Ear pain/discharge :: PLAB 2 Symptomatic Differential Stations

• AOM

  • Other presenting symptoms: 

    • Acute ear pain

    • Fever

  • Past history and PMAFTOSA: 

    • Dont forget allergy history

    • Rule out meningitis

  • Social:

  • Exam and Invs:

    • GPE, vitals

    • Ear examination

  • Referral:

    • None

  • Treatment: 

    • Pain Killers

    • Antibiotics if persists for more than 3 days (Amoxicillin(clarithromycin if allergy))

  • Warning signs:

    • Worsening symptoms

    • Headache, photophobia, neck stiffness

• CSOM

  • Other presenting symptoms: 

    • Elderly

    • Chronic ear discharge

    • Dull ear pain

    • Slight hearing loss

  • Past history and PMAFTOSA: 

  • Social:

    • Life effects

    • Work

    • Living situation

  • Exam and Invs:

    • GPE, vitals

    • Ear examination

    • Neurological examination

  • Referral:

    • ENT urgent referral

  • Treatment: 

    • Pain killers

    • Specialist treatment:

      • Clean the ear

      • Take a swab

      • Antibiotics 

  • Warning signs:

    • Worsening symptoms

    • Headache, blurring of vision