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Acute Otitis Externa — UKMLA MCQ

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HardENTAcute Otitis ExternaUKMLAMRCGP AKTPARAPSA

A child with acute otitis externa has marked external-canal oedema. There is no systemic illness or spreading cellulitis, but the canal is too narrow for topical drops to reach the affected skin. What additional step is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Arrange trained aural toilet and insert an ear wick if needed

B is correct. Topical treatment is first line, but marked oedema or debris can prevent delivery. NICE CKS advises trained aural toilet and considering an ear wick when the canal is extensively swollen. A uses systemic antibiotic without cellulitis or systemic features and fails to deliver local therapy. C obstructs rather than facilitates delivery. D assumes fungal disease. E delays treatment. Aural toilet and wick insertion require appropriate training, and preparation choice must account for suspected tympanic-membrane perforation.

Reference: NICE CKS: otitis externa management: https://cks.nice.org.uk/topics/otitis-externa/management/management/ GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map