External ear: malignant otitis externa: 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.

Try it

ENT · External ear: malignant otitis externa

Sample item

An elderly diabetic has severe otalgia, granulation tissue at the floor of the canal and a facial palsy after several weeks of ear discharge. What is the best treatment?

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

The answer and the reasoning

A. Prolonged systemic antipseudomonal antibiotics with glycaemic control

This is necrotising (malignant) otitis externa due to Pseudomonas aeruginosa causing skull base osteomyelitis. Treatment is weeks of an antipseudomonal agent such as ciprofloxacin or ceftazidime, along with diabetic control and debridement of granulation tissue. Surgery is reserved for sequestra or failure.

Option by option

  • A. Prolonged systemic antipseudomonal antibiotics with glycaemic control (correct)

    Correct. Long-course antipseudomonal therapy and glycaemic control are the mainstay.

  • B. Immediate radical mastoidectomy

    Radical surgery is not first-line.

  • C. Topical antifungal drops only

    Fungal drops do not treat the bone infection.

  • D. Oral amoxicillin for a week

    Amoxicillin has no pseudomonal activity and a week is too short.

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.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Prolonged systemic antipseudomonal antibiotics with glycaemic control. This is necrotising (malignant) otitis externa due to Pseudomonas aeruginosa causing skull base osteomyelitis.

Why is "Immediate radical mastoidectomy" not the answer?

Radical surgery is not first-line.

Why is "Topical antifungal drops only" not the answer?

Fungal drops do not treat the bone infection.

Why is "Oral amoxicillin for a week" not the answer?

Amoxicillin has no pseudomonal activity and a week is too short.

What concept does this question test?

It tests External ear: malignant otitis externa in ENT. Treatment is weeks of an antipseudomonal agent such as ciprofloxacin or ceftazidime, along with diabetic control and debridement of granulation tissue. Surgery is reserved for sequestra or failure.

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 External ear: malignant otitis externa?

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.