Presentation
The Fourth Edition of this best-selling book is packed full of information to help the reader move from a presenting problem to an accurate diagnosis. [books.google.de]
In each of these examples, nausea and vomiting were present in the majority of cases but the presenting symptom complexes were non-specific. [uwgi.org]
[…] skew deviation absent present absent Nystagmus often present acutely peripheral type often present central type absent Peripheral proprioceptive sensory deficit absent absent present Romberg’s test may be present if there is a bilateral vestibulopathy [lifeinthefastlane.com]
It tends to be more severe and may present at a comparatively young age. If shingles affects more than one dermatome, immunocompromise such as HIV should be suspected. Presentation Symptoms The presenting feature is often pain deep within the ear. [patient.info]
Entire Body System
- Falling
What if this same patient is/has: Click on the correct answer Falling A LOT with inability to voluntarily look down, but could overcome this with Doll’s eyes maneuver. [classes.kumc.edu]
[…] consists of irregularities in the rhythm, rate, and amplitude of voluntary movements => voluntary movements become jerky and erratic – cerebellar gait disturbances involve disturbances in stance and gait => see the gait disorders, drop attacks and frequent falls [lifeinthefastlane.com]
Exercises and therapy The physical therapies to decrease dizziness fall into two major groups. [invisiblemeinvisibleyou.com]
Falls could involve simple slips on an icy surface to a fall from a height while on a ladder/construction site for example. [wsiat.on.ca]
- Sepsis
For undifferentiated infection or suspected sepsis, broad-spectrum antibiotics are indicated. Infants with facial stigmata of primary immunodeficiency may be detected in the newborn nursery, while less apparent cases may go undetected for years. [ahcmedia.com]
[…] fever Shaken Baby Syndrome Schistosomiasis Schizophrenia Scleritis Scleroderma (systemic sclerosis) Scoliosis Seasonal affective disorder Seborrheic Dermatitis (SD) Seizures, absence Seizures, febrile Seizures, Generalized Tonic-Clonic Seizures, partial Sepsis [elsevier.com]
[…] potato" voice) Unilateral referred ear pain Tonsillar/cervical lymph nodes enlarged and very tender Fluctuance may be felt on affected side of palate Differential Diagnosis Epiglottitis Gonococcal pharyngitis Complications Obstruction of the airways Sepsis [canada.ca]
- Streptococcal Infection
infections) syndrome is distinguished from Sydenham chorea by onset days to weeks after streptococcal infection and presence of a tic rather than severe motor dysfunction Diagnostic Evaluation Most children (75%) have positive anti-streptolysin O titers [ahcmedia.com]
GAS can also cause invasive infections such as necrotizing fasciitis, myositis and streptococcal toxic shock syndrome. [canada.ca]
- Impaired Balance
Labyrinthine symptoms (hearing loss, dizziness, nausea, vomiting, impaired balance, etc.) are usually pronounced. The patient has to be on the healthy side of the ear, with slightly bowed head anteriorly. [survinat.com]
- Constitutional Symptom
Blindness eventually occurs in 20-50% of untreated patients Jaw claudication when chewing or talking Constitutional symptoms include anorexia and weight loss, fever and sweats, and malaise, fatigue, and depression. [classes.kumc.edu]
Respiratoric
- Aspiration
Burr hole needling burr hole and aspirate the abscess. [powershow.com]
Needle aspiration can occasionally be performed through the mastoidectomy. 23 Small abscesses may be treated with antibiotics alone. [entokey.com]
[…] pressure Focal manifestations Temporal: Aphasia, hemianopia, paralysis Cerebellar: ataxia, vertigo, nystagmus, muscle incoordination 55 OTOGENIC BRAIN ABSCESS Diagnosis CT MRI LP Burr hole needling 56 CT 57 MRI 58 OTOGENIC BRAIN ABSCESS Treatment Repeated aspiration [slideplayer.com]
