Monday, November 11, 2013

11/11/2013

11/11/2013

Answers:
Risk factors for otitis externa include all of the following except.
A) Excess cerumen 
B) Exposure to heat 
C) Excess humidity 
D) Alkaline pH 
E) All of the above are risk factors for OE.

Lack of cerumen is a risk factor for OE, no excess cerumen. Cerumen is acidic and protects the ear from bacterial/fungal growth.

Describe the differences between Grade I, II and III microtia.

-Grade I = mild deformity (often slightly dysmorphic helix/antihelix), all major structures present.
-Grade II = all pinna structures present, but tissue deficiency and significant deformity.
-Grade III = "classic microtia" aka "peanut ear" = few or no recognizable landmarks.



MC Questions:
What is the most common organism responsible for otomycosis?
A) Aspergillus 
B) Candida 
C) Tinea 
D) Coccidio 
E) Pseudomonas

Free Response Question:
What is the classic finding for malignant otitis externa on physical exam?

Quick Facts:
Neoplasms of External Ear and Ear Canal


Basal Cell Carcinoma of Auricle:
-most common neoplasm of auricle (45%)
-chronic long term sun exposure is main cause (particularly UVB)
-Other risks = fair skin, outdoor occupation, hx of skin CA.
-Presents w/ nodular lesion, ulcerated/bleeding. Often on posterior pinna and preauricular area.


Squamous Cell Carcinoma:
-20% of skin cancers
-Risk factors = immunosuppression, old age, nonhealing ulcers, chemical exposure, UV radiation.
-Variable presentation, can be friable plaques, nodules/ulcerations. Often on helix/preauricular region.

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