A 10-Year-Old Girl Is Brought to the Office Due to Right

question 2

Multiple Choice

A 10-year-old girl is brought to the office due to right ear pain that began yesterday.  The patient's ear feels itchy and gives the sensation of something stuck inside.  She recently returned from visiting her grandparents at their beach house for a family reunion; a few cousins also visiting were recovering from an upper respiratory infection.  The patient had recurrent acute otitis media complicated by persistent effusion and required tympanostomy tube placement at age 2.  The tympanostomy tubes have since fallen out, and she has had no ear infections since age 3.  She is not up to date on vaccinations but has no chronic medical conditions.  Her parents are smokers but usually do not smoke inside the house.  Temperature is 37.1 C (98.8 F) , blood pressure is 102/58 mm Hg, and pulse is 94/min.  On examination of the right ear, there is exquisite tenderness to movement of the pinna during otoscopy.  The canal is red and swollen.  Most of the tympanic membrane can be seen, and it is clear with no fluid.  The left ear is normal.  Which of the following risk factors most likely contributed to this patient's condition?

• A)Immunization status
• B)Multiple sick contacts
• C)Recurrent acute otitis media
• D)Tobacco smoke exposure
• E)Tympanostomy tube placement
• F)Water exposure

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Definitions:

Sodium-Potassium Pump

A membrane-bound enzyme complex that exchanges sodium ions out of and potassium ions into a cell, crucial for maintaining cellular homeostasis.

Plasma Membrane

The plasma membrane is the biological membrane that separates the interior of all cells from the outside environment, controlling the passage of substances in and out of the cell.

Membrane Potential

The voltage across a cell's plasma membrane, representing a difference in electrical charge inside and outside the cell.

Afterpotential

The transient change in membrane potential that occurs following a nerve impulse, affecting neuron excitability.