Question 1

Which patient may be given symptomatic treatment with 24 hours follow-up assessment without initial antibiotic therapy?&#10;A) A 36-month-old with fever of 38.5&#176;C, mild otalgia, and red, non-bulging TM&#10;B) A 4-year-old, afebrile child with bilateral otorrhea&#10;C) A 5-year-old with fever of 38.0&#176;C, severe otalgia, and red, bulging TM&#10;D) A 6-month-old with fever of 39.2&#176;C, poor sleep and appetite and bulging TM

Accepted Answer

The child in option A has mild symptoms and a non-bulging tympanic membrane, which suggest that they may have otitis media with effusion rather than acute otitis media. Symptomatic treatment such as acetaminophen may be given with follow-up in 24 hours to reassess the symptoms. Antibiotics may not be necessary unless symptoms persist or worsen. Options B, C, and D all have symptoms and physical exam findings consistent with acute otitis media and would require initial antibiotic therapy.

Question 2

Which symptoms in children are evaluated using a parent-reported scoring system to determine the severity of pain in children with otitis media? (Select all that apply.)&#10;A) Appetite&#10;B) Difficulty sleeping&#10;C) Level of cooperation&#10;D) Poor hearing&#10;E) Tugging on ears

Accepted Answer

The parent-reported scoring system for evaluating pain severity in children with otitis media often includes symptoms like changes in appetite, difficulty sleeping, and tugging on ears, as these are common indicators of discomfort and pain in young children.

Question 3

A pediatric patient's assessment confirms the patient has otalgia, a fever of 38.8°C, and a recent history of upper respiratory examination. The examiner is unable to visualize the tympanic membranes in the right ear because of the presence of cerumen in the ear canal. The left tympanic membrane is dull gray with fluid levels present. What is the correct action?

A) Perform a tympanogram on the right ear.
B) Recommend symptomatic treatment for fever and pain.
C) Remove the cerumen and visualize the tympanic membrane.
D) Treat empirically with amoxicillin 80 to 90 mg/kg/day.

C

Accepted Answer

DRemoving the cerumen to visualize the tympanic membrane is essential for accurate diagnosis and treatment planning. Treating empirically with amoxicillin is appropriate given the symptoms of otalgia, fever, and the appearance of the left tympanic membrane, suggesting otitis media.

Deck 68: Otitis Media