docsrinu
Forum Elite
Topics: 26
Posts: 213
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42. An 8 yr old boy says his right ear hurts. His mother says that he
has been tugging the ear. The external canal and tympanic membrane
appear normal, but the tympanic membrane does not move when the
pressure in the nasopharynx is increased. Which of the following is the
most likely cause of these findings?
A) Otitis externa
B) Cholesteatoma
C) Auditory tube obstruction
D) Purulent otitis media
E) Serous otitis media
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| vanshita
Forum Guru
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C
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| sridevibandaru24
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C
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| fox
Forum Guru
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Its E guys....Always remember...normal appearing TM .....immobile/restricted mobility......young child....its SEROUS OTITIS MEDIA. Here is how u rule out the choices:
A) Otitis externa: R/O as ext canal normal
B Cholesteatoma: R/O as canal & TM normal (!!!however congenital cholestaetoma behind an intact TM is a possibility!!!!!)
c) Purulent OM R/O as the TM is not congested.
D) SOM.... usually presents with a normal looking immobile TM. However u may find the classical air bubbles & distortion of cone of light. Among the choices this is the one that best fits in.
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| fox
Forum Guru
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Sorry for typo...the choices are not in order. Choice C is ruled out as there is no TM retraction.
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| new_n_lost
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Guys same question n the explanation is there, i did tend to agree with Fox but the explanation is there
http://www.prep4usmle.com/forum/thread/27196
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| X-Ray
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I agree with new_n_lost
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| docarchana
Forum Guru
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Posts: 515
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so C is the ans.
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