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31 Cards in this Set
- Front
- Back
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568. Pathophys of presbycusis?
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a. Degeneration of sensory cells and nerve fibers the base of the cochlea.
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569. Pathophys of noise-induced hearing loss?
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a. Chronic, prolonged exposure to sound levels > 85 dB
b. Hair cells in the organ of Corti are damaged |
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570. Infectious causes of sensorineural hearing loss?
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a. Viral or bacterial infection of cochlear structures or labyrinth.
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571. What drugs can cause drug-induced hearing loss (sensorineural)?
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a. Aminoglycosides
b. Furosemide c. Ethacrynic acid d. Cisplatin e. Quinidine |
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572. Risk with aspirin and hearing loss?
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a. Aspirin can cause tinnitus and reversible hearing impairment
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573. Ménière's disease. Presentation?
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a. Fluctuating, unilateral hearing loss
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574. Features of Ménière's disease?
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a. Sensorineural hearing loss (usually unilateral)
b. Sense of pressure/fullness in ear c. Tinnitus d. Vertigo |
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575. Treatment of Ménière's disease?
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a. Vertigo usually responds to dietary salt restriction and meclizine
b. But hearing loss is progressive. |
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576. CNS causes of sensorineural hearing loss?
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a. Acoustic neuromas
b. Meningitis c. Auditory nerve neuritis (multiple sclerosis, syphilis) d. Meningioma |
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577. Clinical features of conductive hearing loss?
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a. Decreased perception of sound (especially for low-frequency sounds)
b. Can hear loud noises well. |
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578. Diagnosis of hearing loss?
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a. Whisper test-ask the patient to repeat words whispered into the tested ear (mask the other ear)
b. In audiogram is an essential component of the evaluation c. MRI- selected cases (e.g., CNS, or MS is suspected). |
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579. History and exam with tympanic membrane perforation?
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a. History: pain, conductive hearing loss, tinnitus
b. Examination: leading from the ear, clot in the meatus, visible tear in the tympanic membrane. |
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580. Prognosis for tympanic membrane perforation?
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a. 90% heal spontaneously within six weeks.
b. Surgery is appropriate for larger perforations |
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581. Rinne and Weber test results for conductive hearing loss?
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a. Abnormal Rinne test- bone conduction is better than air conduction
b. Weber-sound lateralizes to the affected side!!!! (Tuning fork is perceived more loudly in the ear with a conductive hearing loss)! Kinda like pneumonia- better transmission through solid. |
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582. Rinne and Weber test results for sensorineural hearing loss?
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a. Normal Rinne test- air conduction is better than bone conduction
b. Weber-sound lateralizes to the unaffected side. |
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583. Treatment of cerumen impaction?
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a. Best treated by irrigation after several days of softening with carbamide peroxide (Debrox) or Triethanolamine (Cerumenex)
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584. Treatment of conductive hearing loss?
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a. Treat underlying cause
b. Surgical techniques, such as tympanoplasty (reconstructs middle ear) for patients with chronic otitis media. c. Hearing loss. |
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585. Surgical Treatment of otosclerosis?
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a. Stapedectomy.
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586. Treatment of sensorineural hearing loss?
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a. Treat underlying cause
b. Hearing aids c. Cochlear implants-transduce sounds to electrical energy, stimulates CN VIII. |
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587. Most common cause of incontinence in elderly patients?
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a. Urge incontinence
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588. Most common cause of incontinence in women <70?
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a. Stress incontinence
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589. What are the five major types of incontinence?
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1. Urge
2. Stress 3. Overflow 4. Reflex 5. Functional b. Many patients have more than one type |
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590. What is male incontinence usually due to?
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a. BPH, or neurologic disease.
b. A urology evaluation is indicated in incontinent male patients. |
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591. What is female incontinence usually due to?
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a. Hormonal changes
b. Pelvic floor dysfunction or laxity c. Uninhibited bladder contractions (detrusor contractions) due to aging. |
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592. Risk factors for incontinence?
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a. Age
b. Recurrent UTIs c. Immobility, decreased mental status, dementia, stroke, Parkinson's disease, depression d. DM, CHF e. Multiparity, history prolonged labor f. Pelvic floor dysfunction in women, BPH and prostate cancer in men g. Medications |
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593. Why is age a risk factor for incontinence?
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a. Diminished size of bladder
b. Earlier detrusor contractions c. Postmenopausal genitourinary atrophy |
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594. What medications may cause incontinence?
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a. Diuretics- increase bladder filling, increasing episodes of incontinence
b. Anticholinergic and adrenergics c. Beta blockers d. calcium channel blockers and narcotics e. Alcohol, sedatives, hypnotics |
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595. How do anticholinergic and adrenergic drugs cause incontinence?
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a. By causing urinary retention.
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596. Why may beta blockers cause urinary incontinence?
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a. The diminish sphincter tone
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597. Why may calcium channel blockers and narcotics cause urinary incontinence?
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a. Can decrease detrusor contraction
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598. Why may Alcohol, sedatives, and hypnotics cause urinary incontinence?
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a. Depress mentation.
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