Question Easy:
A 65-year-old woman presents with painless vision loss in her right eye over the last month. On examination, there is swelling of the optic disc, and she reports having headaches and jaw pain. What is the most likely diagnosis? 🤔
A) Diabetic retinopathy
B) Age-related macular degeneration
C) Temporal arteritis
D) Retinal detachment
E) Optic neuritis
Question Medium:
A 45-year-old man comes to the clinic complaining of vertigo, tinnitus, and hearing loss in his right ear that come and go. He is otherwise healthy, and his vital signs are normal. What is the most likely diagnosis? 🎧
A) Benign paroxysmal positional vertigo (BPPV)
B) Meniere’s disease
C) Acoustic neuroma
D) Vestibular neuritis
E) Labyrinthitis
Question Hard:
A 29-year-old man presents with double vision and difficulty swallowing for the past few days. On examination, he has ptosis and ophthalmoplegia. Antibody testing reveals the presence of anti-acetylcholine receptor antibodies. What is the most appropriate long-term management for his condition? 👁️
A) Acetylcholinesterase inhibitors
B) Plasmapheresis
C) Corticosteroids
D) Thymectomy
E) Intravenous immunoglobulins (IVIG)
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The symptoms and findings are suggestive of temporal arteritis (giant cell arteritis). NICE guidelines recommend urgent initiation of corticosteroid treatment to prevent irreversible vision loss. Symptoms such as headache, jaw claudication, and vision changes are classic.
Question Medium Answer: B
Question Medium Explanation: Meniere’s disease is characterized by episodic vertigo, tinnitus, and fluctuating sensorineural hearing loss. According to NHS guidelines, management involves lifestyle adjustments and specific medications to control vertigo and nausea.
Question Hard Answer: D
Question Hard Explanation: The presentation is typical of myasthenia gravis. NICE recommends thymectomy as a long-term management option, especially in young patients, as it can provide symptom relief and potentially induce remission.
Medical fact of the day: Did you know that the human ear is capable of hearing a wide range of frequencies, from approximately 20 Hz to 20,000 Hz? The upper limit tends to decrease with age! 👂
Quote of the day: “In the ever-turning cycle of care, one moment of kindness can shift the universe of a patient. 🌟”