Question 1

Which of the following classes of drugs may produce SSHL?

Accepted Answer

Drugs that can cause SSHL are loop diuretics,aminoglycoside anti-infectives,and antineoplastic agents.

Question 2

The number one cause of vertigo is _____.

Accepted Answer

BPPV is the number one cause of vertigo,accounting for approximately 20% of all cases.

Question 3

A home remedy for ear pain is _____.

Accepted Answer

Sweet olive oil is a home remedy for ear pain.

Question 4

What role does fluoride play in otosclerosis?

Accepted Answer

The incidence of otosclerosis is lower in areas that have fluoridated drinking water,according to some epidemiological studies.Fluoride increases bone density by increasing bone mineralization.

Question 5

What produces BPPV?

Accepted Answer

Otoliths are calcium carbonate crystals found in the utricle and saccule of the inner ear.When otoliths dislodge,the debris moves to the lowest part of the posterior semicircular canal each time the head shifts position.The shifting of the otoliths produces vertigo,nausea,and nystagmus.

Question 6

The treatment of choice for BPPV is _____.

Accepted Answer

Physical therapy is the treatment of choice for BPPV.

Question 7

Which of the following drugs is used to help with symptom relief when tinnitus is severe?

Accepted Answer

Medications may produce some symptom relief if tinnitus is severe.Drugs that have been used are benzodiazepines (see Chapter 5)and tricyclic antidepressants (see Chapter 6).

Question 8

Drug treatments for sudden sensorineural hearing loss include all of the following except _____.

Accepted Answer

Treatment of SSHL involves the use of glucocorticosteroids (see Chapter 15).The best response occurs when hearing loss is moderate.Mild hearing loss resolves spontaneously without treatment,and no benefit is observed when hearing loss is severe.Vasodilating drugs and plasma expanders (e.g. ,normal saline,5% glucose)may also be prescribed.

Question 9

Which of the following can be used to treat otalgia?

Accepted Answer

Ear pain,also called auralgia or otalgia,is a symptom of otitis externa,otitis media,swimmer's ear,and many other disorders,including viral myringitis,temporomandibular joint (TMJ)disorders,referred pain from abscessed teeth,and more.It is treated by administration of topical analgesics,local anesthetics,and/or oral analgesics.

Question 10

Which of the following lifestyle changes could be made to help in the treatment of Ménière's disease?

Accepted Answer

Reducing sodium,caffeine,nicotine,and alcohol consumption may be helpful.A low-sodium diet and lifestyle changes that restrict alcohol consumption are useful for the treatment of Ménière's disease.Physical therapy is the treatment of choice for BPPV.

Question 11

Which drug can be used but is controversial for the treatment of Ménière's disease because of possible ototoxicity?

Accepted Answer

Aminoglycoside anti-infectives such as gentamicin and streptomycin are sometimes used,but their use is controversial because they can cause ototoxicity.

Question 12

Why would antihistamines be prescribed to help treat vertigo?

Accepted Answer

When drug therapy is indicated,antihistamines are most widely prescribed.This is most likely because centrally acting antihistamines have anticholinergic actions that can moderate symptoms of motion sickness.Acetylcholine and histamine are excitatory neurotransmitters involved in the control of vomiting (emesis).Nausea and vomiting are common symptoms of vertigo.Moreover,antihistamines and anticholinergics are vestibular suppressants.Vestibular suppression is useful because it reduces the eye activity responsible for symptoms of vertigo.Administration of vestibular suppressants is not recommended when treatment for vertigo involves physical manipulation of the head and "retraining" of vestibular pathways.

Question 13

_____ is a chronic inner ear disease associated with intermittent buildup of fluid in the inner ear.

Accepted Answer

Ménière's disease is the second most common cause of vertigo.It is a chronic inner ear disease associated with intermittent buildup of fluid in the inner ear.

Question 14

Which of the following is not a cause of sudden sensorineural hearing loss (SSHL)?

Accepted Answer

The exact cause of SSHL is unknown;however,it may be caused by a viral infection,vascular disorder,tumor,or rupture of the inner ear membrane,or it may be drug induced.

Question 15

Agents used to remove excess cerumen,or earwax,are called _____.

Accepted Answer

Agents used to remove excess cerumen are called ceruminolytics.

Question 16

Which of the following drugs can be used to treat autoimmune hearing loss?

Accepted Answer

Autoimmune diseases like multiple sclerosis can cause SSHL,but sometimes autoimmune hearing loss occurs in the absence of any other disease.Progression occurs over several months and hearing loss may occur in both ears.Glucocorticosteroids such as prednisone are used in treatment (see Chapter 15).

Question 17

One of the most common causes of drug-induced tinnitus is _____.

Accepted Answer

Alcohol and salicylates (aspirin)are the most common cause of drug-induced tinnitus.

Question 18

When drug therapy is indicated for vertigo,which drug may be prescribed?

Accepted Answer

Many of the treatments for vertigo,Ménière's disease,and other balance disorders do not involve drug therapy.When drug therapy is indicated,antihistamines are most widely prescribed.

Question 19

Which of the following is an over-the-counter (OTC)drug used to remove earwax?

Accepted Answer

Carbamide peroxide 6.5% (OTC)and triethanolamine polypeptide oleate-condensate (OTC in Canada)are agents available to remove earwax.

Question 20

Which of the following will probably not cause vertigo?

Accepted Answer

Vertigo is a balance disorder that is caused by a neural mismatch or sensory conflict.When our eyes tell us our body should be moving,yet our body remains still,such as when we watch a movie of a roller coaster,a sensory conflict occurs.Similarly,when we read a book in a car that is moving,our inner ear and skin receptors tell us we are in motion,yet our eyes are fixed on the book that is not moving.Once again,a sensory conflict occurs.Motion may also produce vertigo.

Quiz 19: Treatment of Disorders of the Ear