There’s an open suggestion trying to change cloze to IV antibiotics. But making that change would make it somewhat of a duplicate to another card. MRI is not necessary in acute mastoiditis as it’s a clinical diagnosis. Imaging is only indicated for certain reasons described in extra field
agree with change but would suggest adding IV Abx treatment to text just to make it clearer, info in extra is easily missed, would leave further details in extra (ceftriaxone, amp-sulbactam)
Acute otitis media and mastoid swelling/anteriorly rotated ear is suggestive of {{c1::mastoiditis::diagnosis}} which is treated with empiric IV antibiotics and may require evaluation with {{c2::CT or MRI::next test(s)}}
There are numerous tagged UW QIDs - please confirm accuracy with all of them before changing
QID 4248 is a 4 year old with mastoiditis but also high concern for brain abscess so answer is MRI of brain. he has nightly severe headaches for past few days. Other cards cover risk factors for brain abscess. This change is accurate to this question.
QID 12379 does not exist under shelf or step 2. I do not have the section that it is under.
QID 18285 is step 3, I don’t have access
Step 2 12379 (from self-assessment): “Imaging is not required for diagnosis but is indicated if further complications (eg, meningitis, neurologic deficits) are suspected, if the child appears toxic, if there is no response to initial treatment, or if the diagnosis is unclear (eg, persistent otorrhea of unclear etiology). In these cases, CT scan of the temporal bones or MRI with contrast is preferred over plain radiographs (Choice D).”
Step 3 18285: “Acute mastoiditis can often be diagnosed clinically. Imaging (eg, CT scan, MRI) is indicated if the diagnosis is unclear, if there is suspicion for further complications (eg, meningitis, neurologic deficits), if the child appears toxic, or if the condition does not respond to initial treatment. In these cases, CT scan shows destruction of the bony septa in the mastoid air cells, confirming the diagnosis of acute coalescent mastoiditis.”
Ok with this change, just wanted to confirm that UW is not testing on the concept as best next step
5 in support of change so far