Ear

Question 1

Abx for pre auricular sinus

Answer 1

Flucloxacillin

Augmenting

Question 2

Where can pin a infections come from

Answer 2

EAC
1ry infection
Cartilage (piercing)

Question 3

Rx for pinna infection

Answer 3

Exclude diabetes
Rx underlying risk factors
Flucloxacillin
Drain abscess

Question 4

Risk factors for otitis externa

Answer 4

Swimming
Diabetes
Eczema

Question 5

Rx for OE

Answer 5

Topical ear drops (quinolone/gentamicin if no perf. Acetic acid)

Quadriderm cream

Otowick with drops if severely obstructed

[give oral abx if pinna involved]

Question 6

Rx for wax impaction

Answer 6

Irrigate with water
Removed wax manually
Soften w water/oil/cerumol

Nb recheck hearing after removal

Question 7

Rx of AOM

Answer 7

Low risk - analgesia + antipyretic

High risk - Down’s, RVD,

Question 8

AOM complications

Answer 8

Extradural - perf, mastoiditis, facial nerve palsy, labrynthitis

Intradural - meningitis, abscess, subdural empyema, brain abscess

Question 9

When does one insert grommets?

Answer 9

Persistent OME and hearing loss

Question 10

4 subtypes of COM

Answer 10

Squamous - active (cholesteatoma) or inactive (eardrum retraction)

Mucosal - active (perf plus discharge) or inactive (perf but dry)

Question 11

Mucosal COM Rx

Answer 11

Medical - aural toilette, topical abx

Surgical - tymanoplasty

Question 12

Indications for surgery in Mucosal COM

Answer 12

Recurrent otorrhoea

Hearing loss

Question 13

Examination finding in cholesteatoma

Answer 13

Squamous debris behind eardrum
Polyp +- granulation tissue
Retraction pocket containing squamous debris

Question 14

Complications of cholesteatoma

Answer 14

Chronic otorrhoea
Ossicular chain obstruction
Facial nerve paresis
Vertigo
Mastoiditis
Intracranial complications

Question 15

Aims of cholesteatoma surgery

Answer 15

Remove cholesteatoma
Prevent recurrence
Restore hearing
Obtain a dry ear

Question 16

Inner ear causes of vertigo

Answer 16

Benign positional vertigo (seconds)
Ménière's disease (hours)
Vestibular neuronitis (days)
Perilabrynthitis (days)
Vertebrobasilar insufficiency (seconds to mins)

Question 17

Management of benign positional paroxysmal vertigo

Answer 17

Epley maneuver - reposition otoliths

Question 18

Main symptoms for Ménière’s disease

Answer 18

Unilateral hearing loss
Tinnitus
Vertigo
Fullness in ear

Question 19

Feeing associated with what in vestibular neuronitis

Answer 19

Nausea and vomiting

Question 20

Causes of conductive hearing loss

Answer 20

Wax
OME
Tymp perf
Ossicular chain disruption

Question 21

Cause of sensorineural hearing loss

Answer 21

Ototoxic drugs (amino glycosides)
Noise 
Age
Ménière's disease
Autoimmune disease
Congenital
Perinatal infection

Question 22

When to excise a pre auricular sinus

Answer 22

Persistent discharge

More than 1 abscess episode