Aspiration via burr hole. Appropriate mastoidectomy operation after subsidence of the acute stage. [quizlet.com]
Gastrointestinal
- Constipation
Only 2 AE were rated as ‘probably' related to the study medication (1 case of constipation and flatulence, 1 case of eructation). [karger.com]
[…] dyskinesia), orthostatic hypotension, sedation Serotonin 5-hydroxytryptamine antagonists‡ (dolasetron [Anzemet], odansetron [Zofran], granisetron [Kytril], palonosetron [Aloxi]) Postchemotherapy nausea and vomiting, severe nausea and vomiting Asthenia, constipation [aafp.org]
GI symptoms of severe hypercalcemia (serum calcium > 12 mg/dl) includes nausea and vomiting, as well as anorexia, constipation and abdominal pain. [uwgi.org]
This results in lethargy, hypotonia, and constipation in affected infants. Foodborne botulism is usually reported as small outbreaks related to homemade canned food. [ahcmedia.com]
[…] of PD Autonomic dysfunction early in the disease course, generally suggests Shy Drager syndrome (a form of multiple system atrophy) – see below (MSA in “Parkinson’s Plus” Syndromes list) Autonomic symptoms seen in PD include Orthostatic hypotension Constipation [classes.kumc.edu]
Cardiovascular
- Thrombosis
Fig. 11.11 Lateral sinus thrombosis of the right ear. (A) Computed tomography shows thrombosis and mural enhancement of the right sigmoid sinus ( arrow ), and opacification of the mastoid air cells. [entokey.com]
(previously Cavernous sinus thrombosis) Sinusitis Sjögren's syndrome Sleep apnea, obstructive Slipped capital femoral epiphysis Small bowel obstruction Smallpox Social anxiety disorder Somatization disorder Spasticity Spina bifida Spinal cord compression [elsevier.com]
Definition: Increased CSF volume in patients with CSOM due to thrombosis of the superior sagittal sinus(arachnoid villi) (dec) interfering with the absorption of CSF. More common in children. [quizlet.com]
CT, MRI. 63 LATERAL SINUS THROMBOPHLEBITIS DIAGNOSIS (427 ENT) Griesingers sign edema over posterior part of mastoid due to emissary vein thrombosis. [powershow.com]
Strategies for imaging CT—signs of hyperacute infarction MR—value of diffusion weighted images (DWI) Etiology Occlusions, large/small vessel Embolic Watershed (hypoperfusion) Hypoxia/anoxia Dissection Fibromuscular dysplasia (FMD) Vasculitis Venous thrombosis [mir.wustl.edu]
Skin
- Erythema
[…] multiforme Erythema nodosum Esophageal tumors Esophageal Varices Essential tremor Factitious disorder (Including Munchausen's Syndrome) Failure to Thrive Falls in the Elderly Fatty Liver of Pregnancy, Acute Felty's syndrome Fetal alcohol syndrome Fever [elsevier.com]
Table 1: Features of Common Forms of Stomatitis Disease Cause Type of Lesions Site Diameter Other Features Herpangina or hand-foot-and-mouth disease Coxsackievirus, echovirus, enterovirus 71 Vesicles and ulcers with erythema Anterior pillars, posterior [canada.ca]
Disease: TICK'S CRAP 10 />Ua)t S\£\ Submitted by Jim McHugh (source: Kanski) Tick-borne Iritis & intermediate uveitis Conjunctivitis Keratitis (subepithelial, punctate) Svvelling of disc & Star at macula Cardiac arrythmias (conduction defects) Rash (erythema [archive.org]
In all of these cases, pain, erythema and swelling at the site of the bite is usually evident. [uwgi.org]
- Blister
Rash or blisters, which may be on the skin of the ear canal, auricle or both, and may become infected secondarily, causing cellulitis Signs There is a rash or herpetic blisters in the distribution of the nervus intermedius. [patient.info]
The virus herpes zoster oticus causes painful blisters and shingles. If the virus attacks the facial nerve, it may result in vertigo. Several bacterial diseases can result in dizziness, including tuberculosis, syphilis, meningitis, or encephalitis. [invisiblemeinvisibleyou.com]
Eyes
- Diplopia
