CME Quiz On Malignant Otitis Externa

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  • 1/20 Questions

    Malignant otitis externa is commonly seen in

    • Hypertensives
    • Diabetics
    • Patients with chronic renal failure
    • Patients with hepatic failure
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Take a quiz on the topic "Malignant otitis externa."
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CME Quiz On Malignant Otitis Externa - Quiz

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  • 2. 

    Majority of patients affected with malginant otitis externa are

    • Infants

    • Teens

    • Elderly

    • Middle aged inviduals

    Correct Answer
    A. Elderly
    Explanation
    Malignant otitis externa is a severe infection of the ear canal that typically affects older individuals. This condition is more common in elderly patients due to factors such as weakened immune systems, chronic illnesses, and decreased mobility, which make them more susceptible to infections. Additionally, elderly individuals may have conditions like diabetes or a compromised immune system, which further increases their risk. Therefore, the correct answer is "Elderly."

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  • 3. 

    Malignant otitis externa is

    • An inflammatory condition

    • Malignancy involving external auditory canal

    • Cholesteatoma of external auditory canal

    • Otomycosis of extenal auditory canal

    Correct Answer
    A. An inflammatory condition
    Explanation
    Malignant otitis externa refers to an inflammatory condition that affects the external auditory canal. It is characterized by severe and persistent ear pain, often accompanied by discharge, hearing loss, and swelling. This condition is not a malignancy or cholesteatoma (a noncancerous growth in the middle ear), nor is it otomycosis (a fungal infection of the external auditory canal). Instead, it is an inflammatory process that can be caused by bacterial infection, typically affecting older individuals with compromised immune systems. Treatment typically involves aggressive antibiotic therapy to control the infection and reduce inflammation.

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  • 4. 

    Causative organism of malignant otitis externa is

    • Staph aureus

    • Beta hemolytic streptoccoi

    • Pneumococci

    • Pseudomonas

    Correct Answer
    A. Pseudomonas
    Explanation
    The correct answer is Pseudomonas. Malignant otitis externa is a severe infection of the external ear canal that can spread to the surrounding tissues and bones. Pseudomonas aeruginosa is the most common causative organism for this condition. It is a gram-negative bacterium known for its ability to cause infections in immunocompromised individuals and those with chronic diseases. Pseudomonas is often found in moist environments and can easily infect the ear canal through breaks in the skin or after swimming. It produces toxins that can cause tissue damage and lead to the characteristic symptoms of malignant otitis externa.

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  • 5. 

    The term malignancy is used in the terminology to 

    • Indicate the histological malignancy

    • Indicate the increased rate of complications

    • Indicate future malignant transformation

    • Since it is similar to basal cell carcinoma

    Correct Answer
    A. Indicate the increased rate of complications
    Explanation
    The term malignancy is used in the terminology to indicate the increased rate of complications. Malignancy refers to the presence of cancerous cells that have the potential to invade and spread to other parts of the body. When a condition or disease is described as malignant, it means that it has a higher likelihood of causing complications or adverse outcomes. This term is commonly used in the medical field to differentiate between benign conditions, which have a lower risk of complications, and malignant conditions, which have a higher risk.

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  • 6. 

    MRI scanning in these patients are useful

    • In studying bone involvement

    • In studying soft tissue involvment

    • In studying the vascularity of the lesion

    • In studying adequacy of treatment

    Correct Answer
    A. In studying soft tissue involvment
    Explanation
    MRI scanning is useful in studying soft tissue involvement in these patients. MRI is a non-invasive imaging technique that uses strong magnetic fields and radio waves to generate detailed images of the body's soft tissues. It provides high-resolution images that can help identify and evaluate soft tissue abnormalities, such as tumors, inflammation, or infection. By visualizing the soft tissues, MRI can aid in the diagnosis and monitoring of various conditions, allowing healthcare professionals to assess the extent of soft tissue involvement and plan appropriate treatment strategies.

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  • 7. 

    Difference between stage ii and stage iii malignant otitis externa is

    • Positive Gallium 67 scan and negative TC 99 scan

    • Extensive skull base osteomyelitis

    • Positive Gallium 67 scan and negative TC 99 scan

    Correct Answer
    A. Extensive skull base osteomyelitis
    Explanation
    The correct answer is "Extensive skull base osteomyelitis." This is because stage II malignant otitis externa is characterized by the spread of infection to the temporal bone and surrounding soft tissues, while stage III malignant otitis externa involves extensive skull base involvement, including osteomyelitis. The presence of extensive skull base osteomyelitis is a differentiating factor between stage II and stage III malignant otitis externa. The other options mentioned, positive Gallium 67 scan and negative TC 99 scan, are repeated and do not provide a valid explanation.

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  • 8. 

