Monday, November 18, 2013

11/18/2103

11/18/2013

Answers:
All of the following are true with regards to congenital cholesteatomas except...
A) Often discovered incidentally 
B) Does not usually present with TM perf 
C) Patients w/ congenital cholesteatoma tend to have well aerated mastoids 
D) Can present in anterior or posterior quadrants 
E) All of the above are true

All answer choices are true with regards to congenital cholesteatomas.

Where are congenital cholesteatomas "classically" found? What do they look like on otoscope exam?

1. "Classically” in anterosuperior quadrant of mesotympanum (27-67%)
2. Small pearls next to long process of malleus


MC Questions:
How many episodes of AOM are required to diagnose "recurrent AOM"?
A) 2 in 6 months with complete resolution of symptoms 
B) 4 in six months without complete resolution of symptoms 
C) 4 in one year with complete resolution of symptoms 
D) 2 in one year without complete resolution of symptoms 
E) None of the above

Free Response Question:
Name an example of both functional and anatomic eustachian tube dysfunction.

Quick Facts:
Pathogenesis of AOM/OME
-All forms of OM due to Eustachian tube dysfunction.
-Eustachian tube aerates middle ear and has mucociliary clearance role.
-Obstruction of eustachian tube can by functional (failure of tensor veli palatini to contract) or anatomic (adenoid hypertrophy).
-Most AOM preceded by viral infection, but bacterial component is in majority.
-Most common pathogens = Strep pneumo, H. flu, Moraxella catarrhalis.
-OME develops after untreated/unresolved AOM.
-Persistent effusion present in 40% of kids after first AOM one month later (10% @ 3 months)
-Risk factors for AOM/OME = parental smoking, absence of breast feeding, day care attendance, craniofacial anomalies, adenoid hypertrophy and allergic rhinitis.

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