Cranial Nerve IV – Trochlear nerve Evaluation Depression of the eye primarily on adduction Injury Causes diplopia which is better when tilting the head to the contralateral side, and the diplopia is worse when tilting to the ipsilateral side. [classes.kumc.edu]
Diplopia due to VI nerve palsy. Increased CSF pressure, otherwise CSF is normal. IX: CT: dilated ventricles; lumbar puncture: inc CSF P e N physical &. chemical parameters. [quizlet.com]
Petrositis as cause of Parapharyngeal in our case was excluded due absence of clinical features like retro-orbital pain and diplopia. [ispub.com]
Patients should be advised to seek further medical care for worsening symptoms - especially neurological symptoms (such as diplopia, slurred speech, gait disturbances, localised weakness or numbness) [ 16 ]. [patient.info]
Severe frontal headache, blurred vision, and diplopia (due to VI nerve paraysis). [powershow.com]
- Eye Pain
This may include information about the eyes, central nervous system, gastrointestinal system and/or respiratory system. [canada.ca]
Recently he suffered from deep seated pain behind the left eye with diplopia. Ear examination 74 revealed a marginal pars flaccida (attic) perforation filled with keratin and surrounded by granulations. [archive.org]
Musculoskeletal
- Torticollis
Surkin et al reported a case of chronic otitis media with neck mass and torticollis initiated by thrombophlebitis of the sigmoid sinus, with extension to the internal jugular vein. [ispub.com]
Thrombocytosis Thrombophlebitis, superficial Venous Thrombotic thrombocytopenic purpura Thyroid carcinoma Thyroid nodule Thyroiditis Thyrotoxic storm Tinea Capitis Tinea corporis Tinea cruris Tinea pedis Tinea versicolor Tinnitus Torsade des pointes Torticollis [elsevier.com]
[…] meaning bending of the neck to the left side, tenderness in the -94- />Ua)t S\£\ left side of the neck) Explain the following manifestations Torticollis: bending of the neck to the left side to minimize the pain in the left jugular vein due to thrombophlebitis [archive.org]
- Osteoporosis
Onychomycosis Opioid Dependence Oppositional defiant disorder (ODD) Optic atrophy Optic neuritis Oral cancer Orchitis Orthostatic Hypotension Osgood-Schlatter disease Osler-Rendu-Webber Syndrome Osteoarthritis Osteochondritis dissecans Osteomyelitis Osteoporosis [elsevier.com]
Ears
- Labyrinth Disease
Turning, Xys., horiz., right 24" DISEASES OF THE LABYKL\TH Case 39: before the serous labyrinth- ( R iti- i ri^'lit t-ar diseased) After the serous labyrinthitis, one month later \ I Case 47: before the serous labyrinth- ' it is (left ear diseased t After [ebooksread.com]
Neurologic
- Vertigo
Labyrinthitis causes VERTIGO, vomiting and a ringing or hissing in the ears ( TINNITUS ). [medical-dictionary.thefreedictionary.com]
Benign paroxysmal positional vertigo 386.12 Vestibular neuronitis 386.19 Other peripheral vertigo 386.2 Vertigo of central origin 386.30 Labyrinthitis, unspecified 386.32 Circumscribed labyrinthitis 386.33 Suppurative labyrinthitis 386.34 Toxic labyrinthitis [healthprovidersdata.com]
Peripheral vertigo is much more common. Peripheral vertigo The most common causes of peripheral vertigo are benign. [dartmouth.edu]
Vertigo and rotary nystagmus are seen on dix halpike with the affected ear down. [entcentergr.com]
Movement of the eye suggests a central cause of vertigo. [patient.info]
- Nystagmus
Nystagmus horizontal - Rotary. Busy the ipsilateral labyrinth in excitement, irritability state. Therefore, the fast phase nystagmus ipsilateral. [e.uuuwell.com]
It is also possible for the nystagmus in the fistula test to be reversed, that is : On compression, nystagmus to the healthy side (reversed compression nystagmus). On aspiration, nystagmus to the diseased side (reversed aspiration nystagmus). [ebooksread.com]
This to-and-fro motion is termed nystagmus. Actually, there are two major types of nystagmus, "jerk nystagmus" and "pendular nystagmus". The first type (and the type generated by the vestibular system) is" jerk nystagmus." [dartmouth.edu]
