Return to Scenario ListShow Learning Points most relevant to Phase 1:

Glue ear

Clinical Discipline(s)/Organ System(s)
General Practice, Hauora Māori, Otorhinolaryngology, Paediatrics, Epidemiology, Population Health
Progress Test Topic(s)
A 4 year old Māori girl is brought to the GP by her mother because she is having difficulty hearing. On otoscopy you see bilateral retracted tympanic membranes.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Anatomy of the middle ear
   - Physiology of the middle ear including function of the pharyngotympanic tube
   - Pathogenesis of otitis media with effusion
   - Common pathogens and microbiology of ear infections
Clinical and Communication Skills 
   - History from a parent and child with hearing or ear complaints
   - Examine comfortably using an otoscope and complete full ear, nose and throat examination
   - Examine hearing with the Rinne and Weber tests
   - Recognise the appearances of otitis media with effusion
   - Interpret audiometry and tympanometry at a basic level
   - Outline management of otitis media with effusion
   - Indications for grommet placement
   - Recognise a tympanic membrane perforation; describe management
Personal and Professional Skills 
   - Explore the social impact of otitis media with effusion, including long term behavioural, speech and educational problems
   - Effectively communicate disease pathogenesis, prognosis, treatment and the rationale for treatment
Hauora Māori 
   - Identify the disproportionately high prevalence of otitis media with effusion in Māori children and explain the reasons for this
Population Health 
   - Epidemiology in New Zealand of otitis media with effusion
   - Prevention of otitis media with effusion related complications e.g. hearing loss, language impairment
   - Screening of hearing in primary schools
Conditions to be considered relating to this scenario
otitis media with effusion, acute otitis media, otitis externa, tympanic membrane perforation
Less common but 'important not to miss'
cholesteatoma, mastoiditis, congenital hearing loss, facial nerve paresis
malignant/necrotising otitis externa