ENT - Ears

Question 1

what is presbyacusis?

Answer 1

age related SN hearing loss

Question 2

features of presbyacusis?

Answer 2

gradual
high frequency lost first
worse when background noise present

Question 3

audiogram of presbyacusis?

Answer 3

high Hz affected

no air bone difference

Question 4

what are the classifications of tinnitus?

Answer 4

objective / subjective

pulsatile / clicking / high pitch/ low pitch

unilateral / bilateral

Question 5

causes of clicking tinnitus?

Answer 5

contraction of tensory tympani/tensor veli palatini

TMJ

Question 6

what are the causes of tinnitus?

Answer 6

conductive
sensorineural
central

Question 7

Ix for tinnitus?

Answer 7

audiometry
Rinnes
Webbers
tympanometry

Question 8

what is rinnes? results?

Answer 8

place behind ear

positive is louder in air than bone
conductive means louder in bone

Question 9

what is webers? results?

Answer 9

place in central forehead

conductive heard loudest in affected air
SN is louder in unaffected ear

Question 10

what is otosclerosis?

Answer 10

autosomal dom cause of hearing loss

Question 11

features of otosclerosis?

Answer 11

adult hearing loss
worsened by preg/menopause/menstruation
conductive hearing loss
tinnitus

Question 12

pathology of otosclerosis?

Answer 12

new bone formation fixes the stapes footplace

Question 13

Ix for otosclerosis?

Answer 13

audiometry has carhart notch
air to bone conductive difference
CT

Question 14

Tx for otosclerosis?

Answer 14

hearing aids
piston insertion
cochlear implant

Question 15

risk factors for otitis externa?

Answer 15

swimming
allergy
DM

Question 16

features of otitis externa?

Answer 16

otorrhoea
tender ear
swollen/obstructed EAC
decreased hearing 
itch
fullness
child may pull ear
pain

Question 17

causes of otitis externa?

Answer 17

pseudomonas
staph

eczema

aspergillus
candida

Question 18

Tx for otitis externa?

Answer 18

painkillers
cleaning and warm compress
acetic acid

sofradex eardrops

clotrimazole gel if funal

Question 19

what happens in malignant otitis externa?

Answer 19

temporal bone destruction and base of skull osteomyelitis for ear infection

Question 20

features of malignant otitis externa? who gets it?

Answer 20

persistent ear pain and fullness
pain out of proportion

DM
immunocompromised

Question 21

Ix and Tx for malignant otitis externa?

Answer 21

CT

debride and Abx

Question 22

features of TMJ dysfunction?

Answer 22

clicking 
facial pain 
earache
headache
masticatory muscle tenderness

Question 23

Tx for TMJ dysfunction?

Answer 23

analgesia
avoidance
physio
CBT

Question 24

what commonly causes acute otitis media?

Answer 24

viral:
rhino 
adeno
parainfluenza
corona

bacterial:
pneumococcus
haemophilus
strep
moraxella

Question 25

features of acute otitis media?

Answer 25

``` otalgia Hx of URTI fever otorrhoea (purulent) pain can subside once eardrum bursts vomiting ear pulling ```

Question 26

features of acute otitis media on otoscopy?

Answer 26

red TM bulging tear with discharge

Question 27

Tx for acute otitis media?

Answer 27

analgesia Abx if: <2 years and bilateral bulging membrane + symptoms otorrhoea amox or clarithro

Question 28

what causes OME?

Answer 28

inflam of middle ear, which causes accumulation of fluid, with no acute signs of inflam

Question 29

risk factors for OME?

Answer 29

``` big adenoids boys recurrent URTI recurrent AOM smoking bottle fed ```

Question 30

features of OME?

Answer 30

``` conductive deafness inattention poor language balance problems no otalgia ```

Question 31

Ix for OME and results?

Answer 31

``` otoscopy: TM retracted reduced mobility grey dull/yellow fluid line ``` audiometry (conductive) tympanometry (flat tracing: Type A)

Question 32

Tx for OME?

Answer 32

watch over 3 months | if > and delay -> grommets ± adenoid removal

Question 33

what happens in chronic otitis media?

Answer 33

ear with a perforated TM in the setting of recurrent infections

Question 34

risk factors for chronic otitis media?

Answer 34

``` smoker asthma URTI increased BMI GORD ```

Question 35

what are the types of chronic otitis media?

Answer 35

``` benign chronic serous (straw coloured fluid) chronic suppurative (purulent) ```

Question 36

Tx for chronic otitis media?

Answer 36

Abx aural cleaning myringoplasty

Question 37

what are those with chronic otitis media at risk of? why?

Answer 37

cholesteatoma retraction pocket can form due to low middle ear pressure can form here

Question 38

what is a cholesteatoma?

Answer 38

presence of keratinising squamous epithelium within the middle ear or temporal bone

Question 39

features of a cholesteatoma?

Answer 39

``` hearing loss foul discharge tinnitus otalgia altered taste vertigo facial nerve weakness dizziness ```

Question 40

Ix for cholesteatoma?

Answer 40

otoscocopy | CT

Question 41

risk factors for cholesteatoma?

Answer 41

chronic OM surgery trauma congenital abnormalities

Question 42

what drugs can cause irreversible hearing loss?

Answer 42

gentamicin | cisplatin

Question 43

what drugs can cause tinnitus?

Answer 43

NSAIDs furosemide quinines