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claire.p.larkin
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Clin Med - Practice Quiz for Ear Conditions

Question 1 of 29

1

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?

Select one of the following:

  • Otitis Media

  • Cholesteatoma

  • malignant otitis externa

  • Otitis externa

Explanation

Question 2 of 29

1

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?

Select one of the following:

  • tympanosclerosis

  • otosclerosis

  • cholesteatoma

  • keratosis obliterans

  • chronic otitis media

Explanation

Question 3 of 29

1

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?

Select one of the following:

  • Conductive hearing loss

  • Sensorineural hearing loss

  • Presbycusis

  • None of the above

Explanation

Question 4 of 29

1

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?

Select one of the following:

  • Bell Palsy

  • Ramsay-Hunt

  • Mobius

  • Millard-Gubler

  • Melkersson-Rosenthal

Explanation

Question 5 of 29

1

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?

Select one of the following:

  • serous otitis media

  • otosclerosis

  • presbycusis

  • tympanosclerosis

Explanation

Question 6 of 29

1

A patient presents with swelling and mild edema of the right ear canal after swimming. What is the most appropriate initial treatment?

Select one of the following:

  • 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

Explanation

Question 7 of 29

1

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?

Select one of the following:

  • Acute Otitis Media

  • Serous Otitis Media

  • Otitis Externa

  • Mastoiditis

  • Auditory Tube Dysfunction

Explanation

Question 8 of 29

1

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?

Select one of the following:

  • Meniere's Syndrome

  • Benign paroxysmal positional vertigo (BPPV)

  • Acoustic Neuroma

  • Cholesteatoma

  • Labyrinthitis

Explanation

Question 9 of 29

1

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?

Select one of the following:

  • central nervous system (CNS) lesion

  • positional vertigo

  • labyrinthitis

  • Meniere disease

  • vestibular neuronitis

Explanation

Question 10 of 29

1

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?

Select one of the following:

  • Meniere disease

  • eustachian tube dysfunction

  • vestibular neuronitis

  • paroxysmal positional vertigo

  • none of the above

Explanation

Question 11 of 29

1

Your patient has sensory hearing loss. Which of the following structures are associated with this condition?

Select one of the following:

  • cochlea

  • 8th cranial nerve

  • outer ear

  • middle ear

  • all of the above

Explanation

Question 12 of 29

1

Which of the following diseases would predispose a patient to auditory tube dysfunction?

Select one of the following:

  • viral URI

  • allergies

  • otitis externa

  • Both Viral URI and Otitis Externa

  • Both Viral URI and Allergies

Explanation

Question 13 of 29

1

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?

Select one of the following:

  • cerebellar degeneration disequilibrium

  • vertebrobasilar insufficiency syncope

  • multiple sclerosis

  • Meniere's syndrome

  • acoustic neuroma

Explanation

Question 14 of 29

1

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?

Select one of the following:

  • Acoustic Neuroma

  • Meniere's syndrome

  • vestibular neuritis

  • BPPV

Explanation

Question 15 of 29

1

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?

Select one of the following:

  • Otitis Externa

  • Acute otitis media

  • serous otitis media

  • cholesteatoma

Explanation

Question 16 of 29

1

You diagnosed your patient with otitis externa. Which of the following is your choice for treatment?

Select one of the following:

  • Erythromycin

  • Corisporin Otic

  • oral steroids

  • oral decongestants

Explanation

Question 17 of 29

1

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?

Select one of the following:

  • Chronic Otitis Media

  • Serous Otitis Media

  • Otitis Externa

  • Tympanic Membrane Perforation

Explanation

Question 18 of 29

1

Which of the following would predispose a patient to develop serous otitis media?

Select one of the following:

  • Allergies

  • Acute otitis media

  • Upper Respiratory Infection

  • Barotrauma

  • Eustachian Tube Dysfunction

  • All of the above

Explanation

Question 19 of 29

1

What is the most effective treatment for serous otitis media?

Select one of the following:

  • autoinflation exercises

  • decongestants

  • oral corticosteroids

  • none of the above is clinically proven to work

Explanation

Question 20 of 29

1

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.

Select one of the following:

  • True
  • False

Explanation

Question 21 of 29

1

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?

Select one of the following:

  • Tympanic membrane perforation

  • Hemotympanum

  • Hemorrhagic blister

  • Cholesteatoma

Explanation

Question 22 of 29

1

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.

Select one of the following:

  • True
  • False

Explanation

Question 23 of 29

1

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?

Select one of the following:

  • Conductive Hearing Loss

  • Sensorineural Hearing Loss

  • Presbycusis

  • None of the above

Explanation

Question 24 of 29

1

Your patient is a 65 year old man complaining of gradual symmetrical hearing loss and high-pitched tinnitus. What is the most likely diagnosis?

Select one of the following:

  • Conductive Hearing Loss

  • Presbycusis

  • Meniere's Syndrome

  • Cholesteatoma

Explanation

Question 25 of 29

1

Which of the following may be responsible for conductive hearing loss?

Select one of the following:

  • foreign body in the ear

  • cerumen impaction

  • otosclerosis

  • serous otitis media

  • all of the above

Explanation

Question 26 of 29

1

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?

Select one of the following:

  • Acoustic Neuroma

  • Labyrinthitis

  • Vestibular Neuritis

  • Meniere's syndrome

Explanation

Question 27 of 29

1

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.

Select one of the following:

  • True
  • False

Explanation

Question 28 of 29

1

Your patient has been experiencing vertigo for the past few months and hearing loss in their right ear. What is the most likely diagnosis?

Select one of the following:

  • Cerebellar degeneration disequilibrium

  • Vertebrobasilar insufficiency syncope

  • Multiple sclerosis

  • Meniere's syndrome

  • acoustic neuroma

Explanation

Question 29 of 29

1

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?

Select one of the following:

  • Cerebellar degeneration disequilibrium

  • Multiple sclerosis

  • Acoustic Neuroma

  • Could be multiple sclerosis or cerebellar degeneration disequilibrium

  • None of the above

Explanation

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