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HEENT ears Flashcards

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1
Q

weber test, unilateral conductive HL…. and SNHL goes to which ear

A

affected ear … unaffected ear

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2
Q

Tympanograms measures

type a
type b
type C

A

ear drum pressure and used for otitis media

a - normal
b - flat = when ear has fluid, hole, wax
c- ET dyfunction = pressure not equalized

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3
Q

most common cause of SNHL is

A

presbycusis (age related)

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4
Q

destruction of the cochlear hair cells and CN8 pathway will lead to

A

SNHL

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5
Q

otoxic medications like …..5…. can lead to SNHL

A

amingolycosides, cisplatin, furosemide, vancomcin, aspirin

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6
Q

autoimmune diseases like MS, SLE,

meniere’s disease

acoustic neuroma (vestibular schwannoma)

A

SNHL

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7
Q

why would you get MRI with and without contrast for SNHL

A

to see if its MS, acoustic neuroma

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8
Q

sudden sensorineural HL

occurs when:
associated symptoms

A

within hours or days, and its unilateral

tinnitus, dizziness

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9
Q

what causes sudden SNHL

A

idiopathic, vascular, autoimmune, viral infections

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10
Q

even though sudden SNHL can improve by itself, you still give high oral dose of…

A

oral steroid taper, or intratympanic steroid injection

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11
Q

no improvement after medication for Sudden SNHL, you get the following tests done

A

MRI of the brain with IAC with contrast to R/O acoustic neuroma

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12
Q

tinnitus, which is ringing in the ears, is very common if it is…… and concerning if it is…

A

subjective, bilateral, constant or intermed, non pulsatile

objective, pulsatile, unilateral, constant

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13
Q

medications that can cause tinnitus is

A

NSAIDs

loop dieutics

chemotherap.

amingolycoside antibiotics

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14
Q

for tinnitus, you will start with an audiogram, and then order the follow lab work up

A

Sed rate, CBC, lyme, thyroid function, rheumatoid factor, FTA-ABS, ANA

MRI with contrast and MRA if unilateral, vertigo, and pulsatile

CT - cholesteatoma

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15
Q

impaired transmission of sound along the EAC, ossicles, and oval window can cause

A

CHL

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16
Q

common causes of CHL is

A

cerumen impaction **
E.T dysfunction
middle ear infection
otosclerosis
tm perforation
cholesteatoma
ossicular disruption/ trauma

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17
Q

to imagine for CHL, get

A

CT scan the temporal bone WITHOUT to look behind the TM

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18
Q

abnormal bone growth around stapes, which causes CHL, is called … and you have to refer to ENT

A

otosclerosis . tympanogram will look normal

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19
Q

auricular hematoma is trauma to the … ear, which results in ….

A

outer eat

swelling, tenderness

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20
Q

if you do not treat auricular hematoma by making an incisions, draining, and compressing with dressing to prevent reaccumlation, the ear will become

A

cauliflower ear

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21
Q

pt has a history of ear fullness, hearing loss, and discomfort. exam reveals CHL. the pt has

