Paediatric infections: acute otitis media: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric infections: acute otitis media

Sample item

A 4-year-old has ear pain and fever, with a bulging, red tympanic membrane. Which treatment is recommended in the usual case?

AOral metronidazoleBTopical antibiotic drops alone with no oral therapy for a bulging drumCOral amoxicillin and analgesia, with watchful waiting acceptable in older children with mild diseaseDIntravenous vancomycin

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Oral amoxicillin and analgesia, with watchful waiting acceptable in older children with mild disease

Amoxicillin is first-line for acute otitis media for 5 to 10 days, and watchful waiting is acceptable in older children with mild unilateral disease. Analgesics are given for pain.

Option by option

A. Oral metronidazole
Metronidazole does not cover the common organisms.
B. Topical antibiotic drops alone with no oral therapy for a bulging drum
Topical drops do not treat the middle ear with intact drum.
C. Oral amoxicillin and analgesia, with watchful waiting acceptable in older children with mild disease (correct)
Correct. Amoxicillin or observation with analgesia fits.
D. Intravenous vancomycin
IV vancomycin is not needed in uncomplicated disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Oral amoxicillin and analgesia, with watchful waiting acceptable in older children with mild disease. Amoxicillin is first-line for acute otitis media for 5 to 10 days, and watchful waiting is acceptable in older children with mild unilateral disease.

Why is "Oral metronidazole" not the answer?

Metronidazole does not cover the common organisms.

Why is "Topical antibiotic drops alone with no oral therapy for a bulging drum" not the answer?

Topical drops do not treat the middle ear with intact drum.

Why is "Intravenous vancomycin" not the answer?

IV vancomycin is not needed in uncomplicated disease.

What concept does this question test?

It tests Paediatric infections: acute otitis media in Pediatrics. Analgesics are given for pain.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric infections: acute otitis media?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.