[…] or intra-axial midline brainstem lesions) – other more bizzare forms of nystagmus can also be seen eg. periodic alternating nystagmus, pendular nystagmus, divergent nystagmus, pure torsional nystagmus on vertical gaze (* see the nystagmus guidemap for [lifeinthefastlane.com]
- Headache
CT and MRI Treatment is by neurosurgical drainage 40 LATERAL SINUS THROMBOPHLEBITIS Pathology Perisinusitis Mural thrombus Occluding thrombus Suppuration Embolization 41 LATERAL SINUS THROMBOPHLEBITIS Diagnosis Fever, rigor, and sweating Headache and [slideplayer.com]
headache The patient may be lethargic & irritable. - Manifest stage (acute abscess): a) Symptoms and signs of increased intracranial pressure: Severe headache. [quizlet.com]
Severe frontal headache, blurred vision, and diplopia (due to VI nerve paraysis). [powershow.com]
Also, they may become very sensitive to light or loud sounds when they are experiencing a dizziness episode or headache. [childrenshospital.org]
Recognize signs and symptoms of migraine headaches and how to differentiate migraines from other causes of headache Plan the management of acute migraine headaches Know the medications used for prophylactic treatment of migraine headaches Pseudotumor [ahcmedia.com]
- Dizziness
Description Labyrinthitis is characterized by dizziness or feelings of motion sickness caused by disturbance of the sense of balance. [medical-dictionary.thefreedictionary.com]
“Dizziness.” The Mayo Clinic. October 10, 2002 (April 4, 2004).. “Dizziness and Motion Sickness.” The American Academy of Otolaryngology and Head and Neck Surgery. January 30, 2004 (April 4, 2004).. “Balance, Dizziness and You.” [invisiblemeinvisibleyou.com]
"Dizziness." The Mayo Clinic. October 10, 2002 (April 4, 2004).. "Dizziness and Motion Sickness." The American Academy of Otolaryngology and Head and Neck Surgery. January 30, 2004 (April 4, 2004).. "Balance, Dizziness and You." [encyclopedia.com]
When the dizziness is severe and cannot be controlled with diet and medications, surgery may be needed. [childrenshospital.org]
Once you have defined what the patient means by dizziness, it is important to understand the timing of the dizziness, whether it appears constantly or in attacks, what they do when they experience dizziness and whether there are any associated symptoms [dartmouth.edu]
- Neuralgia
Postherpetic neuralgia may occur. Chronic tinnitus. Chronic vestibular dysfunction. [patient.info]
[…] the tympanic membrane · Facial lesion, mycosis, eczema · Auditory canal phlegmon · Acute / chronic (epitympanic) otitis media · Tinnitus · Cervical and cervicoencephalic, pain syndromes Tooth-Spy „the light that makes everything visible“ · Migraine · Neuralgia [pdf.medicalexpo.com]
Toxic shock syndrome Toxoplasmosis Tracheitis Transfusion reaction, hemolytic Transient ischemic attack Transverse myelitis Traumatic Brain Injury (TBI) Trichinosis Tricuspid regurgitation Tricuspid stenosis Tricyclic antidepressant overdose Trigeminal neuralgia [elsevier.com]
Corneal reflex (CN V is the afferent and CN VII is the efferent limb of the reflex) Injury Sensory loss in the affected distribution Weakness of mastication on the affected side if V3 is affected Trigeminal neuralgia – brief, intense lancinating pain [classes.kumc.edu]
[…] otorhea: so long as there is a cholesteatoma these manifestations are present due to infection in the cholesteatoma sac the discharge is offensive because of bone necrosis and infection by pseudomonas organism Deep seated eye pain: this is a trigeminal neuralgia [archive.org]
Workup
[…] nausea and vomiting, the cause has been established on previous diagnostic workup. [uwgi.org]
[…] in the ED for a stable patient with an acute cerebellar syndrome can be initiated following consultation with a neurologist, and the workup may include blood tests (including heavy metals, serum ETOH and anticonvulsant drug levels), neuroimaging to exclude [lifeinthefastlane.com]
