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Flashcards in Ear Disease Deck (42)
1

can otitis external affect hearing?

yes
discharge and increased ear wax can cause blockage causing a temporary conductive hearing loss

2

investigation of otitis externa?

can swab

3

management of otitis externa?

topical aural toilet
topical clotrimazole if fungal

4

what is ramsey hunt syndrome?

shingles of the facial nerve affecting the outer ear

5

how might ramsey hunt syndrome present?

hearing loss
vertigo
facial nerve palsy

6

how is ramsey hunt syndrome managed?

systemic anti-herpetic therapy

7

signs of otitis media?

fullness
bulginess
cloudiness
redness of tympanic membrane

8

symptoms of otitis media?

otalgia
fever
irritability
can get some conductive hearing loss

9

investigation of otitis media?

history
otoscopy
audiometry

10

management of acute otitis media?

80% resolve in 4 days without antibiotics
1st line = amoxicillin
2nd line = erythromycin

11

describe aetiology of otitis media with effusion (OME)

more common in males
more common in children

12

signs of OME?

fluid line present on tympanic membrane
retraction of tympanic membrane
altered motility

13

symptoms of OME?

conductive hearing loss
could have poor performance at school, behavioural issues and speech delay

14

how is OME investigated?

otoscope
audiometry
tympanometry

15

how is OME managed?

watch and wait - most resolve within 3 months

16

management of OME if not resolving after 3 months?

1st occurrence = grommet insertion
2nd occurrence = grommet and adenoidectomy

17

what is cholesteatoma and what causes it?

abnormal production of keratin in the middle ear
idiopathic or result of chronic otitis media and perforated tympanic membrane

18

symptoms of cholesteatoma?

hearing loss
discharge
visible keratin in middle ear

19

how is cholesteatoma diagnosed?

diffusion weighted MRI

20

how is cholesteatoma managed?

surgery

21

what is otosclerosis and what causes it?

abnormal thickening of the osicles
idiopathic

22

signs and symptoms of otosclerosis?

gradual onset conductive hearing loss

23

how is otosclerosis managed?

stepedectomy

24

how is vertigo examined?

otoscopy
neurological
blood pressure including lying/standing
balance system
audiometry

25

what is BPPV and what causes it?

benign paroxysmal positional vertigo
calcified otolith becomes dislodged from utricle into semi-circular canal
can be caused by head trauma, ear surgery or can be idiopathic

26

signs/symptoms of BPPV?

position triggered vertigo that lasts seconds (e.g looking up, turning in bed)

27

how is BPPV investigated?

dix-hallpike manoeuvre

28

how is BPPV managed?

epley manoeuvre
brandt daroff manoeuvre

29

what causes menieres?

idiopathic

30

signs/symptoms of menieres?

history of recurrent, spontaneous, rotational vertigo with at least 2 episodes lasting >20 mins (often hours)
prodromal vomiting
feeling of fullness in affected ear
sensorineural hearing loss - before or during

31

how is menieres investigated?

head CT to exclude other causes

32

how is menieres managed?

supportive treatment during episodes
grommets or vestibular suppressors if severe or continuous

33

what usually causes vestibular neuritis/labrynthitis?

usually viral

34

symptoms of vestibular neuritis/labrynthitis?

vertigo for hours/days
nausea
vomiting
no associated tinnitus or hearing loss in vestibular neuritis
hearing loss is seen in labrynthitis
may have viral prodromal symptoms

35

how is vestibular neuritis/labrynthitis managed?

usually self limiting
may need further investigation/rehabilitation if prolonged or atypical
rule of 3s:
- in bed 3 days
- off work 3 weeks
- off balance for 3 months

36

what is an acoustic neuroma/vestibular schwannoma?

rare benign tumour arising in vestibular portion of vestibulocochlear nerve within the temporal bone

37

describe the tumours in acoustic neuroma/vestibular schwannoma?

95% are sporadic and unilateral

38

if a in acoustic neuroma/vestibular schwannoma was bilateral and occurring in a young person, what might this suggest?

Neurofibromatosis 2

39

signs/symptoms of in acoustic neuroma/vestibular schwannoma?

absent corneal reflex
hearing loss
tinnitus
imbalance

40

how is in acoustic neuroma/vestibular schwannoma diagnosed?

MRI

41

noise induced hearing loss has a classical dip at what frequency?

5Hz

42

what is prebyscuis?

age related hearing loss
usually at high frequency
can treat with hearing aids