Otology: complications of otitis media: practice question

A ENT 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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ENT · Otology: complications of otitis media

Sample item

A 4-year-old has had a discharging ear and fever for two weeks. Now there is a tender swelling behind the ear, the pinna is pushed forward and downward, and the postero-superior meatal wall sags. What is the diagnosis and the treatment?

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

The answer and the reasoning

D. Acute coalescent mastoiditis, treated with intravenous antibiotics and cortical mastoidectomy if there is no prompt response or an abscess forms

Acute mastoiditis follows acute otitis media when infection breaks down the mastoid air cell septa. Features are postauricular swelling and erythema, displacement of the pinna forward and downward, tenderness over the mastoid and sagging of the postero-superior meatal wall. Management is intravenous antibiotics with myringotomy, and cortical mastoidectomy for a subperiosteal abscess or failure to improve. Intracranial spread must be excluded.

Option by option

  • A. Branchial cyst, treated with excision

    A branchial cyst is a painless neck swelling at the anterior border of the sternocleidomastoid.

  • B. Otitis externa, treated with ear drops only

    Otitis externa causes pain on moving the pinna and a swollen canal, without a retroauricular abscess.

  • C. Bell's palsy, treated with prednisolone

    Bell's palsy causes facial weakness and does not produce a mastoid swelling.

  • D. Acute coalescent mastoiditis, treated with intravenous antibiotics and cortical mastoidectomy if there is no prompt response or an abscess forms (correct)

    Correct. The picture is typical of mastoid abscess formation after otitis media.

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.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Acute coalescent mastoiditis, treated with intravenous antibiotics and cortical mastoidectomy if there is no prompt response or an abscess forms. Acute mastoiditis follows acute otitis media when infection breaks down the mastoid air cell septa.

Why is "Branchial cyst, treated with excision" not the answer?

A branchial cyst is a painless neck swelling at the anterior border of the sternocleidomastoid.

Why is "Otitis externa, treated with ear drops only" not the answer?

Otitis externa causes pain on moving the pinna and a swollen canal, without a retroauricular abscess.

Why is "Bell's palsy, treated with prednisolone" not the answer?

Bell's palsy causes facial weakness and does not produce a mastoid swelling.

What concept does this question test?

It tests Otology: complications of otitis media in ENT. Features are postauricular swelling and erythema, displacement of the pinna forward and downward, tenderness over the mastoid and sagging of the postero-superior meatal wall. Management is intravenous antibiotics with myringotomy, and cortical mastoidectomy for a subperiosteal abscess or failure to improve. Intracranial spread must be excluded.

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 Otology: complications of otitis media?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.