Term
| Three types of hearing loss? |
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Definition
1. Conductive
2. Sensory
3. Neural |
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Term
| Two types of conductive hearing loss? |
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Definition
1. Obstruction due to cerumen impaction.
*Most common*
2. Transient auditory tube disfunction due to upper respiratory illness. |
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Term
| Hearing loss, itching, tinnitus, fullness in the ear, and pain. Abnormal physiologic condition. |
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Definition
| 1. cerumen impaction - accumulation of ear wax in external ear canal |
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Term
| Common cause of cerumen impaction? |
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Definition
1. cotton-tip applicators
2. surfing |
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Term
| Common use for Cerumenex and Debrox |
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Definition
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Term
| Treatments for Cerumen impaction? |
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Definition
1. Cerumenex or Debrox
2. water irrigation (body temp) by water pick, irrigation kit, or syringe
3. antibiotic ear drops |
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Term
| Ear irrigation side effects? |
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Definition
1. dizziness, nausea, worsening pain, vomiting during irrigation
2. otitis externa secondary to traumatic injury to external canal
3. avoid if suspected tympanic membrane perforation |
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Term
| List the ossicles in order from the eardrum to the inner ear. |
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Definition
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Term
| The ossicles are part of the external, middle, or inner ear? |
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Definition
| Smallest bones in the body, located in the middle ear. |
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Term
| If you want to try and block your hearing so you do not have to listen to Andy, you push in on what part of your ear? |
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Definition
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Term
| An inherited disorder that causes abnormal bone growth in the middle ear. |
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Definition
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Term
| Deterioration of the cochlea, resulting in a loss of hair cells in the organ of Corti, is what type of hearing loss? |
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Definition
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Term
| How can multiple sclerosis, acoustic neuromas, or cerebrovascular disease affect hearing? |
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Definition
| They can cause a lesion on the eighth cranial nerve resulting in sensorineural hearing loss. |
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Term
The most common type of brain tumor.
Benign. Impacts the vestibulocochlear nerve. Slow growing. Symptoms usually appear between 30-60 years of age. |
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Definition
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Term
| List three types of ototoxic agents. |
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Definition
1. Aminoglycoside antibiotics
2. Loop diuretics
3. Chemotherapeutic drugs |
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Term
Gentamicin
Streptomycin
Tobramycin |
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Definition
| Aminoglycoside Antibiotics - Ototoxic Agents |
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Term
Furosemide(Lasix)
Bumetanide(Bumex) |
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Definition
| Loop diuretics - Ototoxic Agents |
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Term
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Definition
| Chemotherapeutic Drug - Ototoxic agent |
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Term
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Definition
| Gradually progressive hearing loss seen with age. NOT normal. Not curable but preventable. |
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Term
| 50 year old male patient complains of significant hearing loss. Weber test results show no lateralization. Rinne test is positive on both left and right sides. Physical exam and patient history yields no disease or other abnormalities except they are retired but was the lead singer in a heavy metal band for 20 years. What is their probable diagnosis? |
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Definition
| Presbyacusis, a sensorineural hearing loss. |
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Term
| Common causes of Presbyacusis? |
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Definition
Aging
Excessive exposure to noise
Head Trauma
Diabetes Mellitus |
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Term
| Patient arrives at the ER complaining of pending doom stating "I feel like I am going to die". They say they are having trouble breathing and can hear their heartbeat. What is a possible cause for hearing their own heartbeat? |
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Definition
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Term
| Jil arrives at the clinic complaining of hearing a ringing noise whenever she smokes pot. What diagnosis could explain the ringing noise? |
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Definition
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Term
| While making your rounds through the local psych hospital you see a patient that has suffered for years from schizophrenia. Recently this patient has seemed to develop a fear of drowning and insists on wearing a life jacket 24 hours a day. The staff say the patient has sometimes repeated "water" while clutching their auricles. What is a possible diagnosis to add to this patients chart? |
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Definition
| Tinnitus - sound of rushing water |
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Term
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Definition
1.Avoid precipitating factors.
2.Retraining or physical therapy.
3.Amplification with hearing aids.
4.Tricyclic Antidepressants - Nortriptyline |
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Term
| You have concluded that the blowing sound Ashley hears all throughout the day are Tinnitus. She has stated the sound has grown louder and is now impacting her day to day life. What medication could you prescribe that may help Ashley's Tinnitus? |
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Definition
| Nortriptyline - Tricyclic Antidepressant |
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Term
| In the Weber test a conductive hearing loss is heard loudest in which ear? |
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Definition
| Affected ear - Weber Test |
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Term
| In the Weber test a sensorineural hearing loss is heard loudest in which ear? |
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Definition
| Unaffected ear - Weber test |
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Term
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Definition
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Term
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Definition
| BC > AC = unilateral conductive hearing loss |
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Term
| Rinne test AC > BC but BOTH decreased |
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Definition
| Unilateral Sensorineural Hearing Loss |
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Term
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Definition
| A sense of motion when there is no motion, or an exaggerated sense of motion. |
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Term
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Definition
| A mismatch of information from two or more senses. |
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Term
| While walking down a street you come upon a group of people, outside a restaurant, trying to help a man who has fallen to the street and vomited. The man is having a hard time standing and says he feels like he is "floating on air". The other bystanders say the man has had a brief syncopal event prior to your arrival. What is a possible diagnosis? |
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Definition
ETOH overdose.
