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Cholesteatoma (P)
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1. What is a cholesteatoma?
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A benign tumour of the cochlea
A cystic lesion of keratinising squamous epithelium in the middle ear
A fungal ear infection
A type of otosclerosis
2. What is a typical presenting symptom of cholesteatoma?
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Intermittent tinnitus only
Bilateral hearing loss and dizziness
Persistent offensive ear discharge and hearing loss
Itchy ears without discharge
3. Which age group most commonly presents with congenital cholesteatoma?
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Adults aged 50+
Children aged 2–5
Teenagers
Newborns
4. What physical sign may be seen on otoscopy in cholesteatoma?
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Bulging tympanic membrane
Normal ear canal and membrane
Retraction pocket with keratin debris
Redness of pinna
5. What is the most common complication of untreated cholesteatoma?
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Complete nasal obstruction
Acute tonsillitis
Ossicular erosion and conductive hearing loss
Facial rash
6. Which cranial nerve may be affected by extensive cholesteatoma?
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Olfactory nerve (CN I)
Facial nerve (CN VII)
Trigeminal nerve (CN V)
Accessory nerve (CN XI)
7. What is the diagnostic imaging modality of choice for suspected cholesteatoma?
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MRI brain
CT temporal bones
Plain X-ray skull
Ultrasound
8. What is the primary treatment for cholesteatoma?
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Antibiotic ear drops
Oral steroids
Surgical removal
Hearing aids
9. Which complication may arise from cholesteatoma spreading intracranially?
*
Otitis externa
Acoustic neuroma
Meningitis
Conjunctivitis
10. What is the purpose of regular follow-up in cholesteatoma cases?
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To check cholesterol levels
To monitor for recurrence
To evaluate balance problems
To treat nasal polyps
11. What finding distinguishes acquired from congenital cholesteatoma?
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Presence of keratin debris
Unilateral ear symptoms
History of ear infections or tympanic membrane retraction
Hearing loss
12. What is the main risk factor for acquired cholesteatoma?
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Repeated otitis media and eustachian tube dysfunction
Diabetes
Swimming
High blood pressure
13. Why is hearing loss often a presenting feature in cholesteatoma?
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Outer ear wax build-up
Ossicular chain erosion
Inner ear malformation
Tympanic membrane thickening
14. Which symptom would most likely suggest cholesteatoma over otitis media?
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Bilateral mild hearing loss
Sudden ear pain
Foul-smelling persistent discharge
Fever and sore throat
15. What is the most common location for cholesteatoma formation?
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External auditory canal
Nasopharynx
Pars flaccida of the tympanic membrane
Semicircular canals
16. In children, what screening clue may suggest underlying cholesteatoma?
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Frequent upper respiratory infections
Behavioural problems
Persistent unilateral otorrhoea not responding to treatment
Night-time coughing
17. Which test is used to assess hearing loss in cholesteatoma?
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Visual fields test
Weber and Rinne tests
Whistle Test
Bose Test
18. What does 'safe ear' vs 'unsafe ear' refer to in otology?
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External ear shape
Presence or absence of cholesteatoma
Ability to equalise pressure
Pain threshold during otoscopy
19. What symptom would raise suspicion of facial nerve involvement in cholesteatoma?
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Double vision
Facial asymmetry or weakness
Tingling in toes
Blurred vision
20. What is a common long-term outcome of untreated cholesteatoma?
*
Resolution without treatment
Permanent hearing loss and possible neurological complications
Improved balance
Tinnitus resolution