An extensive lab workup, including lumbar puncture, is not always necessary. A blood glucose level should be obtained in all children. [ahcmedia.com]
A laboratory workup showed Hb%= 7gm% WBC count 23,000/cc. [archive.org]
Microbiology
- Streptococcus Pneumoniae
pneumoniae Haemophilus influenzae Moraxella catarrhalis Neisseria meningitidis Streptococcus species Staphylococcus species Proteus species Bacteroides species Escherichia coli Mycobacterium tuberculosis Autoimmune labyrinthitis Autoimmune labyrinthitis [emedicine.medscape.com]
MR performed 6 weeks after Streptococcus pneumoniae meningitis shows bilateral labyrinthine enhancement ( C, D ) and signal loss on steady state images in the right proximal scala tympani ( arrows in E ), close to the orifice of the cochlear aqueduct [radiologykey.com]
pneumoniae, streptococcus pyogenes, staphylococcus aureus, branamella catarhalis. [powershow.com]
The bacteriology of acute mastoiditis usually consists of pyogenic organisms, of which Streptococcus pneumoniae is most common. Chronic suppurative otitis media is more likely to be caused by Pseudomonas sp., other gram-negative rods. [entokey.com]
Streptococcus pneumoniae & Haemophilus influenzae & Moraxella catarrhalis These microbes are the most common cause for acute otitis media. [15] S. pneumoniae, H. influenzae (Fig. 10), and M. catarrhalis are all associated with the upper respiratory tract [microbewiki.kenyon.edu]
Colonoscopy
- Polyps
Otoscopic examination revealed polyp arising from the middle ear filling the external auditory canal surrounded by foul smelling discharge. Examination of left ear was normal. [ispub.com]
Referral Refer to a physician if symptoms do not improve after 4 weeks of continuous antibiotic therapy to rule out underlying pathology (for example, nasal polyps, deviated nasal septum, chronic allergies). [canada.ca]
Ear examination shovved an aural polyp and a purulent discharge. [archive.org]
[…] via congenital dehiscence or a preformed pathway - virulent organisms - cholesteatoma & bone erosion - presence of a congenital dehiscence (eg: dehiscent facial canal) or a preformed pathway (eg: skull base fracture) - obstruction of drainage eg: by a polyp [quizlet.com]
Carotid sinus syndrome Carotid stenosis Carpal tunnel syndrome Cataracts Cat-scratch disease Celiac disease Cellulitis Cerebral palsy Cerebral vasculitis Cervical cancer Cervical disk syndromes Cervical dysplasia Cervical insufficiency Cervicitis Cervical polyps [elsevier.com]
Treatment
Serous labyrinthitis after appropriate treatment of inner ear function returned to normal. 2, tinnitus and hearing loss, heavier felt deafness, but not deaf. [e.uuuwell.com]
TREATMENT OF SINUS THROMBOPHLEBITIS Exposure of healthy dura proximal and distal Verify the sinus content 47 SURGICAL TREATMENT OF SINUS THROMBOPHLEBITIS Exposure of healthy dura proximal and distal Verify the sinus content Blood clot: leave alone Pus [slideplayer.com]
Ofce-Bleaching before In-Bleaching before Condition before treatment Condition 1 month after therapy A full-mouth disinfection treatment for 15 minutes. [pdf.medicalexpo.com]
Treatment Rapid treatment is essential in order to stop the infection at the reversible serous stage. The treatment includes: Antibiotics. [quizlet.com]
Prognosis
[…] swelling. objective to explore the diagnosis and treatment of posttraumatic acute diffuse brain swelling (padbs). retention-enema of bhm combined with ea exerts a good effect in treating acute diffuse peritonitis. objective to study the ct diagnosis and prognosis [imword.com]
Reduced speech discrimination appears to carry a poor prognosis. [otologytextbook.net]
Prognosis Most patients with labyrinthitis recover completely, although it often takes five to six weeks for the vertigo to disappear completely and the patient's hearing to return to normal. In a few cases the hearing loss is permanent. [medical-dictionary.thefreedictionary.com]
