Question Easy: 👀 A 65-year-old man presents with sudden onset painless loss of vision in his right eye. He describes it as a “curtain coming down” over his vision. Examination reveals a relative afferent pupillary defect, but the fundoscopic examination is unremarkable. What is the most likely diagnosis?
A) Retinal detachment
B) Optic neuritis
C) Vitreous haemorrhage
D) Central retinal artery occlusion
E) Central retinal vein occlusion
Question Medium: 👂 A 40-year-old woman is experiencing vertigo, tinnitus, and hearing loss in her left ear. The symptoms have been episodic for the past few months. She finds the vertigo episodes quite debilitating. What is the most likely diagnosis?
A) Labyrinthitis
B) Vestibular neuronitis
C) Ménière’s disease
D) Acoustic neuroma
E) Benign paroxysmal positional vertigo (BPPV)
Question Hard: 👃 An 8-year-old boy presents with chronic nasal congestion, nasal speech, and mouth breathing. He also experiences frequent ear infections and has a history of hearing difficulties. What is the most likely underlying cause of his condition?
A) Nasal polyps
B) Adenoid hypertrophy
C) Deviated nasal septum
D) Allergic rhinitis
E) Foreign body in the nose
Explanations & Answers:
Question Easy Answer: D) Central retinal artery occlusion
Question Easy Explanation: Central retinal artery occlusion typically presents with sudden painless vision loss and a relative afferent pupillary defect due to retinal ischemia. The classic “cherry-red spot” on fundoscopy may not always be immediately visible. NICE guidelines recommend urgent ophthalmological referral as it is an ocular emergency.
Question Medium Answer: C) Ménière’s disease
Question Medium Explanation: Ménière’s disease is characterised by episodic vertigo, tinnitus, and sensorineural hearing loss, often affecting one ear. According to NICE guidelines, management includes lifestyle modifications and pharmacotherapy like betahistine to reduce vertigo attacks and improve the quality of life for patients.
Question Hard Answer: B) Adenoid hypertrophy
Question Hard Explanation: Adenoid hypertrophy is common in children and can cause nasal obstruction, mouth breathing, nasal speech, and recurrent ear infections, especially leading to conductive hearing loss due to Eustachian tube dysfunction. Management often involves adenoidectomy depending on the severity of symptoms.
Medical fact of the day: The sense of smell can influence human emotions significantly, and anosmia (loss of smell) is linked to poor quality of life. Recent studies suggest that smell training can help some patients regain their lost sense.
Quote of the day: “Healing is a journey, and every step forward is a chapter of hope in the story you write for your patients and yourself.”