Ear and audiology: management of otorrhoea through a ventilation tube: 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 · Ear and audiology: management of otorrhoea through a ventilation tube

Sample item

A 3-year-old with tympanostomy tubes in place develops sudden purulent otorrhoea with a cold. He is afebrile and otherwise well. What is the best initial treatment?

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

The answer and the reasoning

D. Topical fluoroquinolone ear drops

Acute otorrhoea through a tube in a well child is treated first with topical antibiotic drops, which reach the middle ear directly in high concentration. A quinolone preparation is preferred because it is non-ototoxic and covers Pseudomonas and Staph aureus. Oral antibiotics are reserved for systemic illness or failure of topical therapy.

Option by option

  • A. Immediate removal of the tubes

    Tubes are removed only if otorrhoea persists despite treatment.

  • B. Neomycin-polymyxin ear drops

    Aminoglycoside-containing drops carry a risk of ototoxicity through an open middle ear.

  • C. Oral amoxicillin alone for ten days

    Oral amoxicillin reaches the middle ear poorly for pseudomonal infection and is not first line here.

  • D. Topical fluoroquinolone ear drops (correct)

    Correct. A topical quinolone gives high local concentration and is safe in a perforated or tubed ear.

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, Topical fluoroquinolone ear drops. Acute otorrhoea through a tube in a well child is treated first with topical antibiotic drops, which reach the middle ear directly in high concentration.

Why is "Immediate removal of the tubes" not the answer?

Tubes are removed only if otorrhoea persists despite treatment.

Why is "Neomycin-polymyxin ear drops" not the answer?

Aminoglycoside-containing drops carry a risk of ototoxicity through an open middle ear.

Why is "Oral amoxicillin alone for ten days" not the answer?

Oral amoxicillin reaches the middle ear poorly for pseudomonal infection and is not first line here.

What concept does this question test?

It tests Ear and audiology: management of otorrhoea through a ventilation tube in ENT. A quinolone preparation is preferred because it is non-ototoxic and covers Pseudomonas and Staph aureus. Oral antibiotics are reserved for systemic illness or failure of topical therapy.

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 Ear and audiology: management of otorrhoea through a ventilation tube?

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.