EENT Test 2 Flashcards Preview

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Flashcards in EENT Test 2 Deck (51)
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1
Q

Endocrine conditions Ddx for inner ear conditions (broad list)

A

B12, vit a, vit d, fe, zn, mg, b6, folate;

Hyperlipidemia, hypercholesterolemia, dm, hypothyroidism, celiac, hypoglycemia, electrolyte imblance

2
Q

Why is the organ of corti and vestibular apparatus sensitive to anoxia and nutrient deprivation?

A

They have a very increased metabolic rate

3
Q

Otosclerosis is what kind of hearing loss?

A

Conductive

4
Q

Otosclerosis demographics

A

Onset in 20’s, familial tendency, more women than men, more whites

5
Q

Otosclerosis general hx

A

Progressive hearing loss that preserves speech. Pt often soft spoken, may hear better in loud environment?

6
Q

Otosclerosis PE/ Dx

A

Ct shows fused stapes/malleus

7
Q

Otosclerosis audiology

A

Dip in bone conduction at 2000hz.

Tm may be pink and blue

8
Q

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Play audio for this term

A

Traumatic hearing loss is what kind of hearing loss? Conductive

9
Q

Traumatic hearing loss hx

A

Rupture of Tm from increased pressure

10
Q

Trauma hearing loss PE

A

On otoscopic exam, Tm is floppy.

11
Q

Trauma tympanogram

A

Type ad (disrupted)

12
Q

Inflammatory hearing loss is what kind of hearing loss?

A

Conductive

13
Q

Inflammatory hearing loss PMHX

A

Om, pus and effusion, cholesteotoma

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14
Q

Inflammatory tympanogram type

A

Stiff- low impedence

15
Q

Congenital hearing loss is what kind of hearing loss?

A

Sensorineural

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16
Q

Cause of congenital hearing loss

A

Genetic: usu fhx

Non genetic mbdt injury, disease (rubella)

17
Q

Waadenburg syndrome sxs

A

Genetic hearing loss + white patch of hair.

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18
Q

Congenital hearing screen audiology:

A

Loud volumes resonate at 4k hz

19
Q

Traumatic sensorineural hearing loss causes:

A

Head injury or noisy occupations such as farmers, construction, machinists, military, musician

20
Q

Traumatic sensorineural hearing loss causes:

A

Head injury or noisy occupations such as farmers, construction, machinists, military, musician

21
Q

Traumatic sensorineural hearing loss initial complaint:

A

Tinnitus. This is reversible until hairs on organ of corti are damaged beyond repair.
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22
Q

Traumatic sensorineural hearing loss audiology

A

Drop off in higher frequencies

23
Q

Inflammatory sensorineural hearing loss causes:

A

Infections. Strep endotoxins pass through oval window . Measles, syphilis damage nerves

24
Q

Neoplastic sensorineural hearing loss causes

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A

Granulomas, meningiomas, acoustic neuroma.

25
Q

Suspect neoplastic hearing loss when?

A

Unilateral hearing loss

26
Q

How to rule out neoplastic hearing loss

A

Mri

27
Q

Acoustic neuroma hearing loss

A

Localized in high frequencies, retrocochlear pattern with deep v wave
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28
Q

Speech audiometry measures

A

Threshold that speech is accurately heard at. Increased cochlear hearing loss correlates to decreased word recognition

29
Q

Tympanometry measures

A

Tm mobility

30
Q

Electrocholeography measures

A

Records electrical potential of cochlea, diagnosis menieres

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31
Q

Auditory brain stem response measures what?

A

Nerve conduction. Prolonged with acoustic neuroma. Objective test in young children, delayed test positive for prolonged time.

32
Q

Minerals helpful for presbycussis?

A

Zinc, vit c, e, alpha lipoic acid

33
Q

What is presbycusis?

A

Hearing loss of old age

34
Q

Ototoxic substances ti

A

Aminoglycosides (gentamicin, streptomycin,neomycin), phenytoin, anti htn diuretic, nitroglycerin,quinine, salicylate,sedatives and hypno

35
Q

Improve circulation to middle ear:

A

Bilberry, vinpocetine,ginkgo, pycnogenol, Vinco minor,capsicum, ginger,acupunture

36
Q

Tinnitus causes Infx,

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A

Antibiotics, head/neck trauma, menieres, noise, earwax, bp changes, metabolic changes, presbycusis, otosclerosis, autoimmune disease, neoplasms, genetics.

37
Q

Vestibular neuritis and labyrinthitis both have peripheral vertigo characteristics. What makes them different?

A

VN: viral infection precedes.
L: Infx is current, also has hearing loss.
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38
Q

What PE is appropriate for perilymphatic fistula?

A

Insufflation and pressing on the tragus make sxs worse

39
Q

PE for benign positional vertigo?

A

Dix hall pike induces brief upbeat nystagmus which fatigues

Suspect central if downbeat nystagmus that doesn’t fatigue.

40
Q

How specific is rinnes for conductive hearing loss?

A

Not. Very specific though

41
Q

Red flags for stroke:

A

Older age, hx of cvd, sudden onset, asymmetrical smile or other neuro deficit, ataxia, downbeat or vertical nystagmus, worst headache ever

42
Q

Vertigo definition:

A

Pt says room spins or that they have an internal sense of spinning
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43
Q

Vestibular neuritis features:

A
  • onset often viral Infx.
  • sudden severe vertigo/ imbalance with nausea and vomiting. Worse movement. Vertigo near constant
  • no hearing issues, no tinnitus.
  • resolves days to weeks
44
Q

Labyrinthitis features:

A
  • inflammatory disorder of inner ear. Disturbs balance AND hearing. Can be one or both sides
  • usually resolves in days to weeks, but may have bppv for months
  • nystagmus towards unaffected side, caloric test absent, head impulse pos, hearing loss of higher freq.
45
Q

Cns/ stroke red flags

A

Hyper acute onset vertigo, occipital headache, gait ataxia

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46
Q

Benign Paroxysmal positional vertigo features:

A
  • most common cz of recurrent vertigo.
  • brief episodes which mbdt head trauma/ dental surgery / etc
  • Dix hallpike causes upbeat nystagmus towards affected side
  • no hearing change. Triggered by change in position
47
Q

Red flags for central positional vertigo

A

Hyper acute onset, stroke red flags, negative head impulse, focal neuro deficits, new onset headache, valsalva worsens

48
Q

Menieres features

A

Episodic vertigo attacks with 1-3 hours in between.

  • sense of aural fullness
  • tinnitus and sensorineural hearing loss.
  • hypersensitive to loud noises
  • fhx, usu middle aged women.
49
Q

How to dx menieres

A

Auditory brainstem response

50
Q

What differentiates menieres from Tia

A

Tia has faster onset,episodes get worse, focal neuro deficit,stroke risk factors

51
Q

What usually causes bilateral vestibular failure?

A

Aminoglycoside toxicity.