Question Easy:
A 70-year-old man presents with gradual central vision loss in both eyes over the past few years. He describes seeing straight lines that appear wavy. Which is the most likely diagnosis?
A) Glaucoma
B) Dry macular degeneration
C) Wet macular degeneration
D) Diabetic retinopathy
E) Retinal detachment
Explanations & Answers:
Question Easy Answer:
C) Wet macular degeneration
Question Easy Explanation:
Wet macular degeneration is characterized by rapid central vision loss and distorted vision (metamorphopsia), where straight lines appear wavy. NICE guidelines advise urgent referral to ophthalmology for anti-VEGF treatment to stabilize vision.
Question Medium:
A 55-year-old woman comes to the clinic with complaints of dizziness, tinnitus, and hearing loss in her left ear. The episodes are recurrent and last about 20 minutes each time. What is the most likely diagnosis?
A) Benign paroxysmal positional vertigo (BPPV)
B) Meniere’s disease
C) Labyrinthitis
D) Vestibular migraine
E) Acoustic neuroma
Explanations & Answers:
Question Medium Answer:
B) Meniere’s disease
Question Medium Explanation:
Meniere’s disease presents with a triad of episodic vertigo, tinnitus, and sensorineural hearing loss, usually in one ear. NICE guidelines suggest lifestyle changes such as reducing salt intake and prescribing betahistine to manage symptoms.
Question Hard:
A 32-year-old woman presents with sudden loss of vision in one eye accompanied by pain exacerbated with eye movement. On examination, she has a relative afferent pupillary defect and decreased color vision. What is the most likely diagnosis?
A) Optic neuritis
B) Retinal vein occlusion
C) Anterior uveitis
D) Central retinal artery occlusion
E) Giant cell arteritis
Explanations & Answers:
Question Hard Answer:
A) Optic neuritis
Question Hard Explanation:
Optic neuritis typically presents with sudden, painful vision loss in one eye, an afferent pupillary defect, and reduced color vision. NICE guidelines recommend urgent referral to neurology or ophthalmology, as it can be an early sign of multiple sclerosis.
Medical fact of the day:
Approximately 1 in 5 people over the age of 65 in the UK suffer from age-related macular degeneration, making it the leading cause of blindness in this age group.
Quote of the day:
“In the tapestry of life, health care workers weave threads of hope and compassion, creating a fabric of resilience for all.” 🌼