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Acute otitis media — USMLE Step 2 CK MCQ

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ModeratePediatricsAcute otitis mediaUSMLE Step 2 CK

A 7-year-old Asian American boy comes to the hospital nursery because of new symptoms noticed by a caregiver. History and focused examination are notable for bulging erythematous tympanic membrane with fever and otalgia. Temperature is 102.2°F (39.0°C), blood pressure is 108/66 mmHg, pulse is 112/min, respirations are 22/min, and oxygen saturation is 94% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Growth parameters, hydration status, and focused testing are consistent with the described pediatric presentation. Which of the following is the most appropriate next step in management?

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Correct answer: A — High-dose amoxicillin

The vignette describes Acute otitis media, supported by bulging erythematous tympanic membrane with fever and otalgia. High-dose amoxicillin is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: AAP Acute Otitis Media Guideline