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Acute Otitis Media-Observation Option — USMLE Step 2 CK MCQ

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MediumPediatricsAcute Otitis Media-Observation OptionUSMLE Step 2 CK

A previously healthy 18‑month-old has unilateral acute otitis media with mild otalgia, temperature 100.8°F (38.2°C), and reliable follow-up. What is acceptable management?

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

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Correct answer: D — Watchful waiting with analgesia for 48-72 hours

Explanation lettering: B = shown as A · A = shown as B · E = shown as C · C = shown as D · D = shown as E

For select children ≥6 months with unilateral, mild AOM and reliable follow‑up, observation for 48-72 hours with analgesia is reasonable. Immediate high‑dose antibiotics (A, B) are not necessary. Azithromycin (D) is not first‑line due to resistance. Delayed follow‑up without a plan (E) is inadequate.

Reference: AAP/AAFP (2013): The Diagnosis and Management of Acute Otitis Media