Acute otitis media — MCCQE Part 1 MCQ

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ModerateChild With FeverAcute otitis mediaMCCQE Part 1

A 2-year-old has fever, ear pain and a bulging erythematous tympanic membrane with moderate symptoms for 24 hours. Which of the following is the most appropriate next step?

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Correct answer: D — Treat with analgesia and consider antibiotics based on age, severity and diagnostic certainty

Treat with analgesia and consider antibiotics based on age, severity and diagnostic certainty is the single best answer because the age, timing, examination findings and investigations in the vignette fit Acute otitis media better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CPS acute otitis media statement, with attention to acuity, safety-netting and local provincial pathways.

Reference: CPS acute otitis media statement