ABIM Exam Review Practice Question of the Week: 18-year-old male with right ear pain for one week

This week’s sample ABIM Exam Review Question comes directly from the Knowmedge QVault which covers topics listed on the ABIM Board Exam blueprint. It can also be found in the Knowmedge’s Free ABIM Exam Review Questions eBook.




18-year-old male presents to the clinic with right ear pain that he has been experiencing for one week. He denies any drainage from the ear. On physical exam, he does not have pain when you tug the pinna of his right ear. With otoscopic examination, you visualize fluid in the middle ear and erythema of the tympanic membrane. Patient has no known drug allergies. What is the most efficacious treatment for this condition?


A. Ciprofloxacin

B. Cefdinir

C. Azithromycin

D. Polymyxin ear drops

E. Amoxicillin


ABIM Exam Practice Question Explanation



There are three main types of ear infections:
• Acute otitis media (AOM): Usually painful with common presenting symptoms of fever and redness of eardrum. Treatment is typically with antibiotics.
• Otitis media effusion (OME): Occurs as a result of build up of fluid in the middle ear and generally will not present with symptoms of an acute infection. This is generally not a painful condition and will usually not benefit from antiobiotic treatment. The infection typically goes away on its own.
• Otitis externa: This is an infection of the ear and/or outer ear canal. It is more commonly known as swimmer’s ear. Symptoms include itching, pain and redness around the ear. Treatment is typically with antibiotics.

From the patient’s history and physical exam, he likely has acute otitis media. On physical exam, an erythematous, bulging tympanic membrane is seen. As this patient doesn’t have any known drug allergies, the best treatment is Choice E (Amoxicillin).

Let’s go over the incorrect answer choices:
• Choice A (Ciprofloxacin) is usually not recommended for the treatment of otitis media.
• Choice B (Cefdinir), an example of a cephalosporin, and Choice C (Azithromycin), an example of a macrolide, can be used in patients who have a penicillin allergy.
• Choice D (Polymyxin) would be used for otitis externa or swimmer’s ear.


You can view all the previous ABIM Exam Review Questions of the Week at the Knowmedge Blog. You can also find additional topics and questions directly from the Knowmedge Internal Medicine ABIM Board Exam Review Questions QVault.

Got something to add?

Please log In or register for a free account to write a comment.