Chapter 16. Earache
An 86-year-old patient who wears a hearing aid complains of poor hearing in the affected ear. In addition to possible
1.
hearing aid malfunction, this condition is often due to:
A. Acoustic neuroma
B. Cerumen impaction
C. Otitis media
D. Ménière’s disease
A patient presents to the emergency department due to head trauma related to a motorcycle accident. On physical
2.
examination, you note clear, serous discharge from the ear. This is commonly a sign of:
A. Basilar skull fracture
B. Injury of the auricle
C. Otitis discharge
D. Tympanic membrane perforation
A pneumatic otoscopic examination is used to assess:
3.
A. Inner ear conditions
B. Otitis externa
C. Cerumen impaction
D. Tympanic membrane mobility
Ear pain related to tenderness over the auricle and ear canal is most commonly related to:
4.
A. Excessive exposure to noise
B. Cerumen impaction
C. Otitis externa
D. Ménière’s disease
A 6-year-old child presents with complaints of unilateral ear pain, fever, and sore throat. The clinician should recognize
5.
that this is most commonly due to:
A. Otitis externa
B. Inner ear infection
C. Sinusitis
D. Otitis media
Which of the following symptoms is common with acute otitis media?
6.
A. Bulging tympanic membrane
B. Bright light reflex of tympanic membrane
C. Increased tympanic membrane mobility
D. All of the above
Which of the following microorganisms commonly causes otitis externa?
7.
A. Streptococcus pneumoniae
B. Pseudomonas
C. Moraxella catarrhalis
D. Haemophilus influenza
A 5-year-old patient with a history of chronic otitis media complains of severe unilateral ear pain that worsens at night.
8.
The pain has progressively worsened over the past 3 days. Your examination reveals tenderness, erythema, and swelling below the right ear, and
diminished hearing on the right. Which of the following is a likely diagnosis?
A. Sinus infection
B. Skull fracture
C. Mastoiditis
D. Foreign body
9 Presbycusis is the hearing impairment that is associated with:
A. Physiologic aging
B. Ménière’s disease
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, C. Cerumen impaction
D. Herpes zoster
A nonmalignant cancerous tumor affecting cranial nerve VIII that causes unilateral hearing loss, tinnitus, and vertigo is:
10.
A. Otosclerosis
B. Acoustic neuroma
C. Cholesteatoma
D. Squamous cell carcinoma
A 26-year-old female who gave birth 1 month ago presents with sudden development of fever, neck pain, sore throat
11.
with dysphagia, and radiation of pain to the ear. Which of the following conditions is most important to consider?
A. Diptheria
B. Epiglottitis
C. Thyroiditis
D. Otitis media
Chapter 15 Earache
Answer Section
MULTIPLE CHOICE
1. ANS: B
Elderly clients frequently present with complaints of hardened cerumen and decreased hearing resulting from cerumen impaction
aggravated by hearing aid wear.
PTS: 1
2. ANS: A
In cases of head trauma, there are signs of skull fracture. These signs include cerebrospinal fluid otorrhea, rhinorrhea, and
raccoon eyes.
PTS: 1
3. ANS: D
Pneumatic otoscopy is an examination that allows determination of the mobility of a patient’s tympanic membrane (TM). The
normal tympanic membrane moves in response to a puff of air pressure from the otoscope. Immobility may be due to fluid in the middle ear, a
perforation, or tympanosclerosis, among other reasons. The detection of middle ear effusion by pneumatic otoscopy
is key in establishing the diagnosis of otitis media with effusion. The inner ear is not visible with an otoscope. Cerumen
impaction will impede function of the pneumatic otoscope. Otitis externa is an external ear infection that is diagnosed without the use of an
otoscope.
PTS: 1
4. ANS: C
Ear pain is most often seen in children and is usually associated with bacterial or viral upper respiratory infection. Complaints of
ear pain in the summer are often associated with otitis externa (OE), owing to swimmer’s ear. Complaints of primary ear pain decline with age
and, in adults, are more likely associated with secondary conditions, such as sinus infection; dental disease; malignancy; other disorders of the
head, face, and neck; and nervous and vascular symptoms.
PTS: 1
5. ANS: D
Acute otitis media (AOM) involves infection of the fluid in the middle ear space. The three bacterial organisms most often
associated with AOM include streptococcal pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The patient often complains of
unilateral ear pain, which may radiate to the neck or jaw. There is commonly a current or recent history of symptoms consistent with an upper
respiratory infection.
