مساء الخير يا شباب عارف الوقت ضيق على الكل و أنا اولكم بلاش خالص الصياح و العصبية رغم أنه ده مش هيفيد حد اعمل اللي عليك و بس و اترك النتيجة
بما أنه الوقت ضيق فاحسن حاجة تعملها ي أما تخصص يوم لل ear وبس أو تقسمها على الأيام ديي و ابدأ بال external ear بعدين inner ear بعده middle ear لأنه ذاكرناها قبل
لو الوقت أسعفني و قدرت ممكن انزل نوتس مهمة لل mcq بشكل general كنت نزلت قبل كده ع middle ear

■ NOTES on inner ear :-
● Most cases of cochlear  sudden SNHL are idiopathic
● Secretory& intermittent OM & meniere's &Rupture of R.W membrane & wax cause fluctuant H.L  
● Presbycusis is the commonest cause of SNHL in adults
● Both gentamycin & streptomycin sulphate affect firstly vestibular labyrinth before cochlea 
● Meniere disease :
♧ it is common cause of peripheral labyrinthine vertigo
♧ SNHL is initailly reversible then become permenant
♧ In case of dead ear  : labyrinthectomy
♧ sterptomycin it represents a medical labyrinthectomy in toxic cases ( bilateral severe SNHL )
● both  Radiotherapy & electricity may cause CHL or SNHL
● in acoustic trauma the hearing loss max at 5500 hz , while chronic at 4000 hz 
● Acoustic neuroma :
♧ C/P : unilateral SNHL & tinnitus & Vertigo not marked
♧ The earliest neurological manifest is trigeminal
♧ MRI is the most accurate & most diagnostic

■ Tympanogram : -

● ossicular disruption : type Ad ( hypermoile)

● secretory OM : type B ( flat)

● adhesive OM : type C

● E T dysfunction : type C (-ve peak)

● otosclerosis : type As ( restricted curve

● oscillatory in glomus tumor

■ Notes on audiology :
● Poor speech discrimination in acoustic neuroma
●Acoustic ( stapedial) reflex is absent in case of facial paralysis & otosclerosis
● ABR measures electrical acitivity in cochlear nerve & brain stem &  used in detection  acoustic neuroma ( delayed wave V)
● OAEs is used for detection of cochlear pathology ( ototoxicitiy & noise exposure)
● hearing aids are using in case of :
♧ congeintal deafness as CAA
♧ Aquired deafness :
♤ CHL : when operation is CI or refused
♤ SNHL : cochlear otosclerosis , presbyacusis  
● PTA:
♧ it used for selection of hearing aids
♧ when you perform it , mask of non ear test to avoid cross transmission
♧ frequncy : 125 to 8000 Hz , while intensity from -10 to 120 dB
♧ CHL =  increases Ac threshold + normal BC = air bone gap
♧ SNHL = increase both AC & BC threshold ( no air bone gap) 
♧ Mixed = both AC & BC increased but more AC = air- bone gap   

■ NOTE :

● Key words for ear diseases :
https://t.me/med_Notes2/133?comment=122

● Middle ear diseases :
https://t.me/med_Notes2/95

● inner ear diseases :
https://t.me/med_Notes2/138

● Audiology :
https://t.me/med_Notes2/143
https://t.me/med_Notes2/139
https://t.me/med_Notes2/141

مساء الخير
في أكثر من حد بعت ايه أفضل مصدر لل MCQ يكون شامل كل حاجة سواء في الرمد أو ear
الرمد حل من كتاب د.وائل و لل ear حل من كتاب د.مسعد أو القسم

د. مسعد MCQs

By: @AUData_bot

■ NOTES on TTT of glucoma :-

● Both BBs & CAi & brimonidine act on decrease production of aqueous
● PG analogue & adrenaline act on increase outflow of aqueous
● Brimonidine is CI under the age of 2 years
● Acetazolamide is given in case of acute attack of glucoma with high IOP
● Never given BBs at bed time to avoid profound Hypotension
● Betaxolol is selective B blocker  & Increase ON blood flow
● PG consider as 1st line of TTT , while BB as a 2nd line , BB considers as 1st line if there is no CI
● Nerver give adrenaline locally for fear of closed angle glucoma 
● Mannitol is DOC in Acute closure glucoma , but CI in DM
● Trabeculectomy is DOC in case :
Congeintal glucoma , POAG , PACG 

■ Notes on 2ry glucoma :-
● Open angle :
♤Acute iridocyclitis , 2ry iridocyclitis (early non perforated corneal ulcer), Rubeosis iridies
♤ steriods , sublaxation of lens
♤ Hypopyon , hyphema
♤ DR , CRVO
♤ Phacolytic , phacoanaphylactic glucoma
♤ Pseudo- exfoliation, Pigmentry glucoma
● Closed angle :
♧ Ant. Staphyloma, Ant dislocation of lens , leucoma adherent
♧ Mydriate in narrow angle , maligant glucoma
♧ Occlusion , seclusion ( pupilae)
♧ Inversus , phacomorphic (glucoma), PAS
♧  End stage of NVG