Ear, nose & throat · UKMLA & AKT
Otitis media
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise otitis media — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Otalgia - unilateral; in pre-verbal children may manifest as ear-tugging, irritability, or disturbed sleep
- Fever - high fever (>38.5°C) suggests more severe infection
- Otorrhoea - purulent discharge indicates TM perforation; pain often improves as pressure is relieved
- Conductive hearing loss - due to middle ear fluid; usually temporary
- Otoscopy - bulging TM, loss of light reflex, erythema, reduced mobility on pneumatic otoscopy
A bulging tympanic membrane with loss of the light reflex is the most reliable otoscopic sign of AOM. Erythema alone is insufficient - a crying child can redden the TM without infection.
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