-
Aspirin exacerbated respiratory disease (AERD)
- 1. Asthma
- 2. chronic rhinosinusitis with nasal polyposis
- 3. bronchospasm or nasal congestion following ingestion of aspirin or NSAIDs
- Tx: surgery, although polyps tend to recur
-
Conductive hearing loss
- obstruction of external sounds to inner ear
- Etiology: cerumen impaction, middle ear fluid or infection, decreased movement of small bones, bony tumor in middle ear (otosclerosis)
-
Sensorineural hearing loss
involving inner ear, cochlea, or auditory nerve
-
Rinne test
- tuning fork on mastoid bone until sound is no longer heard, then moved to ear canal
- Air conducted sound should be heard twice as long as bone-conducted
- Abnormal Rinne test = conductive hearing loss
-
Weber test
- tuning fork on the middle of head
- conductive hearing loss: louder in the affected ear
- sensorineural hearing loss: louder in the unaffected ear
-
medication-induced ototoxicity
- aminoglycoside antibiotics
- chemotherapeutic agents
- aspirin: tinnitus, hearing loss at high doses
- loop diuretics (furosemide): greater risk in high doses
-
Epiglotitis
- haemophilus influenzae
- streptococcus pyogenes
-
Malignant otitis externa
- Pseudomonas aeruginosa
- elderly diabetic patients
- presentation: ear pain and drainage, non responsive to topical medications
- granulation tissue in the ear canal
- complications: osteomyelitis
- Dx: CT or MRI
- Tx: systemic antibiotics (anti-pseudomonals), such as ciprofloxacin
-
Primary hyperparathyroidism
etiology, sx
- Parathyroid adenoma: 90%
- hyperplasia (6%)
- Carcinoma (1-2%)
- Associated with MEN 2A
- Sx:
- 80% asymptomatic
- non-specific: fatigue, weakness, mild depression
- Abdominal pain, renal stones, bone pain/fractures
-
Primary hyperparathyroidism
diagnosis
- hypercalcemia with elevated or inappropriately normal PTH
- 24hr urinary calcium > 250mg
- Urine calcium/creatinine >0.02
- Bone mineral density testing to evaluate for osteopenia/osteoporosis
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