quiz 3 part 2 (ear)

Question 1

what is an auricle hematoma?

Answer 1

collection of blood in the cartilaginous auricle/ outer ear

Question 2

complications of auricle hematoma

Answer 2

cauliflower ear and conductive hearing loss, otitis and periosteum damage, must fully drain

Question 3

what is mastoiditis

Answer 3

bacterial infection of the mastoid air cells
-this is an AOM complication

Question 4

what bacteria is linked to mastoiditis

Answer 4

pneumococcus

Question 5

S+S of mastoiditis

Answer 5

fever, postauricle pain, otorrhea, swelling, tenderness, pinna displacement, edema of the external canal, destruction of bony septa, lump pushing the ear forward (pinna displacement0

Question 6

mastoiditis x ray

Answer 6

air cells will coalesce and destory the bony septa

Question 7

mastoiditis treat

Answer 7

iv ceftriaxone
-myringotomy to remove the TM fluid to releive the pressure
-mastoidectomy
*emergency

Question 8

complications of mastoiditis

Answer 8

infection can decompress through the TM and go to lateral mastoid cortex forming a superiosteal abscess
-rare: extends centrally causing Temporal lobe abscess or spetic thrombosis of the lateral sinus

Question 9

what is a possible complication of AOM

Answer 9

cholesteatoma
-only if it was there for a long time

Question 10

trauma or euschian tube dysfunction can also cause?

Answer 10

cholesteatoma

Question 11

why is cholesteatoma bad

Answer 11

it erodes the ear and needs to be cleared out
-can also cause vertigo
-extends from the TM and possible to the bone

Question 12

how can we treat cholesteatoma

Answer 12

-get a ct to see the extent of the spread,
-audiogram to asses conductive and possible sensorineural hearing loss
-surgery to remove the membrane so it does not come back
-ear drop
-antibiotics (questionable)

Question 13

complications of cholesteatoma untreated

Answer 13

bone destruction, deafness, facial nerve paralysis, dizziness, abscess, systemic infection, death

Question 14

neuralgia can affect what?

Answer 14

trigeminal, glossopharyngeal, genticulate or sphenopalatine
-causes ear ache

Question 15

cerumen impaction

Answer 15

-common cause of conductive hearing loss

Question 16

cerumen impaction S+S

Answer 16

-vague pain with hearing loss
-NO OTHER symptoms

Question 17

treatment for cerumen impaction

Answer 17

-clean it out with cerumol or hydrogen peroxide (sometimes dissolves it)
-dont flush TM could be perforated and water would damage

Question 18

what is bullous myringitis

Answer 18

blood filled ball
-caused by herpes or mycoplasma pneumoniae

Question 19

bullous myringitis S+S

Answer 19

balls on TM< sudden pain, fluidy bulging TM, herpetic lessions near the tragus

Question 20

malignant external otitis

Answer 20

persistant otitis externa

Question 21

what bacteria causes malignant external otitis

Answer 21

pseudomonas auregenosa

Question 22

S+S of malignant otitis externa

Answer 22

fouls smelling discharge, granulations in ear canal, deep otalgia, palsies of nerves 6,7,10,11,12

Question 23

what scan should we do for malignant OE

Answer 23

ct scan to look for osseous erosion

Question 24

how are we treating malignant OE

Answer 24

antipseudomonal antibiotics long term (cipro)
-start with an IV bc this is a severe infection then go to oral

Question 25

complications of malignant otitis externa

Answer 25

spread to bone: osteomyelitis -risky especially in immunocomp -can hit the base of the skull

Question 26

otitis externa

Answer 26

-swimmers ear, can be from a lack of hygiene, kocalized to the canal not the TM, not properly drying ears

Question 27

likley bacterial causes of otitis externa

Answer 27

pseudomonas, proteus, aspergillus

Question 28

what are risk factors of otitis externa

Answer 28

seborrhatic dermatitis and mechanical trauma

Question 29

otitis externa S+S

Answer 29

swelling that can cause ear occlusion and hearing loss, pain, **no relief from pulling on the ear**, erythematous and edematous ear canal, tenderness with tragus movement, thick white purulent otorrhea, insufflation of TM (-): there should BE movement unless there is also an otitis media at the same time

Question 30

what does not causes relief of otitis externa

Answer 30

pulling on the ear

Question 31

how to diagnose OE

Answer 31

-culture if there is no improvement and otorrhea -clinical diagnosis

Question 32

how to treat OE

Answer 32

-keep the ear dry, cipro drops if pseudomonas, insert a wick if there is severe edema (not possible if too painful), oral fluroquinolones

Question 33

why can you not give oral fluroquinoloes to under 18yrs

Answer 33

it can cause their tendons to rupture

Question 34

who is at risk to get OE

Answer 34

swimmers and diabetics

Question 35

when does otalgia become chronic

Answer 35

2-3 weeks

Question 36

what else can cause otalgia

Answer 36

refered pain: nasopharynx, tonsils and upt

Question 37

otalgia presents in older pt

Answer 37

suspect tumor

Question 38

differential dx for otalgia

Answer 38

-serous otitis media, otitis media w effusion, otitis externa, barotrauma, fb, dental infection, mastoiditis, TMJ, herpes, chickenpox

Question 39

chronic om vs externa

Answer 39

-externa causes pain -chronic can decrease hearing

Question 40

central hearing loss

Answer 40

-issue is at the cortex/brainstem, ascending auditory pathway (CNS

Question 41

common cause of central hearing loss

Answer 41

vestibular schwanoma/ acoustic neuroma -8th cranial nerve schwanoma are the most common intracranial tumors -the tumor grows from the myelin

Question 42

MRI for vestibular schwanoma

Answer 42

to look for how far the tumor spread

Question 43

malingering hearing loss

Answer 43

faking it for attention

Question 44

psycogenic hearing loss

Answer 44

you are unaware that it is fake

Question 45

nonorganic hearing loss

Answer 45

equal hearing loss at all frequencies and no reponse to pure tones in one or both ears

Question 46

conductive hearing loss results

Answer 46

rinnie: (-) bc they will not be able to hear once it has been moved off the mastoif websters: sound goes to the bad ear because the bone conduction is better

Question 47

causes of congenital:

Answer 47

cholesteatoma, secretory otitis media, euschian tube dysfunction, congenital atresia (narrowing), external otits, TM perforation, ossicular fixation, ossicular disarticulation

Question 48

what can people not hear with congenital

Answer 48

low or flat frequencies -deficit of loudness

Question 49

ossicular disarticulation

Answer 49

ossicles/ middle ear bones are not alignes -from trauma

Question 50

ossicular fixation

Answer 50

-otosclerosis/ age and joint changes -bones can not move properly

Question 51

where does the webster sound go on conductive loss

Answer 51

to the bad ear

Question 52

how do ppl with conductive speak

Answer 52

maintain their soft voice, can hear speech when it is loud, equal loss for all frequencies, can not hear consonants, background noise helps

Question 53

sensorineural loss is

Answer 53

progressive, preventable, permanent and painless

Question 54

how does a sensorineural person speak

Answer 54

shouting

Question 55

sensorineural test results

Answer 55

rinni(+): AC louder than BC webster: sound goes to the good ear

Question 56

what does a sensorineural person hear

Answer 56

sounds are jumbled, background noise makes it worse, high frequency loss

Question 57

what are potential causes of sensorineural

Answer 57

-measles, mumps, meningitis, cmv -menier disease, acoustic neroma, hair cell destruction

Question 58

how does sensorineural speak

Answer 58

yelling, they might have tinnitus