A

cerumen impaction

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22
Q

cerumen ipaction treatment consist of

Study These Flashcards
A

olive oil to soften wax

ear curette, warm water and peroxide

NEVER irrigate if TM is perforated

23
Q

t/f small batteries causes necrosis in the ear

24
Q

FB in the ear can lead to the following complications

Study These Flashcards
A

infection

granulation tissue

laceration of ear canal

rupture of TM

25
otitis externa is known as the ... cause history PE
swimmers ear cause: fungal, moisture, trauma, dermatitis history: ear pain, otorrhea, hearing changes tenderness with auricle movement, TM moves normal, erythema and edema, otorrhea
26
which organisms cause OE
Pseudomonas **** Staph Aureus Fungal- candida, aspergillus niger (otomycosis)
27
treatment for OE is
Topical Antibiotic/ +/-Corticosteroid Acetic Acid Otic Clotrimazole Oral Antibiotics? Debridement Ear Wick
28
can you give antibiotics to treat fungal OE (otomycosis)
no, bc its fungal. send to ent
29
why should you not give cortisporin gtts to a patient
bc it contains neomycin, which is ototoxic and can cause itching if allergic
30
is acetic acid bad for the ear?
no, but avoid if TM if perforated
31
what med is safe for the middle ear?
FQ type drops floxin (ofloxacin) ciprofloxacin Ciprodex
32
how do you treat OE
NO ORAL Abx unless you see celluitis of the face, neck, auricle. NO ORAL alone ORAL and topical Otics to increase efficacy Intact TM: FQ -/+ corticosteroid unknwn TM status: FQ + topical steroid consider ear wick if sig edema No water in ear. use cotton ball with vasline
33
OE Tx
abx 7-10d dry ear/ no manipulation recheck ears 1-2 weeks no improvement: culture and sens * consider psuedomonas or mrsa
34
OE fungal Tx
clean ear canal several appts vosol otic drops - acetic acid in propolyene glycol vosol HC otic drops if swelling +fungal Lotrimin solution (clotrimazole)
35
what can you do to prevent swimmers ear or fungus?
50% white vinegar and 50% rubbing alcohol
36
if you see eczematous OE, you can use
OTC 1% hydrocortisone to outer ear canal with Q-tip when ear itches
37
what is a complication of OE?
Malignant OE / AKA necrotizing OE
38
Malignant OE / AKA necrotizing OE is.. seen in which group of people... caused by ... S/S.... diagnosis... treatment...
osteomyelitis of temporal bone pseudomonas IC ppl, diabetic, elderly foul discharge , deep ear pain, cranial nerve palsies CT/ MRI IV cipro, debridement
39
Viral OE / Herpes zoster oticus
severe pain +/- SNHL herptic vesciles in EAC Treatment: acyclovir +/- steriods
40
what syndrome can you get with viral OE and CNVII, and what are the Symptoms of it
ramsey hunt syndrome pain, rash, facial nerve palsy, SNHL
41
complications for Ramsey hunt syndrome is
permanent HL permanent facial never weakness eye damage post herpetic neuralgia
42
TM perforation can be caused by
trauma, barotrauma, acute infection, cholesteatoma
43
tympanosclerosis will look like and be from..
a white warm be due long standing ear infection = scarring of ear drum
44
blood in the ear drum is called
hemotympanum
45
barotrauma is: happens when: prevent/treat: could result in
inability to = barometric stress on middle ear secondary to diving/flying swallow, yarn, systemic, or topical decongestants hemotympanum, TM perforation, middle ear infection
46
fluid filled hemorrhagic blebs on the TM that causes sever pain is called
bullous myringitis treatment = I & D caused by mycoplasma pneumoniae
47
E.T dysfunction, inflammation of E.T = negative pressure in ear cause history PE treatment
cause: viral, allergies, sinusitis history: decreased hearing, discomfort, fullness PE: retracted TM treatment: decongestants and valsalva
48
E.t dysfunction treatment
correcting rhinities: smoking, pregnancy, allergies, sinnuties, decongestant spray abuse, reflux meds: oral/nasal steriod/ antihistamine ... short term decongestants valsalva and otovent PE tubes not recom.
49
serous otitis media is a middle ear effusion that results from E.T dysfunction cause history pe
cause: URI history: hearing loss , ear pain, pressure pe: translucent effusion, immobile tm, flat tympanogram, CHL, weber to the affected ear
50
treatment for serous OM / OME
NO antihistamine oral/intranasal steroid expectorants, decongestants chronic: myringotomy with and without PE tubes
51
AOM is a bacterial infection of middle ear due to viral URI cause history pe treatment
cause: viral URI * m. cat, H. flu, strep pneumonia, group A strep, staph aureus, pseudomonas history : acute, ear pain, hearing loss pe: TM erythema/bulging, immobile tm, flat tympan., weber to affected ear bc CHL treatment: abs and drainage.
52
treatment for AOM
no treatment unless mild --> analgesics antibotic -oral only if rupture of TM INITAL - amoxicllin doesnt work --> high dose oral amoxicillin/clavulanate (augmentin). oral cefuroxime IM ceftrixone PNC allergy: bactrim, azithromycin, clindamycin
53
Chronic OM definition history cause treatment
happens when fail to response to meds/ untreated speech/blanace delay hearing problems staph aureus , pseudomonas (allergies, smoking, daycare) myringtomy with pe tubes adenoidectomy
54
reasons to place a PE tube (for ventilation to = pressure)
recurrent AOM hearing loss and speech delay failure for OME to resolve

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