hearing loss

Question 1

rinnes and Webbers are carried out using what kind of tuning fork

Answer 1

512

Question 2

ask the pat if they hear the vibration better infront of the ear or when tuning fork is on the mastoid process

Answer 2

rinnes

Question 3

positive rinnes

Answer 3

air conduction is better than bone - hear better infront than behind

Question 4

negative rinnes indicates

Answer 4

conductive hearing loss

Question 5

place tuning fork in middle of patients forehead and ask if they hear the vibration equal in both ears

Answer 5

Webbers

Question 6

normal Webbers

Answer 6

sound is equal in both ears

Question 7

in conductive hearing loss where does Webbers localise to

Answer 7

the side effected

Question 8

in SNHL where does Webbers localise

Answer 8

to the opposite side to the effected side

Question 9

test used to identify the nature and degree of hearing loss

Answer 9

audiometry

Question 10

0 in audiogram

Answer 10

air conduction on RHS

Question 11

X on audiogram

Answer 11

air conduction on LHS

Question 12

triangle on audiogram

Answer 12

bone conduction on RHS/LHS

Question 13

[ on audiogram

Answer 13

masked bone conduction on RHS

Question 14

] on audiogram

Answer 14

masked bone conduction on LHS

Question 15

air bone gap on audiogram

Answer 15

CHL

Question 16

no air bone gap on audiogram

Answer 16

SNHL

Question 17

normal plot of audiogram

Answer 17

10-20

Question 18

mild loss on audiogram

Answer 18

30

Question 19

moderate loss on audiogram

Answer 19

40

Question 20

severe loss on audiogram

Answer 20

70

Question 21

profound loss on audiogram

Answer 21

90

Question 22

assesses how well the tympanic membrane is moving

Answer 22

tympanography

Question 23

type A tympanography

Answer 23

normal

Question 24

type B tympanogrpahy

Answer 24

membrane not moving

Question 25

cause of Type B tympanography

Answer 25

OME, ossification

Question 26

type C tympanography

Answer 26

membrane is moving but it is being retracted

Question 27

cause of type C in tympanography

Answer 27

middle ear congestion

Question 28

type As in tympanography

Answer 28

very little movement

Question 29

type As in cause in tympanography

Answer 29

otosclerosis

Question 30

type Ad in tympanography

Answer 30

too much movement

Question 31

cause of type Ad in tympanography

Answer 31

perforation

Question 32

deafness due to failure to adequately transmit sound from out to inner ear

Answer 32

conductive hearing loss

Question 33

causes of conductive hearing loss

Answer 33

cholesteatoma, otosclerosis, was impaction, perforated ear drum, otitis media with effusion, infection with otitis externa and media

Question 34

most common cause of conductive hearing loss

Answer 34

wax impaction

Question 35

rinnes- negative, webers - localising to effected side, air-bone gap on audiometry - diagnose

Answer 35

conductive hearing loss

Question 36

when skin grows into the middle ear causing local destruction and inflammation

Answer 36

cholesteatoma

Question 37

a patient presents with conductive hearing loss, oltagia, headache, foul smelling, cheesy white discharge, a pearly white tympanic membrane and is between the age 5-15 - what is the diagnosis

Answer 37

cholesteatoma

Question 38

management of cholesteatoma

Answer 38

surgical removal

Question 39

hereditary autosomal dominant metabolic condition of the otic capsule that results in fixation of the footlate of the stapes to the oval window

Answer 39

otosclerosis

Question 40

conductive hearing loss better with background noise, resents in early adult life, made worse by pregnancy, +/- tinnitus and vertigo

Answer 40

otosclerosis

Question 41

carhaarts notch on audiometry

Answer 41

otosclerosis

Question 42

management of otosclerosis

Answer 42

hearing aid, surgery- replace tapes, CO2 laser, cochlear implant

Question 43

otitis media with effusion

Answer 43

inflammation of middle ear in absence of infection

Question 44

majority of otitis media with effusion cases come from

Answer 44

follow an acute otitis media

Question 45

development of acute otitis media is though to be due to what

Answer 45

dysfunction of the Eustachian tube

Question 46

risk factors of otitis media with effusion

Answer 46

URTI, prematurity, craniofacial abnormalities and smoking households

Question 47

child presents with deafness, speech delay, behavioural issues, poor school performance and a retracted tympanic membrane with a visible fluid level +/- fluid bubbles behind the membrane

Answer 47

otitis media with effusion

Question 48

unilateral OME in an adult - suspect what

Answer 48

nasopharyngeal cancer

Question 49

investigation of OME

Answer 49

CHL and flat type B tympanogram

Question 50

management of OME

Answer 50

usually resolve in 3 months - refer if longer, bilateral or having significant implication

Question 51

management of OME in <3 years old

Answer 51

grommets

Question 52

management of OME in > 3 year old

Answer 52

1st time grommets then grommets with adenoidectomy

Question 53

why are grommets used in OME

Answer 53

to improve hearing p not to treat effusion

Question 54

deafness due to failure of the hair cells to detect sound in the inner ear

Answer 54

SNHL

Question 55

SNHL is typically worse or better with background noise

Answer 55

WORSE

Question 56

SNHL is usually associated with what symptoms

Answer 56

tinnitus / change in quality of sound

Question 57

causes of SNHL

Answer 57

prebysusis, noise induces, menieres, vestibular schwannoma, drug side effects

Question 58

red flag drugs for SNHL

Answer 58

gentamicin, loop diuretics, chemotherapy, hydrochloroquine

Question 59

rinnes positive, weber localised to opposite ear, no ear bone gap but a bilateral symmetrical high frequency loss on audiometry indicates

Answer 59

SNHL

Question 60

mainstay management of SNHL

Answer 60

hearing aids q

Question 61

age related hearing loss

Answer 61

presbycusis

Question 62

presbycusis presentation

Answer 62

gradual reduction in hearing loss as individual ages - particular difficulty hearing when there is background noise

Question 63

benign sheath tumour of CN 8 that grows at the cerebellar - pontine age

Answer 63

vestibular schwannoma

Question 64

most commonly vestibular schwannomas are

Answer 64

unilateral

Question 65

bilateral vestibular schwannomas are indicative of

Answer 65

NF2

Question 66

a patient presents with SNHL w/ distortion of sound and tinnitus, they Compton of unsteadiness, vertigo and deep earache, facial pain, palsy and paraethesiae, unilateral headache

Answer 66

vestibular schwannoma

Question 67

investigation of vestibular schwannoma

Answer 67

MRI - ix of choice bt CT

Question 68

management of vestibular schwaonnoma

Answer 68

watch and wait or surgical excision

Question 69

acoustic neuromas are more correctly called

Answer 69

vestibular schwannomas

Question 70

acoustic neuroma affecting cranial nerve VIII presentation

Answer 70

hearing loss, vertigo, tinnitus

Question 71

acoustic neuroma affecting cranial nerve V presentation

Answer 71

absent corneal reflex

Question 72

vestibular neuroma impacting CNVII presentation

Answer 72

facial palsy

Question 73

head injury can cause what type of hearing loss

Answer 73

mixed