A 62-year-old woman presents with a 3-week history of progressively more painful and worsening external otitis. She is a type 2 diabetic patient and has been poorly controlled on oral hypoglycemics. Examination demonstrates a foul-smelling purulent drainage and the presence of granulation tissue within the auditory canal. The tympanic membrane (TM) appears to be normal and mobile to pneumatic testing. What is your diagnosis?
malignant otitis externa
A 55-year-old woman patient presents with a lengthy history of chronic ear infections and episodic purulent drainage from the right ear canal. The patient is without symptoms at this time. Examination of the tympanic membrane shows it to be retracted with a pocket of white material behind the TM. What is this finding called?
chronic otitis media
A 35-year-old man presents with a 1-week history of a marked decrease of hearing in his right ear. He denies trauma, otorrhea, or vertigo. The physical examination appears to be normal except for his tuning fork tests. The Weber test lateralizes to the better ear and the Rinné test shows air conduction to be better than bone conduction in both ears. What type of hearing loss does your patient have?
Conductive hearing loss
Sensorineural hearing loss
None of the above
A 60-year-old woman presents with an acute onset of left facial nerve paralysis. She has severe pain. You notice that she has vesicles on the pinna. What is the name of this syndrome?
A 50-year-old woman presents with a progressive sense of decreased hearing in her right ear and tinnitus over several years. Her father had hearing problems at a young age but never was evaluated. She denies trauma, noise exposure, or ear disease as a child. Your examination demonstrates a completely normal-appearing tympanic membrane, which is mobile to pneumatic testing. Tuning fork tests show a Weber test that lateralizes to the affected (right) ear. Air conduction is greater than bone conduction of the left; on the right bone conduction is greater than air conduction. What is your diagnosis?
serous otitis media
A patient presents with swelling and mild edema of the right ear canal after swimming. What is the most appropriate initial treatment?
oral antibiotics to prevent further swelling
insert an otowick into the canal to prevent the canal from closing
antibiotic ear drops
vigorous irrigation with saline to clean the ear
self-limited disorder requiring no treatment
A child with a history of a recent episode of acute otitis media presents with a painful swelling of the area behind the right ear. There is protrusion of the ear. The child is febrile and looks very ill. Your examination shows a hyperemic and bulging right tympanic membrane (TM) with a purulent effusion. The TM is immobile to pneumatic testing. What is your diagnosis?
Acute Otitis Media
Serous Otitis Media
Auditory Tube Dysfunction
A 60-year-old man presents with a 2-week history of sensation of spinning when turning over in bed at night. He occasionally has a spinning sensation when turning his head to the right. He denies tinnitus or decrease in his hearing. He also complains about ringing in his ear and notes that his wife complains about his inability to hear. He hears a pulsating sound in his right ear, which is worse at night. What is your diagnosis?
Benign paroxysmal positional vertigo (BPPV)
A patient presents with a 3-day history of vertigo associated with turning over in bed, which lasts for several minutes. There are no other symptoms of the ear. Dix– Hallpike testing shows rotary nystagmus, which diminishes with repeated testing. Which of the following is the most likely diagnosis?
central nervous system (CNS) lesion
A 50-year-old woman presents with episodes of vertigo lasting about 20 minutes and associated with fluctuating hearing loss and a low-frequency nonpulsatile tinnitus in the affected ear. After these episodes of vertigo, the patient states that her hearing improves and the tinnitus resolves. The symptoms appear to wax and wane. Which of the following illnesses is suggested by these symptoms?
eustachian tube dysfunction
paroxysmal positional vertigo
none of the above
Your patient has sensory hearing loss. Which of the following structures are associated with this condition?
8th cranial nerve
all of the above
Which of the following diseases would predispose a patient to auditory tube dysfunction?
Both Viral URI and Otitis Externa
Both Viral URI and Allergies
Pt. is a 60 year old woman who complains of symptoms of vertigo for the past 2 months, progressive hearing loss, tinnitus, continuous disequilibrium and slight facial weakness on the right side. What condition is your patient suffering from?
cerebellar degeneration disequilibrium
vertebrobasilar insufficiency syncope
Your pt. is a 52 year old female complaining of right-sided hearing loss with aural pressure, dizziness with the sensation of the room spinning around her, and she presents with a horizontal nystagmus. Which of the following conditions does your pt have?
Your pt is a 25 year old presenting with otalgia, pruritus, and purulent discharge. Pt states they recently went on a scuba diving trip. You do a culture of the discharge and find gram negative rods. What condition does your pt have?
Acute otitis media
serous otitis media
You diagnosed your patient with otitis externa. Which of the following is your choice for treatment?
Your patient recently had AOM in the right ear and is back in your office complaining of hearing loss in that ear. Upon physical exam you find hypo mobility of the TM, amber fluid behind the TM, but no otalgia or fever. What is your diagnosis?
Chronic Otitis Media
Tympanic Membrane Perforation
Which of the following would predispose a patient to develop serous otitis media?
Upper Respiratory Infection
Eustachian Tube Dysfunction
All of the above
What is the most effective treatment for serous otitis media?
none of the above is clinically proven to work
Infants often acquire acute otitis media if they are held in a horizontal position during feeding and milk travels up the eustachian tube when the infant swallows.
Your patient comes in for examination after a recent traumatic brain injury and during your otoscopic exam you notice blood in the middle ear. You would chart this finding as which of the following?
Tympanic membrane perforation
If your patient has a tympanic membrane perforation that is small it should resolve on its own in a few weeks. If the perforation is large, you should refer them to an otolaryngologist for possible surgical correction.
Your patient complains of hearing loss in the right ear for the past week. You conduct the Weber test and find lateralization to the affected ear. You then conduct the Rinne test and find bone conduction to air conduction in the right ear to be 2:1, and air conduction to bone conduction in the left ear to be 2:1. What type of hearing loss is your patient experiencing?
Conductive Hearing Loss
Sensorineural Hearing Loss
Your patient is a 65 year old man complaining of gradual symmetrical hearing loss and high-pitched tinnitus. What is the most likely diagnosis?
Which of the following may be responsible for conductive hearing loss?
foreign body in the ear
Your patient recently had a URI and is now experiencing acute onset, continuous vertigo, tinnitus, and hearing loss in the right ear. You notice they have a horizontal nystagmus that is quick beating towards the left ear. What is your diagnosis?
During otoscopic examination, if you find white patches on the TM you are likely seeing tympanosclerosis and if you find white patches behind the TM you are likely seeing a cholesteatoma.
Your patient has been experiencing vertigo for the past few months and hearing loss in their right ear. What is the most likely diagnosis?
Cerebellar degeneration disequilibrium
Vertebrobasilar insufficiency syncope
Your patient has been experiencing vertigo for the past few months and denies any auditory symptoms. Your first assumption would be that the patient has which of the following conditions?
Could be multiple sclerosis or cerebellar degeneration disequilibrium