Immunology Review Corner

Chapter 79 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al.

Prepared by Drs. Karla R. Davis, Landstuhl Regional Medical Center in German, and Soo Kim-Delio, Walter Reed Army Medical Center.

Chapter 79: Otitis Media

1. At one month following the first episode of acute otitis media, what percent of children still have a middle ear effusion?
A. 10 percent
B. 20 percent
C. 40 percent
D. 7 percent

2. Which of the following host-related factors is associated with a higher incidence of acute otitis media?
A. African American ethnicity
B. Birth at less than 33 weeks estimated gestational age
C. Female gender
D. Onset of first episode of acute otitis media after 12 months of age

3. Which of the following occurs more frequently in children with recurrent acute otitis media than in healthy controls?
A. HLA-A2
B. HLA-A3
C. Active opening function of the Eustachian tube
D. High tubal resistance of the Eustachian tube

4. Which of the following has been associated with an increased risk for ear disease in early childhood?
A. Bacterial colonization of pacifiers
B. Birth order: firstborn child status
C. Breastfeeding
D. Increased saliva cotinine

5. What is the most common intratemporal complication of Otitis Media?
A. Meningitis
B. Hearing loss
C. Facial nerve paralysis
D. Cholesteatoma

6. Viruses may play a role in secondary bacterial infections and otitis media. Which of the following viruses has been shown to depress granulocytic function and cell-mediated immunity?
A. Coxsackie A virus
B. Influenza virus
C. Rhinovirus
D. Respiratory syncytial virus

7. What is the most common complication associated with tympanostomy tubes?
A. Tympanosclerosis
B. Persistent perforation
C. Cholesteatoma
D. Otorrhea

8. A 3-year-old child presents with otalgia, fever, postauricular erythema, tenderness, and swelling. What diagnosis should you be most concerned about?
A. Meningitis
B. Coalescent mastoiditis
C. Infected cholesteatoma
D. Perforated tympanic membrane

9. What is the major human rhinovirus receptor?
A. VLA-1
B. ICAM-1
C. ICAM-3
D. E-Selectin

10. Which is the most common intracranial complication of otitis media?
A. Epidural abscess
B. Facial nerve paresis
C. Mastoiditis
D. Meningitis

Answers:
1. C, page 1437
2. B, page 1438
3. A, page 1439
4. D, page 1440
5. B, page 1450
6. B, page 1445
7. D, page 1450
8. B, page 1450
9. B, page 1443
10. D, pages 1450-1451