PTS: 1
6. ANS: A
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An 86-year-old patient who wears a hearing aid complains of poor hearing in the affected ear. In addition to possible
1.
hearing aid malfunction, this condition is often due to:
A. Acoustic neuroma
B. Cerumen impaction
C. Otitis media
D. Ménière’s disease
A patient presents to the emergency department due to head trauma related to a motorcycle accident. On physical
2.
examination, you note clear, serous discharge from the ear. This is commonly a sign of:
A. Basilar skull fracture
B. Injury of the auricle
C. Otitis discharge
D. Tympanic membrane perforation
A pneumatic otoscopic examination is used to assess:
3.
A. Inner ear conditions
B. Otitis externa
C. Cerumen impaction
D. Tympanic membrane mobility
Ear pain related to tenderness over the auricle and ear canal is most commonly related to:
4.
A. Excessive exposure to noise
B. Cerumen impaction
C. Otitis externa
D. Ménière’s disease
A 6-year-old child presents with complaints of unilateral ear pain, fever, and sore throat. The clinician should recognize
5.
that this is most commonly due to:
A. Otitis externa
B. Inner ear infection
C. Sinusitis
D. Otitis media
Which of the following symptoms is common with acute otitis media?
6.
A. Bulging tympanic membrane
B. Bright light reflex of tympanic membrane
C. Increased tympanic membrane mobility
D. All of the above
Which of the following microorganisms commonly causes otitis externa?
7.
A. Streptococcus pneumoniae
B. Pseudomonas
C. Moraxella catarrhalis
D. Haemophilus influenza
A 5-year-old patient with a history of chronic otitis media complains of severe unilateral ear pain that worsens at night.
8.
The pain has progressively worsened over the past 3 days. Your examination reveals tenderness, erythema, and swelling below the right ear, and
diminished hearing on the right. Which of the following is a likely diagnosis?
A. Sinus infection
B. Skull fracture
C. Mastoiditis
D. Foreign body
9 Presbycusis is the hearing impairment that is associated with:
A. Physiologic aging
B. Ménière’s disease
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, C. Cerumen impaction
D. Herpes zoster
A nonmalignant cancerous tumor affecting cranial nerve VIII that causes unilateral hearing loss, tinnitus, and vertigo is:
10.
A. Otosclerosis
B. Acoustic neuroma
C. Cholesteatoma
D. Squamous cell carcinoma
A 26-year-old female who gave birth 1 month ago presents with sudden development of fever, neck pain, sore throat
11.
with dysphagia, and radiation of pain to the ear. Which of the following conditions is most important to consider?
A. Diptheria
B. Epiglottitis
C. Thyroiditis
D. Otitis media
Chapter 15 Earache
Answer Section
MULTIPLE CHOICE
1. ANS: B
Elderly clients frequently present with complaints of hardened cerumen and decreased hearing resulting from cerumen impaction
aggravated by hearing aid wear.
PTS: 1
2. ANS: A
In cases of head trauma, there are signs of skull fracture. These signs include cerebrospinal fluid otorrhea, rhinorrhea, and
raccoon eyes.
PTS: 1
3. ANS: D
Pneumatic otoscopy is an examination that allows determination of the mobility of a patient’s tympanic membrane (TM). The
normal tympanic membrane moves in response to a puff of air pressure from the otoscope. Immobility may be due to fluid in the middle ear, a
perforation, or tympanosclerosis, among other reasons. The detection of middle ear effusion by pneumatic otoscopy
is key in establishing the diagnosis of otitis media with effusion. The inner ear is not visible with an otoscope. Cerumen
impaction will impede function of the pneumatic otoscope. Otitis externa is an external ear infection that is diagnosed without the use of an
otoscope.
PTS: 1
4. ANS: C
Ear pain is most often seen in children and is usually associated with bacterial or viral upper respiratory infection. Complaints of
ear pain in the summer are often associated with otitis externa (OE), owing to swimmer’s ear. Complaints of primary ear pain decline with age
and, in adults, are more likely associated with secondary conditions, such as sinus infection; dental disease; malignancy; other disorders of the
head, face, and neck; and nervous and vascular symptoms.
PTS: 1
5. ANS: D
Acute otitis media (AOM) involves infection of the fluid in the middle ear space. The three bacterial organisms most often
associated with AOM include streptococcal pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The patient often complains of
unilateral ear pain, which may radiate to the neck or jaw. There is commonly a current or recent history of symptoms consistent with an upper
respiratory infection.
PTS: 1
6. ANS: A
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