Vertigo is not syncope nor disequilibrium. |
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Term
Alan states he has had this constant sensation that he is falling for about a year and it has slowly become worse.
He does not believe he has any hearing loss nor tinnitus and his otoscopic exam is normal.
What is your top differential? |
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Definition
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Term
| Jessica calls you and says she suddenly has this sensation she is spinning, has been vomiting, and intermittently hears her heartbeat. She states the symptoms come and go and started about 20 minutes ago. What is your top differential? |
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Definition
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Term
| This diagnostic maneuver for BPPV may induce vertigo. |
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Definition
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Term
| Maneuver to temporarily treat BPPV. |
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Definition
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Term
| Benzodiazepine to treat Central Vertigo |
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Definition
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Term
| Free floating particles (Canalolithiasis) can cause this condition by activating the posterior semicircular canal. |
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Definition
| Benign Paroxysmal Positional Vertigo (BPPV) |
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Term
| Mario is a new patient to your clinic. Your initial interview reveals a history of HTN, asthma, two broken legs (three years ago in an MVC), and a family history of prostate cancer. His chief complaint is that whenever he turns his head quickly he rapidly (less than 5 seconds) becomes nauseas and feels like he is spinning. The sensation may last as long as 40 seconds and then ceases. Your physical exam and EKG yield no abnormalities. A Dix-Hallpike test is positive. What is your top differential? |
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Definition
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Term
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Definition
Epley Maneuver
Transdermal Scopolamine
Antihistamines
-Meclizine (Antivert) q6-12h
-Dimenhydrinate(Dramamine) IV,IM, or PO q4h |
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Term
A 65 year old female patient has cone to your clinic complaining of episodes of dizziness, a very loud ringing in her ears, fullness in her ears, difficulty hearing, nausea, and diaphoresis. She states that it started about three months prior unilaterally with episodes lasting about 30 minutes. Since then she states it has spread bilaterally and the episodes last around two hours occuring a couple of times per week.
What is your top differential? |
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Definition
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Term
| Confirmatory test for Meniere Disease |
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Definition
| Positive glycerol induction test |
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Term
| Symptomatic treatments for Meniere Disease |
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Definition
Antihistamines
Diuretics
-Triamterene(Dyrenium) [K+ sparing]
-Hydrochlorothiazide(HCTZ) [Thiazide diuretic]
Calcium channel blocker
Intratympanic steroid injections |
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Term
John has come to the ER complaining of a sudden onset of hearing loss on his left ear, dizziness, and vomiting that began shortly after his flight in an air show. You perform a pneumatic otoscopy and it elicits a nystagmus.
What is your top differential and how do you treat it? |
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Definition
Perilymphatic fistula
Treat symptoms with antihistamines.
Treat with bed rest and refer to ENT for surgical repair. |
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Term
| Emily has come to your clinic complaining of a sensation that she is spinning, nausea, upper respiratory congestion, and a fever. She states it started about a week ago and all the symptoms appear to be somewhat better today. What is your top differential and how do you treat it? |
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Definition
Vestibular neuronitis
Treat with Antihistamines and Antiemetics [Promethazine(Phenergan) q6-8h] |
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Term
| Rachel arrived at the ER by ambulance. Her husband said she been sick with a fever and congestion for about a week. Today she suddenly started feeling dizzy, has vomited several times, and can hear her heartbeating in her ear but has trouble hearing other sounds. What is your top differential? |
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Definition
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Term
| Possible etiologies of Labyrinthitis are? |
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Definition
This disease has these possible etiologies:
1. Viral
-Measles
-Mumps
2. Bacterial illness
-Otitis media
-Mastoiditis
-Meningitis |
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Term
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Definition
Viral
-antihistamines and antiemetics
Suspected bacterial etiology
-symptomatic treatment
-possible hospital admission
-antibiotics |
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Term
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Definition
Viral
-antihistamines and antiemetics
Suspected bacterial etiology
-symptomatic treatment
-possible hospital admission
-antibiotics |
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Term
Andrea is 30 years old and is a new patient to your clinic. She has a history or diabetes and depression. She has been taking the same medications with no changes for the past two years. About two weeks prior to admission she started to have a falling sensation and sometimes feels dizzy. The feeling is constant and changing her body or head condition does not effect the sensation. She has a vertial nystagmus.
What is your top differential? |
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Definition
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Term
Micah arrived by ambulance to the ER with a chief complaint of not N/V and not being able to sit up on his own. He is 65 with a history of asthma and COPD. Micah stated he has a feeling that he is moving forward and backward when he is really not moving. He is still not able to sit up on his own and states his headache is now a 7/10. What is your top differential?
What would be a good test to order to further isolate the problem? |
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Definition
Cerebellar Hemorrhage or Infarction
Diagnostic imaging can differentiate hemorrhagic from ischemic etiologies. |
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Term
Daron was brought to the ER by friends. He is complaining of a headache and symptoms indicating vertigo. Onset was one hour prior to admission, shortly after blocking spiked volleyvball where the volleyball struck the right side of his frontal bone. There is contusion and edema in this area.
What is possibly causing Daron's S/S? |
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Definition
| Veterbral Artery Dissection |
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Term
| Jake has been troubled with migraines for years. His migraines seem to occur about two times and month and last for at least 24 hours. His past two have been accompanied with a constant feeling that he is spinning. What is a possible new diagnosis for Jake? |
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Definition
| Migraine-related dizziness and vertigo. |
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