    Efficacy of treatment can be judged by performing

    • CT scan

    • MRI

    • Conventional radiographs

    • Serial Ga 67 scans

    Correct Answer
    A. Serial Ga 67 scans
    Explanation
    Serial Ga 67 scans can be used to judge the efficacy of treatment. Ga 67 is a radiopharmaceutical agent that is used in nuclear medicine imaging. It accumulates in areas of inflammation and infection in the body. By performing serial Ga 67 scans, the healthcare provider can track the changes in inflammation or infection over time, which can help in evaluating the effectiveness of the treatment. This is particularly useful in conditions such as cancer or certain types of infections where monitoring the response to treatment is crucial. CT scan, MRI, and conventional radiographs are also imaging techniques but may not specifically assess inflammation or infection.

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  • 9. 

    Otoscopic findings of malignant otitis externa include:

    • Granulation tissue at the bony cartilaginous junction

    • Perforation of ear drum

    • External auditory canal skin soggy and oedematous

    • Attic perforation

    Correct Answer(s)
    A. Granulation tissue at the bony cartilaginous junction
    A. External auditory canal skin soggy and oedematous
    Explanation
    The correct answer is granulation tissue at the bony cartilaginous junction and external auditory canal skin soggy and oedematous. Malignant otitis externa is a severe infection of the external ear canal that can spread to the surrounding bone and tissues. Granulation tissue at the bony cartilaginous junction indicates tissue damage and inflammation. The external auditory canal skin being soggy and oedematous suggests swelling and fluid accumulation, which are common signs of infection. Perforation of the eardrum and attic perforation may occur in severe cases but are not specific findings for malignant otitis externa.

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  • 10. 

    Features of malignant otitis externa are

    • Common in elderly

    • Common in diabetics

    • Inflammation involving external auditory canal

    • Malignant lesion involving the external auditory canal

    • Females outnumber males

    Correct Answer(s)
    A. Common in elderly
    A. Common in diabetics
    A. Inflammation involving external auditory canal
    Explanation
    Malignant otitis externa is a serious infection of the external auditory canal, typically caused by the bacteria Pseudomonas aeruginosa. It is more commonly seen in elderly individuals and those with diabetes, as their immune systems may be compromised. The infection causes inflammation in the external auditory canal, leading to symptoms such as pain, discharge, and hearing loss. The term "malignant" does not refer to a cancerous lesion, but rather the aggressive and potentially life-threatening nature of the infection. There is no mention of females outnumbering males in the features of malignant otitis externa.

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  • 11. 

    Levenson's criteria for diagnosis of malignant otitis externa include

    • Refractory otitis externa

    • Refractory otitis media

    • Severe nocturnal otalgia

    • Purulent otorrhoea

    • Granulation tissue in external canal

    • Growth of pseudomonas from external canal

    • Growth of streptococci from external canal

    • Presence of diabetes

    Correct Answer(s)
    A. Refractory otitis externa
    A. Severe nocturnal otalgia
    A. Purulent otorrhoea
    A. Granulation tissue in external canal
    A. Growth of pseudomonas from external canal
    A. Presence of diabetes
    Explanation
    The correct answer includes the criteria for diagnosing malignant otitis externa according to Levenson. These criteria include refractory otitis externa, severe nocturnal otalgia, purulent otorrhoea, granulation tissue in the external canal, growth of pseudomonas from the external canal, and the presence of diabetes.

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  • 12. 

    Role of conventional radiology in these patients is

    • To identify intracranial extension

    • To identify bony erosion

    • It is of no use

    • To identify involvement of parotid gland

    Correct Answer
    A. It is of no use
    Explanation
    The role of conventional radiology in these patients is deemed to be of no use. This means that using conventional radiology techniques would not provide any valuable information or aid in identifying any of the mentioned aspects, such as intracranial extension, bony erosion, or involvement of the parotid gland. Therefore, alternative imaging modalities or diagnostic methods may be necessary to assess these specific conditions in patients.

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  • 13. 

    Category of patients affected with malignant otitis externa are

    • Diabetics

    • Hypertensives

    • Pts with blood cancer

    • Pts on anticancer drugs

    • Pts with HIV infections

    • Pts with hepatitis

    Correct Answer(s)
    A. Diabetics
    A. Pts with blood cancer
    A. Pts on anticancer drugs
    A. Pts with HIV infections
    Explanation
    The category of patients affected with malignant otitis externa includes diabetics, patients with blood cancer, patients on anticancer drugs, and patients with HIV infections. These individuals are more susceptible to developing malignant otitis externa due to their weakened immune systems and compromised health conditions. Malignant otitis externa is a severe infection of the external ear canal that can spread to the surrounding tissues and bones, leading to serious complications. Therefore, it is important for healthcare professionals to be aware of these risk factors and provide appropriate care and management for these patients.

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  • 14. 

