Factor the expression completely. 
Definitions:
Startle
A quick, automatic response to a sudden unexpected stimulus, often characterized by jerking bodily motions.
Drainage
The removal of fluids from a body cavity, wound, or other source, often for therapeutic reasons.
Ear Infections
Infections that occur in the ear, often in the middle ear, leading to pain, fever, and sometimes hearing difficulty.
Otoscopic Examination
A visual examination of the ear canal and eardrum using an otoscope, an instrument designed for looking into the ear canal.
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