Random
Which portion of ear contains the hair follicles, sebaceous glands, ceruminous glands?
Lateral 1/3 (fibrocartialage)
Extra 50 pts: Which nerves were mentioned that innervated the ear? i dont think theyll ask this
Arnolds(branch of vagus)
Great auricular nerve (cervical plexus)
facial nerve
Auricotemporal branch of v3
I have acute otitis media and im smh. What are the common pathogens?
Streptococcus pneumoniae
Moraxella catarrhalis
Haemophilus Influenzae
Chronic ear drainage. Painless. Conductive hearing loss. White pearly mass.
Cholesteatoma
Patient with BPPV. What is the diagnosis and what is the treatment?
First get orthostatic then Dix-Hallpike
Epley
Dont use this drug combination in OE! What is it?
Neomycin/PolymyxinB/Hydrocorisone (Cortisporin) -its ototoxic
What percentage of Cerumen Impaction is necessary to cause conductive hearing loss? (5 to 50dB)
80%
Extra 50 points for MC cause of SNHL? Think Presbyterian church
MC of Otitis externa "swimmers ear" is caused by this bacteria
Pseudomonoas Aeruginoasa
Extra 50 points, what is presentation and treatment?
Forward protrusion of Ear, Redness, Pain
Mastoiditis
Treatment of Meniere's disease includes stress reduction, salt restriction, alcohol and caffeine avoidance. What medication also helps to reduce pressure?
HCTZ (Hydrochlorothiazide)
8 yo patient presents to the E.R complaining of AOM x24 hours. Pt denies fever or severe pain. What treatment should be given?
None. 60% of cases will resolve in 24 hours. 80% in 2-3 days. if not amoxicillin for 7-10 days and Augmentin if needed or if recurrent.
Most common cause of PEDIATRIC hearing loss.
Serous Otitis Media
Ambient pressure changes (diving/flying/altitude changes) can cause this
Barotrauma
Meniere's disease symptomatic triad?
Episodic vertigo
Episodic SNHL
Tinnitus
Ear fullness
3 Treatments for OE?
Ofloxacin x10 days
Ciprodex if steroid is needed for inflammation
Ear wick if needed
Risk factors for Acute Otitis Media?
Daycare doubles your risk
What is position 1 and 2 on Rinne test?
If AC>BC is this a positive or negative Rinne?
In Weber test, which side will it lateralize to in a Conductive loss? Sensorineural loss? No loss at all?
Position 1= AC Position 2= BC (Mastoid)
Negative
Bad ear. Good ear. No lateralization
What clues may present if OE is fungal?
Itching
White fluffy spores found on exam
Horizontal (rotary) nystagmus on exam. Brief episodic vertigo. Hearing loss. Tinnitis
BPPV
What was a cautionary triad for young children presenting with acute otitis media and what could it be mistaken for?
Fever, fussy, ear pulling
could be teething child
These types of patients are more likely to have complications with chronic OE. Who are they and what are the complications?
Immunocompromised & diabetic patients (Malignant Otitis Externa)
This disorder arises from the vestibular portion of the vestibulocochlear nerve (Cranial Nerve 8).
Progressive asymmetric, high frequency SNHL, continuous virtigo.
Vestibular Schwannoma or "Acoustic Neuroma"
What cells are affected by mastoiditis? What pathogens affect this space? What presentation needs acute treatment?
Mastoid air cells
S. pneumoniae
Strep
Staph aureus
opacification w/ loss of bony septations
NO hearing loss
NO tinnitus
YES nystagmus, balance issues, nausea & vomiting
= what disorder?
Vestibular Neuritis-Inflammation of the vestibular nerve ONLY
Extra 100 points- If hearing loss was present and there was tinnitus along with the entire _____being inflamed. What condition would it be?
Treatment and diagnostic for complications of Otitis Externa?
CT temporal bone w/o contrast
IV ABX (Ciprofloxacin) & otic drops
for Malignant Otitis Externa
What are concerns for adults with chronic unilateral middle ear infections?
CANCER!!! inspect the nasopharynx