Rotations 2.0 Episode 61 Otitis Media

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Episode 61 Otitis Media

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Innovation by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 60 Mononucleosis 

Question 1 — Diagnostic strategy early in illness

A 19‑year‑old college student presents on day 3 of fever, severe sore throat, fatigue, and posterior cervical lymphadenopathy. A rapid heterophile (Monospot) test obtained today is negative. Her CBC shows 52% lymphocytes with 12% atypical lymphocytes. She does not take regular medications. Which of the following is the most appropriate next step?

C. Order Epstein–Barr virus (EBV) viral capsid antigen (VCA) IgM/IgG serology

Question 2 — Therapeutics and special situations

A 17‑year‑old with confirmed infectious mononucleosis has progressive tonsillar hypertrophy, drooling, and muffled voice but maintains oxygen saturation at 97% on room air. Which of the following is the best next step?

A. Administer a short course of systemic corticosteroids

Question 3 — Return‑to‑play and splenic complications

A 20‑year‑old linebacker is diagnosed with infectious mononucleosis after 5 days of symptoms. He is afebrile today and wants to play in next week’s game. Which statement is most accurate for counseling?

C. Most splenic ruptures occur within the first 21 days of symptom onset, and ~90% occur by day 31; therefore, no athletic activity should occur for the first 3 weeks

Paper for Next Week:

Caldwell, Jane M., Nathan A. Ledeboer, and Bobby L. Boyanton Jr. 2024. “Review: Known, Emerging, and Remerging Pharyngitis Pathogens.” The Journal of Infectious Diseases 230, Supplement 3: S173–S181.

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Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

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