CMN 568 UPDATED EXAMS SCRIPT QUESTIONS AND
ANSWERS SURE A+
✔✔squamous cell carcinoma - ✔✔most common neoplasm of ear canal
- suspect is OE does not resolve
- high mortality
✔✔Acute Otitis Media (AOM) - ✔✔- middle ear infection
- usually precipitated by viral URI that cause ET obstruction
- erythema and decreased TM motility
- purulent otorrhea
✔✔chronic otitis media - ✔✔- repeated episodes of acute otitis media causing
irreversible tissue damage and persistent tympanic membrane perforation
- conductive hearing loss
✔✔Glomus tumor - ✔✔- middle ear neoplasm
- pulsatile tinnitus
- occ vascular mass behind TM
✔✔presbycusis - ✔✔- age related hearing loss
- progressive, gradual
- high frequency
✔✔ototoxic agents - ✔✔- aminoglycosides, loop diuretics, antineoplastic agents
(cisplatin)
- may be irreversible in therapeutic doses
- inc risk if kidney dx, combo therapy, or pre-existing hearing loss
✔✔tinnitus - ✔✔- ringing or buzzing in the ears
- intermittent and brief is normal
- if pulsatile - refer
✔✔vertigo - ✔✔- the sensation of dizziness
- hallmark of vestibular dz
- peripheral: sudden and sever, tinnitus strong indicator, horizontal nystagmus able to
be stopped with fixation
- dix hallpike testing, fukuda test, frenzel goggles
- causes: benign paroxysmal positioning, ethanol tox, meneire dz, vest neuritis, inner
ear barotraumas, labyrinthitis
- central: gradual, progressive, vertical nystagmus, not able to be suppressed
✔✔Acute Rhinosinusitis - ✔✔<4wk
✔✔Chronic Rhinosinusitis - ✔✔Lasts beyond 12 weeks
, ✔✔viral rhinosinusitis - ✔✔nasal congestion/drain, watery drainage
mild general headache
symptoms <10 days and not worsening
✔✔acute bacterial rhino - ✔✔- acute onset
- purulent discharge and secretions
- sinus pressure, nasal congestion, a/w cough, malaise, fever, HA
- staph, strep, flu, moraxella
- s/s >10 days or improvement then worsening in 10 d
- acute maxillary sinusitis most common (largest sinus, single drainage pathway, easily
obstructed)
- abx only for complicated or protracted; s/s >10d
✔✔allergic rhinitis - ✔✔- hay fever
- clear rhinorrhea, sneezing, tearing, pruritus, eye irritation
- a/w bronchospasm, cough, eczema
- environmental; IgE
- seasonal v perennial
- pale nasal turbinates
- polyps a/w LT
- tx: IN corticosteroids and antihistamines
✔✔epistaxis emergency - ✔✔if nasal bleeding posterior, BL or lg volume
✔✔nasal polyps - ✔✔benign mucous membrane masses that form slowly in response to
repeated inflammation of the sinus or nasal mucosa and project into the nasal cavity.
- seen in pt with AR
- if occur with asthma, AVOID ASA (triad asthma) - may lead to bronchospasm
✔✔Inverted papilloma - ✔✔- Benign tumor on lateral nasal wall of the sinuses caused
by HPV
- UL obstruction
- excision b/c squamous cell carcinoma seen in 10%
✔✔Leukoplakia - ✔✔- condition characterized by white spots or patches on mucous
membrane, which may be precancerous
- d/t chronic irritation
- cannot be removed
- always refer and biopsy
✔✔Erythroplakia - ✔✔oral mucosal lesion with definitive erythema or granular red and
velvety patch
ANSWERS SURE A+
✔✔squamous cell carcinoma - ✔✔most common neoplasm of ear canal
- suspect is OE does not resolve
- high mortality
✔✔Acute Otitis Media (AOM) - ✔✔- middle ear infection
- usually precipitated by viral URI that cause ET obstruction
- erythema and decreased TM motility
- purulent otorrhea
✔✔chronic otitis media - ✔✔- repeated episodes of acute otitis media causing
irreversible tissue damage and persistent tympanic membrane perforation
- conductive hearing loss
✔✔Glomus tumor - ✔✔- middle ear neoplasm
- pulsatile tinnitus
- occ vascular mass behind TM
✔✔presbycusis - ✔✔- age related hearing loss
- progressive, gradual
- high frequency
✔✔ototoxic agents - ✔✔- aminoglycosides, loop diuretics, antineoplastic agents
(cisplatin)
- may be irreversible in therapeutic doses
- inc risk if kidney dx, combo therapy, or pre-existing hearing loss
✔✔tinnitus - ✔✔- ringing or buzzing in the ears
- intermittent and brief is normal
- if pulsatile - refer
✔✔vertigo - ✔✔- the sensation of dizziness
- hallmark of vestibular dz
- peripheral: sudden and sever, tinnitus strong indicator, horizontal nystagmus able to
be stopped with fixation
- dix hallpike testing, fukuda test, frenzel goggles
- causes: benign paroxysmal positioning, ethanol tox, meneire dz, vest neuritis, inner
ear barotraumas, labyrinthitis
- central: gradual, progressive, vertical nystagmus, not able to be suppressed
✔✔Acute Rhinosinusitis - ✔✔<4wk
✔✔Chronic Rhinosinusitis - ✔✔Lasts beyond 12 weeks
, ✔✔viral rhinosinusitis - ✔✔nasal congestion/drain, watery drainage
mild general headache
symptoms <10 days and not worsening
✔✔acute bacterial rhino - ✔✔- acute onset
- purulent discharge and secretions
- sinus pressure, nasal congestion, a/w cough, malaise, fever, HA
- staph, strep, flu, moraxella
- s/s >10 days or improvement then worsening in 10 d
- acute maxillary sinusitis most common (largest sinus, single drainage pathway, easily
obstructed)
- abx only for complicated or protracted; s/s >10d
✔✔allergic rhinitis - ✔✔- hay fever
- clear rhinorrhea, sneezing, tearing, pruritus, eye irritation
- a/w bronchospasm, cough, eczema
- environmental; IgE
- seasonal v perennial
- pale nasal turbinates
- polyps a/w LT
- tx: IN corticosteroids and antihistamines
✔✔epistaxis emergency - ✔✔if nasal bleeding posterior, BL or lg volume
✔✔nasal polyps - ✔✔benign mucous membrane masses that form slowly in response to
repeated inflammation of the sinus or nasal mucosa and project into the nasal cavity.
- seen in pt with AR
- if occur with asthma, AVOID ASA (triad asthma) - may lead to bronchospasm
✔✔Inverted papilloma - ✔✔- Benign tumor on lateral nasal wall of the sinuses caused
by HPV
- UL obstruction
- excision b/c squamous cell carcinoma seen in 10%
✔✔Leukoplakia - ✔✔- condition characterized by white spots or patches on mucous
membrane, which may be precancerous
- d/t chronic irritation
- cannot be removed
- always refer and biopsy
✔✔Erythroplakia - ✔✔oral mucosal lesion with definitive erythema or granular red and
velvety patch
