Tympanic membrane perforation



Tympanic membrane perforation



Tympanic membrane perforation


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USMLE® Step 1 questions

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Tympanic membrane perforation

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USMLE® Step 1 style questions USMLE

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A 6-year-old boy is brought to the pediatrician for evaluation of left ear pain. The patient's mother states, “He has been tugging on his left ear for the past three days; he just cannot seem to get any relief.”  The patient has been taking tylenol at home for symptomatic relief. Temperature is 38.0°C (100.4°F), pulse is 99/min, respirations are 16/min, and blood pressure is 100/65 mmHg. Physical examination is notable for the following finding:

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Which of the following pathogens is the most likely cause of this patient’s clinical presentation?


Tympanic membrane perforation, also known as a ruptured eardrum, is a condition where there is a tear or hole in the thin membrane that separates the outer ear from the middle ear. This can be caused by a variety of factors, such as otitis media, trauma (e.g. by trying to clean the ear with sharp instruments), explosion, or loud noise.

Symptoms of tympanic membrane perforation may include pain, hearing loss, ringing in the ears, and drainage from the ear. In some cases, the perforation may heal on its own within a few weeks, but in other cases, medical intervention may be necessary. Treatment options include medications to prevent or treat infection and reduce inflammation, or surgery to repair the perforation.


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