ENT (otorhinolaryngology)
Ear infections, sore throat, epistaxis, hearing loss and airway emergencies. Ear disease in Aboriginal children is a well-known Australian exam theme.
High-yield points
Acute otitis media: most resolve without antibiotics; amoxicillin is first line when needed (e.g. under 2 with bilateral disease, systemically unwell, or high-risk populations).
Chronic suppurative otitis media: persistent discharge through a perforation; treat with ear toilet and topical ciprofloxacin drops.
Sore throat: eTG recommends phenoxymethylpenicillin for 10 days if antibiotics are indicated, mainly to prevent rheumatic fever in high-risk people.
Peritonsillar abscess (quinsy): trismus, uvula deviation, 'hot potato' voice; drain and give IV antibiotics.
Epistaxis first aid: sit up, lean forward, pinch the soft part of the nose for 10-15 minutes.
Sudden sensorineural hearing loss is an emergency; refer urgently for steroids.
Red flags for head and neck cancer: persistent hoarseness over 3 weeks, neck lump, unilateral ear pain, dysphagia.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Acute otitis media | Antibiotics given routinely. | Most children get analgesia and watchful waiting. Antibiotics (amoxicillin) for infants, unwell children and First Nations children. |
| Sore throat | Antibiotics very commonly prescribed. | Most don't need antibiotics. Treat with penicillin where acute rheumatic fever risk is high, e.g. many First Nations communities. |
| Chronic suppurative otitis media | Common, managed mainly surgically. | Very high rates in First Nations children, affecting hearing, speech and schooling. Ear health is a public health priority. |
| Hearing screening | Not universal at birth. | Universal newborn hearing screening in every state and territory. |
Acute otitis media
India (MBBS)
Antibiotics given routinely.
Australia (AMC): what the exam expects
Most children get analgesia and watchful waiting. Antibiotics (amoxicillin) for infants, unwell children and First Nations children.
Sore throat
India (MBBS)
Antibiotics very commonly prescribed.
Australia (AMC): what the exam expects
Most don't need antibiotics. Treat with penicillin where acute rheumatic fever risk is high, e.g. many First Nations communities.
Chronic suppurative otitis media
India (MBBS)
Common, managed mainly surgically.
Australia (AMC): what the exam expects
Very high rates in First Nations children, affecting hearing, speech and schooling. Ear health is a public health priority.
Hearing screening
India (MBBS)
Not universal at birth.
Australia (AMC): what the exam expects
Universal newborn hearing screening in every state and territory.
The Australian context
Aboriginal and Torres Strait Islander children have some of the highest rates of chronic suppurative otitis media in the world, which affects hearing, speech and education. In this group AOM is treated with antibiotics more readily, and sore throat is treated with penicillin to prevent acute rheumatic fever.