Disorders of the Ears

Question 1

Test used to determine conductive vs sensorineural loss in unilateral loss

Answer 1

Weber test

Question 2

Test used to compare patient’s air and bone conduction

Answer 2

Rinne test

Question 3

Conductive loss with Weber test

Answer 3

tone will be louder in poorer ear

Question 4

Sensorineural loss with Weber test

Answer 4

tone will be louder in better ear

Question 5

Classification of recurrent otitis media

Answer 5

3 or more AOM in 6 months or 4 or more AOM in 1 year

Question 6

PE findings of otitis media

Answer 6

decreased TM mobility and bulging TM

Question 7

When should a patient with otitis media be seen again?

Answer 7

14-21 days after initial presentation

Question 8

The presence of middle ear effusion (MEE) in the absence of acute signs of infection

Answer 8

OM with effusion aka serous otitis media aka “glue ear”

Question 9

Sx of hearing loss, fullness in ear, delayed speech development, unsteady gait

Answer 9

OM with effusion aka serous otitis media aka “glue ear”

Question 10

PE of OM with effusion aka serous otitis media aka “glue ear”

Answer 10

TM is dull and retracted, No mobility of TM, Straw or tan color of ear drum or translucent gray

Question 11

Diagnostic method of choice for OM with effusion aka serous otitis media aka “glue ear”

Answer 11

Pneumatic otoscopy

Question 12

First line of tx of OM with effusion aka serous otitis media aka “glue ear”

Answer 12

watchful waiting. Test hearing after 3 months and re-examine until effusion is resolved, hearing loss is identified, or structural abnormalities of the tympanic membrane or middle ear are suspected

Question 13

Tx of unresolved OM with effusion aka serous otitis media aka “glue ear”

Answer 13

tympanostomy and tube

Question 14

A perforated tympanic membrane with persistent drainage from the middle ear or Chronic otorrhea (>6-12wks) through a perforated TM

Answer 14

chronic suppurative otitis

Question 15

most common bacteria involved with chronic suppurative otitis

Answer 15

pseudomonas

Question 16

Tx of chronic suppurative otitis

Answer 16

Removal of exudate from canal tissue with 50% peroxide with sterile water. Cipro PO reserved for failed cases

Question 17

A skin growth that occurs in the middle ear behind the eardrum

Answer 17

cholesteoma

Question 18

Sx include otorrhea, hearing loss, achy ear, dizziness, facial weakness

Answer 18

cholesteoma

Question 19

Inflammation of the external auditory canal or auricle

Answer 19

otitis externa

Question 20

Bacteria implicated in otitis externa

Answer 20

Staph aureus, Pseudomonas aeruginosa (swimmers ear), Proteus

Question 21

Sx include otalgia, pain at tragus or auricle when pulled***, pruritis, discharge, hearling loss

Answer 21

otitis externa

Question 22

Tx of otitis externa

Answer 22

Irrigate with 1:1 dilution of 3% hydrogen peroxide AT BODY TEMP. Tx infection with either cortisporin, cipro HC, tobradex put on wick so it doesn’t go thru membrane

Question 23

An invasive infection of the external auditory canal and skull base.

Answer 23

malignant external otitis/necrotizing otitis externa

Question 24

Bacteria primarily responsible for malignant external otitis/necrotizing otitis externa

Answer 24

pseudomonas

Question 25

Illness characterized by exquisite otalgia and otorrehea, and granulatioin in the inferior portion of external auditory canal

Answer 25

malignant external otitis/necrotizing otitis externa

Question 26

Complications of malignant external otitis/necrotizing otitis externa

Answer 26

osteomylitis of skull, mastoiditis, TMJ osteomyelitis

Question 27

Tx for malignant external otitis/necrotizing otitis externa

Answer 27

Ciprofloxin 750mg PO BID for 6-8 weeks. No role for topical abx

Question 28

Condition characterized by sudden decrease in ear pain followed by drainage from that ear, tinnitus, and pus/blood drainage

Answer 28

TM perforation

Question 29

TM perforation tx

Answer 29

heal on their own, keep ear dry, maybe ear drum patch or tympanoplasty

Question 30

Most common cause of barotrauma

Answer 30

flying

Question 31

characterized by pressure in ear, pain due to stretching of TM, hearing loss, tinnitus

Answer 31

barotrauma to ear

Question 32

Tx of ear barotrauma

Answer 32

valsalva, decongestants, myringotomy

Question 33

characterized by Postauricular pain and erythema, Spiking fever, Tender mass

Answer 33

mastoiditis

Question 34

Management of mastoiditis

Answer 34

admit for IV abx and ENT consult

Question 35

benign lesions but grow to eventually compress the pons resulting in hydrocephalus

Answer 35

acoustic neuroma (vestibular schwannoma).

Question 36

Sx of acoustic neuroma (vestibular schwannoma) associated with cochlear nerve involvement

Answer 36

Hearing loss and tinnitus

Question 37

Sx of acoustic neuroma (vestibular schwannoma) associated with vestibular nerve involvement

Answer 37

Unsteadiness while walking

Question 38

Sx of acoustic neuroma (vestibular schwannoma) associated with trigeminal nerve involvement

Answer 38

Facial numbness and Hypesthesia and pain

Question 39

Sx of acoustic neuroma (vestibular schwannoma) associated with facial nerve involvement

Answer 39

Facial paresis and taste disturbances

Question 40

difference between peripheral and central veritigo syndromes

Answer 40

peripheral has sudden onset with horizontal nystagmus that is inhibited by visual fixation whereas central has gradual onset with usually vertical nystagmus no inhibited by visual fixation

Question 41

Maneuver to determine benign paroxysmal positional vertigo

Answer 41

Dix-Hallpike maneuver

Question 42

Positive Dix-Hallpike maneuver

Answer 42

consists of a burst of nystagmus. The eyes jump upward as well as twist so that the top part of the eye jumps toward the down side.

Question 43

Tx for benign paroxysmal positional vertigo

Answer 43

epley maneuver

Question 44

Describe epley maneuver

Answer 44

movement of the head into four positions, staying in each position for roughly 30 seconds.

Question 45

sensorineural hearing impairment in elderly individuals that involves bilateral high-frequency hearing loss associated with difficulty in speech discrimination and central auditory processing of information

Answer 45

presbycusis

Question 46

epithelial atrophy with loss of sensory hair cells and supporting cells in the organ of Corti.

Answer 46

sensory presbycusis

Question 47

atrophy of nerve cells in the cochlea and central neural pathways

Answer 47

nerual presbyscusis

Question 48

atrophy of the stria vascularis represented by a flat hearing curve

Answer 48

metabolic presbycusis

Question 49

thickening and secondary stiffening of the basilar membrane of the cochlea

Answer 49

mechanical presbyscusis

Question 50

inflammation of inner ear that causes vertigo and is often triggered by URI

Answer 50

labyrinthitis

Question 51

Results from distention of the endolymphatic compartment of the inner ear

Answer 51

Meniere’s (Endolymphatic Hydrops)

Question 52

condition characterized by episodic vertigo lasting 1-8hrs, low frequency sensorineural hearing loss, tinnitus, sensation of aural pressure

Answer 52

Meniere’s (Endolymphatic Hydrops)