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Finals Flashcards (passMed) > Ear > Flashcards

Ear Flashcards

1
Q

What is otosclerosis?

A

When the normal bone is replaced by vascular spongy bone

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2
Q

What type of hearing loss does otosclerosis cause?

A

Progressive conductive deafness (stapes becomes fixed to the oval window).

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3
Q

What are the features of otosclerosis?

A

Autosomal dominant
Onset usually 20-40 years
Conductive deafness
Tinnitus
Positive family history
Tympanic membrane usually normal
Can be precipitated by pregnancy

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4
Q

What is the management of otosclerosis?

A

Hearing aid
Stapedectomy

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5
Q

What is the management for auricular haematomas?

A

Same-day assessment by ENT - to prevent cauliflower ear
Usually treated with incision and drainage

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6
Q

What is an auricular haematoma?

A

bleeding between the cartilage and perichondrium
this can restrict blood supply and lead to necrosis of the connective tissue

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7
Q

What is the treatment for a burst tympanic membrane?

A

No treatment - review in 2 weeks

Should have resolved within 6-8 weeks - if not, refer to ENT

Antibiotics only indicated if the perforation occurs after an episode of acute otitis media

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8
Q

What is acute otitis media?

A

An infection of the middle ear
Usually preceded by an URTI but is usually a secondary bacterial infection

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9
Q

What are the common causes of acute otitis media?

A

Streptococcus pneumonia
Haemophilus influenza
Moraxella catarrhalis

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10
Q

What are the signs and symptoms of acute otitis media?

A

Otalgia
Fever in half
Hearing loss
recent URTI
Ear discharge (if tympanic membrane perforation)
Bulging tympanic membrane
Erythematous tympanic membrane

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11
Q

What is the management of acute otitis media?

A

Usually self limiting - analgesia alone. Parents advised to seek help if symptoms don’t resolve within 3 days.

Antibiotics if:
- symptoms >4 days
- systemically unwell
- immunocompromised
- <2 years with bilateral otitis media
- otitis media with perforation

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12
Q

What antibiotics are given for acute otitis media?

A

5-7 days of amoxicillin

Penicillin allergy - erythromycin or clarythromycin

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13
Q

What is vestibular neuronititis?

A

A cause of vertigo that develops following a viral infection

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14
Q

What are the signs of vestibular neuronitits?

A

Recurrent vertigo attacks lasting hours or days
Nausea and vomiting
Horizontal nystagmus
NO HEARING LOSS OR TINNUTIS

HiNTs exam - done to distinguish vestibular neuronitis from a posterior circulation stroke

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15
Q

What is the management of vestibular nerutonitis?

A
  • Buccal or intramuscular prochlorperazine
  • Short course of prochlorperazine or antihistamines (cinnarizine, cyclising or promethazine)
  • Vestibular rehabilitation exercises - for chronic symptoms
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16
Q

What is benign paroxysmal positional vertigo?

A

Characterised by sudden onset dizziness and vertigo triggered by changes in head position

One of the most common causes of vertigo

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17
Q

What are the features of benign paroxysmal positional vertigo?

A

Vertigo triggered by a change in head position
Associated nausea
Episodes last 10-20 seconds

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18
Q

What will be seen on dix-hallpike test in BPPV?

A

Patient experiences vertigo
Rotational nystagmus

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19
Q

What is the treatment for BPPV?

A

Employ manoeuvre - successful in 80% of cases
Medication - Betahistine (limited value)

Mean age of diagnosis is 55
50% will have recurrence of BPPV within 3-5 years after diagnosis

20
Q

What is acute labrynthitis?

A

Inflammation of the labyrinth if the inner ear

Most commonly viral

21
Q

What are the symptoms of acute labyrinthitis?

A

Acute onset
Diziness
Nausea
Unilateral hearing loss (sensorineural hearing loss)
Sudden onset
Preceding or concurrent symptoms of URTI
Unidirectional horizontal nystagmus
Gait disturbance

22
Q

What is the main difference between labyrinthitis and vestibular neuritis?