    Pseudomonas otitis externa was first described by

    • Meltzer

    • Chandler

    • Kerry

    • Levenson

    Correct Answer
    A. Meltzer
    Explanation
    Pseudomonas otitis externa is a type of ear infection caused by the bacterium Pseudomonas aeruginosa. The correct answer, Meltzer, suggests that Meltzer was the first person to describe this specific type of ear infection caused by Pseudomonas aeruginosa.

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  • 15. 

    Spread of infection from malignant otitis externa occurs

    • Inferiorly through stylomastoid foramen involving facial nerve

    • Anteriorly to parotid

    • Posteriorly to submandibular gland

    • Posteriorly to mastoid and sigmoid sinus

    • Medially to sphenoid

    • Spread via vascular channels

    Correct Answer(s)
    A. Inferiorly through stylomastoid foramen involving facial nerve
    A. Anteriorly to parotid
    A. Posteriorly to mastoid and sigmoid sinus
    A. Medially to sphenoid
    A. Spread via vascular channels
    Explanation
    The spread of infection from malignant otitis externa can occur through multiple routes. The infection can spread inferiorly through the stylomastoid foramen, involving the facial nerve. It can also spread anteriorly to the parotid gland, posteriorly to the mastoid and sigmoid sinus, and medially to the sphenoid bone. Additionally, the infection can spread via vascular channels, allowing it to spread throughout the body.

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  • 16. 

    Diabetics are predisposed to malignant otitis externa because

    • They have impaired phagocytosis

    • They secrete wax which is less in lysosome content

    • Impaired intracellular digestion of bacteria

    Correct Answer(s)
    A. They have impaired phagocytosis
    A. They secrete wax which is less in lysosome content
    A. Impaired intracellular digestion of bacteria
    Explanation
    Diabetics are predisposed to malignant otitis externa due to multiple factors. Firstly, they have impaired phagocytosis, which means their immune system is less effective at engulfing and destroying bacteria. Secondly, they secrete wax that has lower lysosome content, which is an enzyme that helps in breaking down bacteria. Lastly, diabetics have impaired intracellular digestion of bacteria, meaning their cells are less efficient at breaking down and eliminating bacteria. These factors collectively increase the susceptibility of diabetics to develop malignant otitis externa.

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  • 17. 

    Features of Stage I of malignant otitis externa include:

    • Soft tissue otitis

    • Positive Gallium 67 scan and negative TC 99 scan

    • Positive Gallium 67 and positive TC 99 scans

    • Skull base osteomyelitis

    Correct Answer(s)
    A. Soft tissue otitis
    A. Positive Gallium 67 scan and negative TC 99 scan
    Explanation
    Stage I of malignant otitis externa is characterized by soft tissue otitis, which refers to inflammation of the soft tissues in the external ear canal. In addition, a positive Gallium 67 scan indicates active inflammation or infection, while a negative TC 99 scan suggests no evidence of bone involvement. Therefore, the combination of soft tissue otitis, positive Gallium 67 scan, and negative TC 99 scan is consistent with the features of Stage I malignant otitis externa.

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  • 18. 

    Features of Stage II malignant otitis externa

    • Skull base osteomyelitis

    • Positive Ga 67 and positive TC 99 scans

    • Positive Gallium 67 scan and negative TC 99 scan

    Correct Answer(s)
    A. Skull base osteomyelitis
    A. Positive Ga 67 and positive TC 99 scans
    Explanation
    The features of Stage II malignant otitis externa include skull base osteomyelitis and positive Ga 67 and positive TC 99 scans. This means that there is an infection and inflammation of the skull base bone, and both the Ga 67 and TC 99 scans show evidence of this infection. The Ga 67 scan is positive, indicating increased uptake of the radioactive material in the affected area, while the TC 99 scan is also positive, suggesting the presence of infection.

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  • 19. 

    Pathogenicity of pseudomonas is due to

    • Its ability to secrete exotoxin

    • Secrete enzyme lecithinase

    • Secretes hydrochloric acid

    • Secretes proteases

    • Secretes lipase

    • Organism is clothed by mucin

    Correct Answer(s)
    A. Its ability to secrete exotoxin
    A. Secrete enzyme lecithinase
    A. Secretes proteases
    A. Secretes lipase
    A. Organism is clothed by mucin
    Explanation
    The pathogenicity of pseudomonas is due to its ability to secrete exotoxin, secrete enzyme lecithinase, secrete proteases, secrete lipase, and the fact that the organism is clothed by mucin. These factors contribute to the ability of pseudomonas to cause infections and damage host tissues. The exotoxin, lecithinase, proteases, and lipase help the organism to break down and invade host cells, while the mucin provides a protective covering for the organism. Overall, these characteristics enhance the virulence of pseudomonas and enable it to cause disease.

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  • 20. 

    What are the clinical features of malignant otitis externa?

Quiz Review Timeline (Updated): Mar 20, 2023 +

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  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Aug 07, 2011
    Quiz Created by
    Drtbalu
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