chronic suppurative otitis media (MCQ)

1) Regarding chronic suppurative otitis media(CSOM)

a. Major cause of acquired hearing impairment in children
b. perforation of the pars tensa is complicated with cholesteatomas
c. Middle ear effusion without tympanic perforation
d. Common during the first 6 years of child's life
e. Caused by Pseudomonas aeuginosa


2) Regarding chronic suppurative otitis media(CSOM)

a. In children, it is due to short Eustachian tube
b. Oral antibiotic is the most preferred treatment.
c. Chronic mastoiditis is a recognized complication
d. Will never cause brain abscess
e. Inhibit language and cognitive development in children.



3) Regarding chronic suppurative otitis media(CSOM)

a) Patient may complaint of ear fullness due to chronic ear discharge
b) Conductive hearing loss is not a complication.
c) can be treated with aural toilet
d) Tympanoplasty is contraindicated.
e) Reconstructive ear surgery may cause total deafness


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Stridor History mnemonic (SPECSR)

S: severity: parents subjective impression regarding the severity of the obstruction

P: progression of the obstruction over time

E: eating or feeding difficulties, aspiration, and failure to thrive

C: cyanotic episodes, apparent life-threatening events

S: sleep—obstruction so severe that retractions occur even during sleep

R: radiology—specific radiologic abnormalities

Source: Hammer J “Acquired upper airway obstruction”, Paediatr Respir Rev 5:25–33, (2004)

“5R” Indication for Tracheostomy

1) Respiratory obstruction

2) Respiratory failure

3) Respiratory paralysis

4) Removal of retain secretion

5) Reduction of anatomical dead space

Type of Thyroid ca

1) Well differentiated malignant neoplasm (85% of all ca)

a) Papillary thyroid ca

- Occult

- Intrathyroidal

- Extrathyroidal

b) Follicular thyroid ca

c) Hurthle ca thyroid ca

2) Aggressive variant

a) Medullary (parafollicular c-cell)

- Sporadic

- Family trait

i) Sipple syndrome

ii) Wermer syndrome

- Anaplastic

3) Other tumor

a) Lymphoma (pre exist hashimoto thyroiditis, Graves disease)

b) Metastatic (melanoma, lung, kidney, breast, colon)

Indication for Thyroidectomy

Thyrotoxicosis

Medication failure

Compressive syndrome

Malignancy

Cosmetic

Laryngotectomy