DO-HNS (RCSI) Practice Questions - Diploma In Otolaryngology - Head And Neck Surgery (DO-HNS) (RCSI, Ireland) Exam

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A 4-year-old child presents with a 24-hour history of severe right ear pain, high fever of 39.5°C, and irritable behavior. Otoscopy reveals a bulging, intensely erythematous right tympanic membrane with loss of landmarks and visible purulent effusion behind it. What is the single best initial management step for this child, assuming no signs of systemic complications?

Reassurance and watchful waiting for 48 hours Oral amoxicillin at 80-90 mg/kg/day split into two doses Immediate referral for urgent myringotomy and grommet insertion Topical ciprofloxacin-dexamethasone ear drops

Correct Answer:

Oral amoxicillin at 80-90 mg/kg/day split into two doses

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