[…] weeks postop • Initial good hearing results followed by an increase in the high frequency bone line thresholds • Associated tinnitus and vertigo • Exam – reddish discoloration of the posterior TM • Treatment – ME exploration – Removal of granuloma • Prognosis [docsity.com]
Vestibular function testing: Caloric testing and an electronystagmogram may help in diagnosing difficult cases and in determining the prognosis for recovery. [patient.info]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
C 2 Treatment should be directed at the underlying etiology of the nausea and vomiting. [aafp.org]
Still other treatment ideas are directed at other presumed etiologies. [otologytextbook.net]
When no other etiology is apparent clinically, a pattern of involvement of both the nerve, especially distally within the IAC and the labyrinth, suggests a viral etiology.) FIGURE 117.4. [radiologykey.com]
The precise etiology is often unknown. The infection may be viral, in which case the clinical course is similar to that of vestibular neuronitis. Cases have reportedly been associated with measles and mumps. Bacteria may also cause labyrinthitis. [vertigoexercises.us]
Epidemiology
Prevalence and Epidemiology Bacterial meningitis in children has been reported to cause permanent hearing loss in 10.0% to 13.9%. 1, 2 It is the most common cause of postnatal acquired sensorineural hearing loss. [radiologykey.com]
Causative viruses and bacteria Little direct evidence suggests a viral cause for labyrinthitis; however, a wealth of epidemiologic evidence implicates a number of viruses as potentially causing inflammation of the labyrinth. [emedicine.medscape.com]
Epidemiology Herpes zoster is seen as a disease of older people (most commonly over 60 years old). [ 1 ] However, it can affect all ages, although is rare in children. [patient.info]
An Epidemiologic Study of 17,245 Cases and a Review of the Literature. Otol Neurotol 2003; 24:387-391. [wsiat.on.ca]
Pathophysiology
[…] deep ear pain. edit the segment disease etiology secondary to the limitations of labyrinthitis or otitis media, bacterial or viral toxins into the inner ear caused by vestibular window or snail households. inner ear with congestive edit this paragraph pathophysiology [e.uuuwell.com]
Plan the management of infantile botulism Periodic paralysis Plan the management of acute periodic paralysis Understand the pathophysiology of acute periodic paralysis Postviral Cerebellar Ataxia, Acute Know the etiology and understand the pathophysiology [ahcmedia.com]
The anatomic relationships of the labyrinth, middle ear, mastoid, and subarachnoid space are essential to understanding the pathophysiology of labyrinthitis. [emedicine.medscape.com]
This test is primarily performed to identify the presence of endolymphatic hydrops (the pathophysiologic correlate of Ménière’s disease). [wsiat.on.ca]
II) Pathology and Pathophysiology: Learn the basic pathology and pathophysiology of diseases of the brain, spine, and head and neck. [mir.wustl.edu]
Prevention
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.de]
Prevention The most effective preventive strategy includes prompt treatment of middle ear infections, as well as monitoring of patients with mumps, measles, influenza, or colds for signs of dizziness or hearing problems. [medical-dictionary.thefreedictionary.com]
Earwax not only is pushed out of the ear by skin growth, thereby physically removing microbes from the ear, earwax also contains antimicrobial peptides that prevent bacterial infestation of the ear. [1][5][16][24] Proteins in cerumen chemically prevent [microbewiki.kenyon.edu]
Goals of Treatment Prevent suppurative complications Footnote a-2 Prevent spread of GAS infection to others Footnote a-2 Relieve symptoms Footnote a-2 Non-Pharmacological Interventions Interventions Gargling with warm salt water to relieve pain of sore [canada.ca]