A

Labyrinthitis affects both the vestibular nerve and labyrinth so causes both vertigo and hearing loss

Neuritis only affects the vestibular nerve so there is no hearing impairment

23
Q

What is the management of acute labyrinthitis?

A

Episodes are usually self limiting
Prochlorperiazine or antihistamines might help the sensation of dizziness

24
Q

What is Meniere’s disease?

A

A disorder of the inner ear of unknown cause

Characterised by excessive pressure

25
Q

What are the main features of Menieres disease?

A

Vertigo - most prominent symptom
Tinnitus
Sensorineural hearing loss
Sensation of aural fullness/pressure
Symptoms resolve within 5-10 years
Majority of patients will be left with a degree of hearing loss
Psychological distress is common

26
Q

What is the management of Menderes disease?

A

ENT assessment
Inform the DVLA
Acute attacks - Buccal or intramuscular prochlorperazine
Prevention - Vestibular rehabilitation exercises or betahistine

27
Q

What is the management for sudden-onset sensorineural hearing loss?

A

Urgent referral to ENT

Most cases are idiopathic

MRI is done to rule out vestibular schwannoma

Treatment for all: 7 days oral prednisolone

28
Q

What is the name given to age-related hearing loss?

A

Presbycusis

29
Q

What are the features of presbycusis?

A

Occurs Bilaterally
Progressive sensorineural hearing loss
High pitched sounds are most difficult to hear

30
Q

What medications can cause tinnitus?

A

Aspirin
NSAIDs
Loop diuretics
Quinine
Aminoglycosides

31
Q

What are the causes of otitis external?

A

Bacterial: Staphylococcus aureus, pseudomonas aeurginosa, fungal

Seborrhoea dermatitis

Contact dermatitis

Recent swimming

32
Q

What are the features of otitis external?

A

Ear pain
Itch
Discharge

33
Q

What is the treatment for otitis external?

A

First-line:
- Topical antibiotics +/- steroid
- removal of debris from canal

Second-line:
- Oral antibiotics (flucloxacillin)
- swab of ear canal

Failure to respond - referral to ENT

34
Q

What is malignant otitis external?

A

When there is an extension of otitis external infection into the bony ear canal and the soft tissues

IV antibiotics may be required

More common in elderly diabetics

35
Q

What are the symptoms of acoustic neuromas (Vestibular schwannoma)?

A

Cranial nerve VIII: Vertigo, unilateral sensorineural hearing loss, unilateral tinnitus

Cranial nerve V: Absent corneal reflex

Cranial nerve VII: Facial palsy

36
Q

What is an acoustic neuroma?

A

A benign tumour

37
Q

What is a cholesteatoma?

A

A non-cancerous growth of squamous epithelium that is trapped within the skull base causing local destruction.

38
Q

What are the main features of a cholesteatoma?

A

Most common in aged 10-20
Increased risk in patients born with a cleft palate
Foul smelling, non-resolving discharge
Hearing loss

Other: (If local invasion)
Vertigo
Facial nerve palsy
Cerebellopontine angle syndrome

39
Q

What is the management of choelsteotoma?

A

Referred to ENT for surgical removal

40
Q

What is glue ear?

A

Otitis media with an effusion

41
Q

What are risk factors for glue ear?

A

Male
Siblings with glue ear
Winter and spring
Bottle fed
Day care attendance
Parental smoking

42
Q

What are the common features of glue ear?

A

Peaks at 2 years old
Hearing loss is the presenting complaint - most common cause of conductive hearing loss in childhood)
Secondary problems may occur - speech, language delay, behavioural and balance problems

43
Q

What is the treatment for glue ear?

A

Grommet insertion - stop functioning after 10 months

adenoidectomy

44
Q

what is Ramsay hunt syndrome?

A

Herpes zoster oticus - caused by the reactivation of the varicella zoster virus in the geniculate ganglion of the seventh cranial nerve

45
Q

What are the features of Ramsay hunt syndrome?

A

Auricular pain
Facial nerve palsy
Vesicular rash around the ear
Vertigo
Tinnitus

46
Q

What is the treatment for Ramsay hunt syndrome?

A

Oral acyclovir - 7 days
Oral prednisolone - 5 days

Finals Flashcards (passMed) (3 decks)

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