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Y2 ENT > Ear Conditions > Flashcards

Ear Conditions Flashcards

(72 cards)

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1
Q

what ages are affected by cholesteatoma

A

any age

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2
Q

what is the presentation of cholesteatoma

A

unilateral pain/discomfort, mild hearing loss, cheesy discharge

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3
Q

what type of hearing loss can cholesteatoma cause

A

conductive

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4
Q

what is common causes of cholesteatoma

A

chronic otitis media, trauma or metaplasia

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5
Q

what type of metaplasia occurs in cholesteatoma

A

middle ear respiratory epithelium becomes keratinized squamous epithelium

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6
Q

what is the pathology of cholesteatoma

A

keratinous flakes and -ve middle ear pressure cause a vacuum which retracts the TM until it perforates

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7
Q

what is done in primary care for cholesteatoma

A

otoscope and referral

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8
Q

what is done is secondary care for cholesteatoma and why

A

diffusion weighted MRI to assess ossicle involvement

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9
Q

what is the management of cholesteatoma

A

removal under general anaesthetic

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10
Q

what are the complications of cholesteatoma

A

brain abscess, vertigo, ossicle damage

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11
Q

what is the presentation of meniere’s disease

A

acute attacks and hearing and balance function destroyed over years, feeling of aural fullness

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12
Q

what happens in an acute attack of meniere’s disease

A

hours of unilateral tinnitus, nausea and vomiting, nystagmus

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13
Q

what type of hearing loss does meniere’s disease cause

A

low frequency sensineural loss

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14
Q

how is meniere’s disease diagnosed

A

exclusion, MRI to exclude vestibular trauma and SOL

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15
Q

what is the management of meniere’s disease in an acute attack

A

vestibular sedative

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16
Q

what is the prophylaxis of meniere’s disease attacks

A

betahistine

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17
Q

what is the management of meniere’s disease to stop vertigo (only when hearing completely abolished)

A

grommet delivering intratympanic gentamicin

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18
Q

what are some risk factors for glue ear

A

smoking household, premature, recurrent URTI

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19
Q

what age and gender is most commonly affected by glue ear

A

boys age 2-7

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20
Q

what is the cause of glue ear

A

chronic otitis media or recurrent AOM

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21
Q

what is the pathology of glue ear

A

eustachian tube dysfunction causes -ve pressure vacuum retracts TM, effusion behind membrane

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22
Q

what is seen on otoscopy in glue ear

A

retracted or bulging grey drum, air fluid level behind membrane, bubbles

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23
Q

when to refer glue ear from primary care

A

> 3 months

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24
Q

what type of hearing loss does glue ear cause

A

mild conductive loss (20-30)

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25
what is the presentation of glue ear
midl hearing loss, URTIs +- speech delay, no pyrexia no pain, no discharge
26
what tests are done after referral for glue ear
tympanogram + PTA
27
what is the initial management of glue ear
wait, review after 3 months
28
what is the treatment of glue ear and when is it indicated
if persisted >3month and CHL >25 and bilateral grommets + amoxicillin
29
what is the management of unilateral glue ear
do nothing
30
what is the management of a recurrence of glue ear
grommets plus adenoidectomy
31
what is the presentation of benign positional paroxysmal vertigo
when moving head/looking up 30sec-1min episodes of vertigo (room spinning)
32
what is the pathology of benign positional paroxsymal vertigo
Ca crystals detach from urticle, moving stimulates posterior semicircular canal
33
what test is diagnostic of BPPV and what is a positive result
dix-hallpike test, nystagmus
34
what is the management of BPPV
epley maneuver
35
what are the 4 types of hearing loss
conductive sensorineural mixed central
36
what is the pathology of conductive hearing loss
effusion/blood/CSF/wax/foreign body obstruct middle ear
37
what scan is useful in conductive hearing loss
CT
38
which type of hearing loss is Rinne's positive in
sensorineural
39
what is otosclerosis
stapes fixation in round window, conductive hearing loss
40
is bone or air conduction affected by conductive hearing loss
air conduction
41
what causes a sensory hearing loss
hair cell damage
42
is bone or air conduction affected by sensorineural hearing loss
bone and air conduction the same
43
what type of hearing loss is presbycusis
sensorineural
44
what type of hearing loss is noised induced hearing loss
sensorineural
45
what scan is useful in sensorineural hearing loss
MRI
46
what is the cause of acute otitis media
viral URTI +- secondary bacterial infection spreads via eustachian tube
47
what bacteria can cause AOM
s. pneumoniae, h. influenzae, s. pyogenes, Moraxella
48
what bacteria can cause chronic otitis media
pseudomonas
49
what is seen on otoscopy in acute otitis media
opaque/bulging TM +- TM perforation
50
what ages are affected by AOM
child/infant
51
what is the presentation of AOM
otalgia, discharge, fever, lethargy, +- decreased hearing
52
what causes relief of symptoms in AOM
TM perforates
53
what is the management of AOM
most self limiting
54
when are ABx indicated in AOM
less than 2y.o or severe
55
what ABx are used for AOM
1st PO amoxicillin, 2nd erythromycin
56
why is amoxicillin used over penicillin in AOM
better oral absorption
57
what are the common infecting organisms in otitis externa
fungal: Aspergillus/ candida bacterial: s. aureus/ pseudomonas
58
what is the general presentation of otitis externa
red, swelling, itch, pain, discharge, >ear wax, +- hearing loss
59
what is the management of fungal otitis externa
clean + TOP clotrimazole
60
what is the management of bacterial otitis externa
acetic acid ABx and TOP aural toilet. gentamicin if severe
61
what is the cause of vestibular neuritis
viral infection
62
what is the presentation of vestibular neuritis
sudden onset vertigo for days, no tinnitus or hearing loss
63
what is the management of vestibular neuritis
vestibular sedative, self-limiting
64
what is the cause of labyrinthitis
viral infection
65
what is the presentation of labyrinthitis
sudden onset vertigo for days, tinnitus, hearing loss
66
what is the management of labyrinthitis
vestibular sedative, self-limiting
67
what is a vestibular schwannoma
benign vestibular nerve tumour in temporal bone
68
what is seen on histology of a vestibular schwannoma
spindle cells
69
what condition are you suspicious of in bilateral vestibular schwannoma in a young patient
neurofibromatosis type 2
70
what is cauliflower ear
pinna haematoma (sub-perichondral haematoma)
71
what is the management of cauliflower ear
aspirate blood, pressure dressing
72
give an example of an ototoxic drug
gentamicin

Y2 ENT (12 decks)

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