Question Easy:
A 45-year-old woman presents with sudden hearing loss in her left ear. She denies any pain or discharge. She mentions having a recent upper respiratory tract infection. What is the most appropriate initial management?
A) Prescribe antibiotics
B) Refer to ENT urgently
C) Prescribe oral corticosteroids
D) Advise monitoring symptoms for two weeks
E) Recommend nasal decongestants
Question Medium:
A 32-year-old man experiences recurrent episodes of vertigo lasting several hours, associated with tinnitus and a feeling of fullness in his right ear. What is the most likely diagnosis?
A) Benign paroxysmal positional vertigo (BPPV)
B) Labyrinthitis
C) Vestibular migraine
D) Ménière’s disease
E) Acoustic neuroma
Question Hard:
A 70-year-old man presents with painless progressive vision loss in both eyes. Fundoscopy reveals significant cupping of the optic discs. His intraocular pressure is elevated. What is the most likely diagnosis?
A) Cataract
B) Macular degeneration
C) Primary open-angle glaucoma
D) Retinal detachment
E) Diabetic retinopathy
Explanations & Answers:
Question Easy Answer: C) Prescribe oral corticosteroids
Question Easy Explanation: Sudden sensorineural hearing loss is commonly treated with high-dose corticosteroids, typically within the first 72 hours to improve prognosis. Urgent ENT referral is also crucial but prescribing corticosteroids should not be delayed.
Question Medium Answer: D) Ménière’s disease
Question Medium Explanation: Ménière’s disease is characterized by episodic vertigo, sensorineural hearing loss, tinnitus, and aural fullness. Management often includes lifestyle changes and sometimes medications such as betahistine.
Question Hard Answer: C) Primary open-angle glaucoma
Question Hard Explanation: Primary open-angle glaucoma presents with progressive vision loss, primarily peripheral, and characteristic cupping of the optic disc on fundoscopy due to elevated intraocular pressure. Treatment often involves lowering intraocular pressure with medications or surgery to prevent further damage to the optic nerve.
Medical fact of the day: Did you know? In the UK, glaucoma is a leading cause of preventable blindness. Regular eye checks are essential as the condition often presents without symptoms until significant damage has occurred.
Quote of the day: “The gift of sight is precious; let’s commit to preserving it with passion and precision. Every small act makes a big difference in the world of healthcare.”