A patient presents with severe ear pain, itching, and discharge from the ear. Upon examination, the external auditory canal is swollen and red. Which of the following is the most appropriate initial intervention for a patient diagnosed with otitis externa?

Recommend cleaning the ear with cotton swabs daily.

Advise the patient to use over-the-counter ear drops.

Administer oral antibiotics.

Administer topical antibiotics and corticosteroids.

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Recommending cleaning the ear with cotton swabs daily is not appropriate for managing otitis externa. Using cotton swabs can further irritate the ear canal, potentially worsening the inflammation and increasing the risk of infection. It is generally advised to avoid inserting anything into the ear canal to prevent damage and irritation.

Choice B Reason:

Advising the patient to use over-the-counter ear drops is not the best initial intervention. While some over-the-counter ear drops may provide temporary relief, they are not as effective as prescription topical antibiotics and corticosteroids in treating the underlying infection and inflammation associated with otitis externa. Proper medical treatment is necessary to ensure effective management of the condition.

Choice C Reason:

Administering oral antibiotics is not typically the first-line treatment for uncomplicated otitis externa. Oral antibiotics are reserved for cases where the infection has spread beyond the ear canal or in patients with risk factors for severe infection. Topical antibiotics and corticosteroids are preferred for their direct action on the affected area and fewer systemic side effects.

Choice D Reason:

Administering topical antibiotics and corticosteroids is the most appropriate initial intervention for otitis externa. Topical treatments effectively target the infection and reduce inflammation, providing relief from symptoms such as pain, itching, and discharge. This approach is supported by clinical guidelines and is considered the standard of care for managing otitis externa.

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Correct Answer is A

Explanation

Choice A Reason:

Administering intravenous acetazolamide is a critical intervention for acute narrow-angle glaucoma. Acetazolamide is a carbonic anhydrase inhibitor that reduces the production of aqueous humor, thereby lowering intraocular pressure (IOP) quickly. Reducing IOP is essential to prevent optic nerve damage and preserve vision. Normal IOP ranges from 10 to 21 mmHg, and in acute narrow-angle glaucoma, it can exceed 30 mmHg. Rapid reduction of IOP is crucial to alleviate symptoms and prevent further complications.

Choice B Reason:

Applying warm compresses to the affected eye is not an appropriate intervention for acute narrow-angle glaucoma. Warm compresses may provide temporary relief for some eye conditions, but they do not address the underlying issue of elevated intraocular pressure. In fact, warm compresses can potentially increase blood flow to the eye, which might exacerbate the condition.

Choice C Reason:

Encouraging the patient to drink plenty of fluids to stay hydrated is generally good advice for overall health, but it is not a prioritized intervention for acute narrow-angle glaucoma. Hydration does not directly impact intraocular pressure or alleviate the acute symptoms of glaucoma. The primary focus should be on reducing IOP to prevent optic nerve damage.

Choice D Reason:

Administering a mydriatic agent to dilate the pupil is contraindicated in acute narrow-angle glaucoma. Mydriatic agents can worsen the condition by further narrowing the anterior chamber angle, increasing intraocular pressure, and potentially causing more damage to the optic nerve. It is crucial to avoid pupil dilation in this scenario.

A. Shortness of breath. B. Chest pain. C. Fever. D. Vertigo.

Correct Answer is D

Explanation

Choice A Reason:

Shortness of breath is not typically associated with Meniere’s disease. This condition primarily affects the inner ear, leading to symptoms related to balance and hearing. Shortness of breath is more commonly linked to respiratory or cardiovascular issues.

Choice B Reason:

Chest pain is not a characteristic symptom of Meniere’s disease. Chest pain is usually related to cardiac or musculoskeletal problems. Meniere’s disease affects the inner ear and does not typically cause chest pain.

Choice C Reason:

Fever is not a common symptom of Meniere’s disease. Fever is generally associated with infections or inflammatory conditions. Meniere’s disease involves the buildup of fluid in the inner ear, leading to vertigo, tinnitus, and hearing loss, but not fever.

Choice D Reason:

Vertigo is the most characteristic symptom of Meniere’s disease. Vertigo involves a spinning sensation that can be severe and debilitating. It is caused by the abnormal fluid buildup in the inner ear, which disrupts the balance and hearing functions. This symptom is a hallmark of Meniere’s disease and is often accompanied by tinnitus and hearing loss.

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A patient presents with severe ear pain, itching, and discharge from the ear. Upon examination, the external auditory canal is swollen and red. Which of the following is the most appropriate initial intervention for a patient diagnosed with otitis externa?

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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