathology of Meniere’s disease

A

Dilatation of endolymph spaces of membranous labyrinth

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7
Q

Sx of meniere’s

A

Vertigo

Tinnitus

Aural fullness / SNHL

Attacks in clusters

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8
Q

Mx of Meniere’s

A

Antihistamine - betahistone, cyclizine

Gentamicin ablation in severe disease

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9
Q

Other name for vestibular neuritis

A

Labyrinthitis

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10
Q

Presentation of labyrinthitis

A

Sudden onset vertigo

N/V

No hearing loss

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11
Q

Causes of labyrinthitis

A

Post viral infection

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12
Q

Mx of labyrithitis

A

Reassure

Sedate / Rx symptoms

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13
Q

Recovery from labyrithitis

A

Vertigo resolves in days

Complete recovery 3-4 wks

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14
Q

Conductive hearing loss def

A

impaired between auricle and round window

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15
Q

Causes of external canal obstruction

A

wax, pus, foreign body

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16
Q

Causes of tympanic membrane perforation

A

trauma
infection

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17
Q

Causes of ossicle defects

A

Otosclerosis
Infection
Trauma

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18
Q

Causes of conductive hearing loss

A

External canal obstruction
TM perforation
Ossicle defects

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19
Q

Sensorineural hearing loss def?

A

defects of cochlea, cochlear nerve or brain

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20
Q

Causes of sensorineural hearing loss?

A

drugs
post-infective
others

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21
Q

Drugs causing sensorineural hearing loss

A

aminoglycosides
vancomycin

22
Q

Post-infective causes of sensorineural hearing loss

A

meningitis
measles
mumps
herpes

23
Q

Other causes of sensorineural hearing loss?

A

Menieres
Trauma
MS
low B12

24
Q

Purpose of audiometry

A

quantify hearing loss and determine its nature

25
Q

Types of audiometry

A
  • Pure tone audiometry (PTA)
  • Tympanometry
  • Evoked response audiometry
26
Q

Features of pure tone audiometry

A
  • Headphones deliver tones at different frequencies and strengths
  • Pt. indicates when sound appears and disappears
  • Mastoid vibrator → bone conduction threshold
  • Threshold at different frequencies are plotted to give an audiogram.
27
Q

Features of tympanometry

A

Measures stiffness of ear drum

28
Q

Evoked response audiometry features

A
  • Auditory stimulus with measurement of brain response by surface electrode
  • Used for neonatal screening
29
Q

Tinnitus definition

A

Sensation of sound without external sound stimulation

30
Q

Causes of tinnitus

A

Meniere’s

Acoustic neuroma

Otosclerosis

Noise induced

Drugs

31
Q

Drugs causing tinnitus

A

Aspirin

Aminoglycosides

Loop diuretics

EtOH

32
Q

Unilateral tinnitus

A

Acoutsic neuroma

33
Q

Ix of tinnitus

A

Audiometry

MRI (acoustic neuroma)

34
Q

Mx of tinnitus

A

Treat underlying cause
Psychiatric support: tinnitus retraining therapy
Hypnotics at night

35
Q

Laryngitis causes

A

Usually viral and self limiting

36
Q

Consequences of laryngitis

A

Secondary bacterial infection

37
Q

Sx of laryngitis

A

Pain

Hoarse voice

Fever

Red vocal cords

38
Q

Mx of laryngitis

A

Usually self limiting

Penicillin V if required

39
Q

Laryngeal papilloma definition

A

Pedunculated vocal cord swellings

40
Q

Laryngeal papilloma cause

A

HPV

41
Q

Laryngeal papilloma sx

A

Hoarse voice

42
Q

Laryngeal papilloma Mx

A

Laser removal

43
Q

Sx of recurrent laryngeal nerve palsy

A

Hoarse voice

Breathy voice

Cough

Exertional dyspnoea

44
Q

Causes of recurrent laryngeal nerve palsy

A

Cancers

Iatrogenic

Aortic aneurysm

45
Q

Cancers causing recurrent laryngeal nerve palsy

A

Larynx

Thyroid

Oesophagus

46
Q

Presentation of Laryngeal squamous cell carcinoma

A

Male smoker
Progressive hoarseness → stridor
Weight loss

47
Q

Mx of laryngeal SCC

A

Radiotherapy

Total laryngectomy

48
Q

Total laryngectomy

A

Permanent tracheostomy

Speech valve

49
Q

Sx of acoustic neuroma

A

Unilateral hearing loss

Vertigo later

Cranial nerve involvement

Late raised ICP

50
Q

Cranial nerves affected by acoustic neuroma

A

5, 6, 9, 10

MRCS med school (44 decks)

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