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ENT · External ear: diffuse otitis externa
Sample itemA swimmer has an itchy, painful ear with a narrowed oedematous canal and tragal tenderness. What is the best initial treatment?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Aural toilet and topical antibiotic-steroid drops with a wick if needed
Acute diffuse otitis externa is treated by cleaning the canal, topical antibiotic-steroid drops and keeping the ear dry. A wick helps drops reach a swollen canal. Systemic therapy is reserved for cellulitis or immunocompromised patients.
Option by option
A. Aural toilet and topical antibiotic-steroid drops with a wick if needed (correct)
Correct. Cleaning and topical therapy is the standard treatment.
B. Mastoidectomy
Mastoidectomy is for mastoid disease, not otitis externa.
C. Systemic aminoglycoside
Systemic aminoglycosides are unnecessary and ototoxic.
D. Oral antifungal therapy
Oral antifungals are not first-line for bacterial otitis externa.
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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