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* Fred - ENT q ---
  mocha260 - 09/12/20 05:47
  A 23-year-old woman who is an active-duty enlisted airman in the US Air Force comes to the base clinic because of a 4-week history of an itchy sensation in her right ear. She has not had ringing in her ears or hearing loss. She works as a fuel specialist and at first attributed her symptom to the earplugs she uses when she is on the flight line. The symptom has not improved despite the patient's wearing headphones instead of the earplugs during the past 2 weeks. She has no history of serious illness and takes no medications. Vital signs are within normal limits. During examination, pulling of the right pinna inferiorly to examine the ear canal produces pain. The right ear canal appears erythematous and edematous. The tympanic membrane cannot be fully visualized because of the presence of cerumen. Examination of the left ear shows no abnormalities. Which of the following is the most likely diagnosis?

(A) Cerumen impaction
(C) Otitis externa

Otitis externa = I was thinking it can't be since vitals are normal, no fever and the pt isn't even diabetic or immunocompromised. I know pulling pinna is a sign of it, but I was thinking you need other symptoms too and why would there be cerumen impaction?

Cerumen impaction made sense because pts ear canal couldn't be visualized due to it and normal vitals.

---- Please, help I'm confused.
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* Re:Fred - ENT q ---
  studytea - 09/14/20 00:29
  I think cerumen impaction won't cause pain on pulling ear, that's specific for Otitis externa. Her headphones caused internal ear allergic reaction - contact dermatitis leading to otitis externa.

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