Jolly-Radiology and ENT Clinic Overview
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Questions and Answers

Which specialty does Dr. Bhamjee practice?

  • Pediatrics
  • Dermatology (correct)
  • Otolaryngology
  • Gastroenterology
  • Who is responsible for the DERM outreach clinics on the specified days?

  • Dr. R. Forde (correct)
  • Miss G. Clarke
  • Dr. Thomas
  • Mr. C. Maynard
  • What is the schedule for self-study for group B?

  • 1:00 PM on Tuesdays (correct)
  • 2:00 PM on Thursdays
  • 1:00 PM on Fridays
  • 1:00 PM on Wednesdays
  • What is the main risk associated with cholesteatoma?

    <p>Life-threatening complications</p> Signup and view all the answers

    Which is a potential complication of cholesteatoma?

    <p>Facial nerve palsy</p> Signup and view all the answers

    What is the typical treatment option for patients medically fit to undergo it?

    <p>Modified radical mastoidectomy</p> Signup and view all the answers

    What type of organisms are commonly involved in infections associated with cholesteatoma?

    <p>Gram-negative organisms and anaerobes</p> Signup and view all the answers

    What condition may arise from chronic suppurative otitis media and is characterized by lateral rectus palsy?

    <p>Gradenigo's syndrome</p> Signup and view all the answers

    Which condition is NOT directly mentioned as a complication of cholesteatoma?

    <p>Eustachian tube dysfunction</p> Signup and view all the answers

    What type of cholesteatoma develops from trapped congenital squamous epithelial rests?

    <p>Congenital cholesteatoma</p> Signup and view all the answers

    What should be optimized before surgical intervention for a cholesteatoma?

    <p>Ear swab culture and sensitivity</p> Signup and view all the answers

    What is the most common organism responsible for malignant otitis externa?

    <p>Pseudomonas aeruginosa</p> Signup and view all the answers

    In which population is malignant otitis externa most frequently found?

    <p>Elderly diabetics</p> Signup and view all the answers

    Which cranial nerve is most frequently affected by malignant otitis externa complications?

    <p>Facial nerve</p> Signup and view all the answers

    What symptom is typically seen in patients with malignant otitis externa?

    <p>Purulent otorrhoea</p> Signup and view all the answers

    How does microangiopathy affect treatment outcomes in diabetic patients with malignant otitis externa?

    <p>It causes tissue ischemia</p> Signup and view all the answers

    What characteristic feature is commonly observed in the external auditory canal of a patient with malignant otitis externa?

    <p>Granulation tissue</p> Signup and view all the answers

    Which of the following is NOT a typical complication of untreated malignant otitis externa?

    <p>Chronic sinusitis</p> Signup and view all the answers

    What type of hearing loss is commonly associated with malignant otitis externa?

    <p>Conductive hearing loss</p> Signup and view all the answers

    What type of hearing loss is associated with otitis externa?

    <p>No significant hearing loss</p> Signup and view all the answers

    Which symptom is indicative of acute otitis media rather than acute otitis externa?

    <p>Presence of mucopurulent discharge</p> Signup and view all the answers

    What is a common source of obstruction to the eustachian tube in children?

    <p>Adenoidal hyperplasia</p> Signup and view all the answers

    What is the effect of nasopharyngeal carcinoma on the eustachian tube?

    <p>Obstructs the ostium of the eustachian tube</p> Signup and view all the answers

    Which function of the eustachian tube is compromised during dysfunction?

    <p>Drainage of middle ear secretions</p> Signup and view all the answers

    Which of the following accurately describes pain in acute otitis externa?

    <p>Significant pain on palpation</p> Signup and view all the answers

    What characterizes the discharge associated with acute otitis media?

    <p>Mucopurulent</p> Signup and view all the answers

    What is the primary reason for dysfunction of the eustachian tube?

    <p>Obstruction and/or infection</p> Signup and view all the answers

    What percentage of all malignancies found in the nasopharynx is comprised of nasopharyngeal carcinoma?

