This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: NEET Jan 2020, Subject name: ENT
Tuberculous otitis media of the middle ear has all of the following except:- 
Select and explain. 
A. Multiple perforation are seen, B. Pale granulomas are seen, C. ATT should be staed, D. Painful otorrrhea is seen
D: Painful otorrrhea is seen
Answer: D: Painful otorrrhea is seen 
Explanation: Tubercular Otitis Media-Presents with Chronic painless foul smelling otorrhea,Severe conductive type hearing loss (out of propoion to symptoms), involvement of labyrinth can lead to SNHL, Facial nerve palsyO/E- Multiple perforations in tympanic membrane followed by coalesce into single large perforation (Sieve Like Tympanic Membrane), Characteristic of tuberculous otitis media, Middle ear and mastoid are filled with pale granulation tissue Treatment-ATT for Primary disease, Oral toilet, Mastoid surgery