Ear

Question 1

Pt hears Weber test on unaffected side?

Answer 1

sensory/sudden hearing loss

Question 2

Pt hears Weber test on affected side?

Answer 2

cerum impaction

Question 3

If pt gets a bug in the ear?

Answer 3

use lidocaine to paralyze the bug

Question 4

If pt gets FB in the ear?

Answer 4

DO NOT USE AQUEOUS SOLUTION

Question 5

Cerum impaction - tx?

Answer 5

do NOT use QTIP - mechanical or solution removal

Question 6

Contact dermatitis - tx?

Answer 6

mineral oil

Question 7

Pt hears LOW pitch (tinititus)?

Answer 7

conductive hearing loss

Question 8

Ototoxic drugs?

Answer 8

gentamyacin (aminoglycosides)
loop diuretics (Ferusomide)
oral steroids

Question 9

Pt hears HIGH pitch (tinitus)?

Answer 9

sensorineural hearing loss

Question 10

Facial nerve is compressed?

Answer 10

acoustic neuroma/vesticular schwannoma

Question 11

Pt has blunt trauma while playing baseball?

Answer 11

traumatic auricular hematoma

Question 12

Complication of traumatic auricular hematoma if not tx?

Answer 12

cauliflower

Question 13

Progressive unilateral hearing loss?

Answer 13

acoustic neuroma/vesticular schwannoma

Question 14

Surfer has ear pain?

Answer 14

exostoses

Question 15

Parent smokes and child has “plugged ear” - what PE finding?

Answer 15

retracted tympanic membrane

NO fever

Question 16

Post URI? -child

Answer 16

eustachian tube dysfxn

Question 17

Pt is flight attendant + ear pain - PE?

Answer 17

red + retracted

Question 18

Barotrauma - tx?

Answer 18

decongestants

Question 19

Otits externa - bugs?

Answer 19

Pseudomonas
S. Epidermidis
S. Aureus

Question 20

Pt has pain when pulling on ear?

Answer 20

otitis externa

Question 21

Pt has repeated exposure to COLD water?

Answer 21

exostoses

osteomas

Question 22

How to tx Surfer’s ear?

Answer 22

one - observe

many - remove if hearing impaired

Question 23

Pt has red + retracted ear drum?

Answer 23

barotitis media

Question 24

Cx of barotitis media?

Answer 24

pressure gradient from flying/diving

Question 25

Sx of barotitis media?

Answer 25

hearing loss | tinnitus

Question 26

Tx for barotitis media?

Answer 26

decongestants - pseudophedrine | refer if severe

Question 27

When do you insert a tube in the ear?

Answer 27

chronic serous otitis media >3mo recurrent AOM 3x/6mo OR 4x/12mo complication of AOM complication of eustachian tube

Question 28

Pt has "plugged ear" + retracted tympanic membrane + NO fever?

Answer 28

eustachian tube dysfxn

Question 29

Risks for eustachian tube dysfxn?

Answer 29

URI allergy smoke

Question 30

Bugs for otitis externa?

Answer 30

PSEUDOMONAS S. aureus S. epidermis

Question 31

Excessive cleaning and scratching of ear?

Answer 31

otitis externa

Question 32

Tx otitis externa?

Answer 32

``` quinolone abx drops cipro HC (cover for pseudomonas and s. aureus) ```

Question 33

Bloody otorrhea + lesions + facial paralysis + hearing loss?

Answer 33

external ear canal carcinoma

Question 34

BUBBLES + NO infxn?

Answer 34

serous otitis media

Question 35

Tx for serous otitis media?

Answer 35

self limiting 4-6wks +/- pseudoephedrine (RUI) +/- corticosteroids - allergy

Question 36

Bugs for acute otitis media?

Answer 36

S. pneumonia H. influenzea M. catarrahlis

Question 37

What are the bugs for acute otitis media the same as?

Answer 37

meningitis, pneumonia, sinusitis s. pneumonia h. influenzae m. catrrahalis

Question 38

Pt has fever and posterior ear pain?

Answer 38

acute mastoiditis

Question 39

Child has conjunctivitis + ear tugging? Bug?

Answer 39

acute otitis media | bug: h. influenzae

Question 40

Gold standard dx for AOM?

Answer 40

insufflation

Question 41

Tx for AOM?

Answer 41

tylenol WASP 24-48hrs first line- Amoxicillin HD 90mg/kg/day BID

Question 42

When to use abx in AOM?

Answer 42

>6mo + otorrhea >6mo + severe sx >6mo to 2yo + bilateral sx

Question 43

When to WASP in AOM?

Answer 43

>2yo + NO otorrhea + bilateral | >6mo + NO otorrhea + unilateral

Question 44

Imaging for mastoiditis?

Answer 44

ct scans

Question 45

Tx for mastoiditis?

Answer 45

admit + IV abx

Question 46

Painless + purulent ear discharge + ruptured?

Answer 46

chronic suppurative otitis media

Question 47

Cx for chronic suppurative otitis media?

Answer 47

recurrent AOM

Question 48

Tx for chronic suppurative otitis media?

Answer 48

cipro

Question 49

Recurrent AOM + NO hearing loss + NO dizziness + NO otorrhea?

Answer 49

cholesteatoma (keratin filled sacs)

Question 50

Tx for cholesteatoma?

Answer 50

surgically remove

Question 51

"Room is spinning" + NO hearing + NO ear pain?

Answer 51

benign paroxysmal positional vertigo

Question 52

When is complaint common for BPPV (time of day)?

Answer 52

getting up from bed

Question 53

What skills test for BPPV?

Answer 53

Dix-hallpike

Question 54

Tx for BPPV?

Answer 54

epley manuever antihistime anitcholinergics

Question 55

Cx of BPPV?

Answer 55

Ca debris in POSTERIOR semicircular canal

Question 56

Pt has vertigo for min to hrs + hearing loss + ear fullness?

Answer 56

menieres syndrome

Question 57

Cx for meniere's sx?

Answer 57

TOO MUCH endolymphatic hydrops

Question 58

Tx for meniere's sx?

Answer 58

REDUCE hydrops --> reduce Na, use diuretics

Question 59

Prognosis for meniere's sx?

Answer 59

peak @2yrs and vertigo free after 5-8yrs

Question 60

Pt has TEMPORARY vertigo + N/V + post ivral?

Answer 60

vestibular neuronitis/labryinthitis

Question 61

Tests for vestibular neuronitis?

Answer 61

horizontal nystagmus

Question 62

Tx for vestibular neuronitis?

Answer 62

supportive | +/- abx for infxn