    <p>90%</p> Signup and view all the answers

    Which ethnic group has the highest incidence of nasopharyngeal carcinoma?

    <p>Cantonese Chinese</p> Signup and view all the answers

    What is the male to female ratio for nasopharyngeal carcinoma?

    <p>2-3:1</p> Signup and view all the answers

    In which region is the incidence of nasopharyngeal carcinoma significantly lower than in Southeast Asia?

    <p>North America</p> Signup and view all the answers

    What is the aetiology of nasopharyngeal carcinoma primarily attributed to?

    <p>Viral, genetic, and environmental factors</p> Signup and view all the answers

    At what age range does the incidence of nasopharyngeal carcinoma typically peak in high-risk regions?

    <p>Fourth decade</p> Signup and view all the answers

    In low-risk countries, what demographic shows a high proportion of nasopharyngeal carcinoma cases?

    <p>Adolescents in the second decade of life</p> Signup and view all the answers

    What should clinicians maintain regarding nasopharyngeal carcinoma to avoid missing cases?

    <p>An elevated index of suspicion</p> Signup and view all the answers

    Study Notes

    ENT Clinics and Schedule

    • Jolly-Radiology and ENT Clinic sessions are segmented into two groups, A and B.
    • Dr. R. Forde oversees the DERM outreach clinics, occurring weekly for all students.
    • DERM clinics at various locations are held on designated Tuesdays and Fridays throughout the month.

    Otitis Externa vs. Otitis Media

    • Otitis Externa:

      • Severe otalgia that does not decrease with otorrhoea onset.
      • Otorrhoea without mucus.
      • Mild hearing loss.
      • Significant pain when pressing on the tragus or moving the pinna.
    • Otitis Media:

      • Otalgia reduces significantly with early onset of otorrhoea.
      • Discharge is mucopurulent.
      • Mild to moderate hearing loss.
      • Pain is unrelated to pinna movement.

    Pathogenesis of Middle Ear Infections

    • Dysfunction of the eustachian tube leads to:

      • Poor middle ear ventilation.
      • Pressure imbalance with atmospheric pressure.
      • Accumulation of middle ear secretions.
      • Risk of nasopharyngeal infections ascending via the eustachian tube.
    • Common causes of eustachian tube obstruction include:

      • Adenoidal hyperplasia in children.
      • Congenital cysts.
      • Angiofibromas in male teenagers, potentially leading to severe epistaxis.
      • Nasopharyngeal carcinoma, which may obstruct eustachian tube drainage.

    Cholesteatoma

    • Cholesteatoma can arise from:

      • Penetrating injuries or surgical procedures affecting the tympanic membrane.
      • Congenital cohort, where epithelial rests are trapped.
    • Complications of cholesteatoma:

      • Hearing loss due to ossicular disruption and middle ear exudate.
      • Facial nerve palsy and various abscess formations.
      • Potential for meningitis and intracranial complications.

    Malignant Otitis Externa

    • Often occurs in elderly diabetics, characterized by:

      • Purulent otorrhoea and disproportionate otalgia, worsened at night.
      • Granulation tissue at the osseo-cartilaginous junction in the external auditory canal.
      • Conductive hearing loss.
    • Pseudomonas aeruginosa is frequently implicated as the causative organism.

    • Affected cranial nerves may lead to complications like osteomyelitis.

    Nasopharyngeal Carcinoma

    • A malignant epidermoid tumor, predominantly found in specific ethnic groups such as Cantonese Chinese.

    • Incidence rates vary regionally, with high rates in Southern China compared to low rates in Caucasians.

    • Key statistics:

      • Hong Kong: 26 per 100,000 males.
      • Jamaica: 1.4 per 100,000 males; 0.5 for females.
      • Incidence peaks in the 4th decade of life in high-risk areas.
    • Aetiology involves genetic, viral, and environmental factors, highlighting the complex nature of carcinogenesis in this type of cancer.

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    Description

    This quiz focuses on the operations and features of Jolly-Radiology and the ENT Clinic. It includes information about doctors involved and their respective group consultations. It's designed to test your knowledge of clinic management and radiology services.

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