Ear disorders

Question 1

hematoma formation in subperichondrium

Answer 1

Auricle Trauma–> cauliflower eat if not tx promptly

• can treat with abx in case infection from S. aeurus (MRSA)
• I&D and pressure dressing

Question 2

inflammation of auricle cartilage

pathogens:

Answer 2

perichondritis

pathogens: pseudomonas, staph, strep pyogenes

Question 3

difference between perichodritis and polychondirits

Answer 3

peri- one area and infectious (Pseudomonas, Staph, Strep Pyogenes
Poly- diffuse cartilaginous areas; AUTOIMMUNE mediated

Question 4

a sudden or gradual loss of hearing usually self-induced

Treatment?

Answer 4

cerumen impaction

Cerumen softening agent:
-3%H2O2
-debrox OTC (earwax removal drops)
- sweet oil
OR
curette
OR
suction and irrigation w 50/50 mix of H2o2 and warm H20

Question 5

corticosteroids are used to treat—

Answer 5

inflammation

Question 6

what medication is given when bacteria is the cause

Answer 6

antibiotic: mainly Fluoquinoles like Cipro

Question 7

inflammation of the EAC

Answer 7

otitis externa

Question 8

pathogens for otitis externa

Answer 8

s. Aureus, pseudomonas, fungal (10%)

Question 9

1st line treatments for otitis externa “swimmers ear”

Answer 9

ciprodex ($$$)4 drops for 7 days
OR
ofloxacin 0.3% 10gtts once a day x7days

Question 10

treatment of fungal infection

Answer 10

clotrimazole 1% soln

Question 11

invasive infection of EAC and skull base (pathogen?)

Answer 11

malignant otitis externa; pseudomonas

Question 12

if TM is ruptured you would avoid what medication?

Answer 12

corticosteroids

Question 13

entrapment of air within the middle ear causing failure of tube opening for ventilation
tx?
etiology:

Answer 13

Eustachian tube dysfunction

• tx underlying cause
• valsalva
• URI, viral,, allergies, younger pos due to underdevelopment

Question 14

INJURY via change in atmospheric pressure i.e. flying or diving caused by ear tube dysfxn

Answer 14

otic barotrauma

Question 15

infx of middle ear causing bulging TM, redness, and decrease in mobility
state pathogens

Answer 15

Acute otitis media
pathogens: Pneumonnia*** MOST COMMON,
H. influenza, M. catarrhalis, S. aureus
-viral (less common)

Question 16

medication for Acute Otitis Media

Answer 16

• Amoxicillin 80-90 mg/kg BID 5-10 days
• augmentin if amoxicillin FAIlS
• Allergic—> Macrolides (Azithro or Erythromycin)

2nd line: augmentin, ceftan, omnicef

Question 17

what medication is given to those allergic to penicillins

Answer 17

Macrolides: ACE
Azythro
Clar
Erythromycin

Question 18

otitis media with effusion; hypomobile TM

Answer 18

Serous otitis media

Question 19

TM perforation failure to heal after an AOM

and treatment

Answer 19

chronic supporative otitis media ‘TUBOTYMPANIC”

-tympanoplasty

Question 20

CSOM pathogens

Answer 20

Psodomonas a., Staph aureus, Proteus

Question 21

Abnl accumulation of squamous epithelial in middle ear and mastoid destroying ossicles —> conductive hearing loss

Answer 21

Cholesteatoma

• cn7 affected
• inward creating sac lined w SCC that become infx

Question 22

What’s Bullous myringitis a variant of and how would you treat it?

Answer 22

codones for pain
-same as AOM–
same pathogens! Strep pneumonia, H. flu, M. catarahlis, S.aeurus

Question 23

most frequent complication of middle ear infx with postaurical pain and erythema, fever,

tx

Answer 23

Mastoiditis
IV abx ceftriaxone
or myringotomy or mastoidectomy

Question 24

two conditions due to trauma:

• blood accumulation behind ear___
• discoloration behind ear indicative of basilar skull fracture

Answer 24

Hemotympanum

Battles sign

Question 25

Ramseys hunt sx & treatment (4)

Answer 25

herpes zoster oticus: shingles of facial nerve - facial paralysis and hearing loss - Acyclovir, vala, fam (viral tx) - prednisone (corticosteroids boost effect of antiviral drugs) - diazepam (anxiety) - narcotics (pain)

Question 26

medication for anxiety/relieve vertigo

Answer 26

diazepam, meclizine, scopalamine, antihistamine and or antiemetics

Question 27

two types of tinnitus

Answer 27

pulsatile and clicking= staccato

Question 28

sensation of motion

Answer 28

vertigo

Question 29

types of vertigo and which is more dangerous

Answer 29

- peripheral: sudden, horizontal nyst. BPPV, Menderes etc | - central**** : gradual and vertical nystagmus (usually from braistem)

Question 30

maneuver to diagnose and see nystagmus | -maneuver to TREAT(get otolith back in place)

Answer 30

Dix-Halpike vs Epley

Question 31

short episodes of vertigo brought on by head movement | & treatment

Answer 31

Benign paroxysmal positional vertigo (BPPV) | *epley maneuver

Question 32

tetrad for Maniere's disease

Answer 32

- vertigo - hearing loss - tinnitus - aural pressure

Question 33

increase volume of lymph fluid

Answer 33

Meniere's disease

Question 34

vascular compression of vestibular nerve causes

Answer 34

permanent/CONSTANT form of positional vertigo and severe nausea

Question 35

what makes vestibular neuritis/neuropathy different? treatment?

Answer 35

nerve inflammation/vertigo WITHOUT cochlear/hearing loss supportive care, tx sx

Question 36

Most worrisome and most common intracranial tumors and sx

Answer 36

Acoustic neuroma aka benign schwannoma of CN VIII - a peripheral lesion - asymmetric or unilateral hearing loss, tinnitus, vague vertigo

Question 37

difference between hearing loss: - conductive - sensory - neural - ototoxic

Answer 37

- conductive: problem of external or midd ear affecting sound traveling to inner ear due to obstruction,URI - sensory: cochlear deterioration from hair cell loss most commonly by presbycusis - neural: lesions of CNVIII (least common) - ototoxic: secondary to RX