Question Easy:
A 7-year-old girl presents to the GP with her mother, complaining of ear pain and a fever 😷. On examination, the tympanic membrane is bulging and red. What is the most likely diagnosis?
A) Otitis externa
B) Otitis media
C) Labyrinthitis
D) Eustachian tube dysfunction
E) Chronic suppurative otitis media
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation:
Otitis media, particularly acute otitis media, is very common in children and presents with ear pain, fever, and a bulging tympanic membrane. According to NICE guidelines, the presence of these symptoms, especially in children, is suggestive of otitis media.
Question Medium:
A 55-year-old man complains of gradual hearing loss over the past year. He also experiences a sensation of fullness in the affected ear. An audiogram shows conductive hearing loss. Which condition is most likely?
A) Vestibular schwannoma
B) Otosclerosis
C) Meniere’s disease
D) Presbycusis
E) Cholesteatoma
Question Medium Answer: B
Question Medium Explanation:
Otosclerosis is characterized by abnormal bone remodeling in the middle ear, leading to conductive hearing loss. It’s classically associated with gradual onset hearing loss and a sensation of ear fullness. NICE guidelines recommend considering otosclerosis in adults with these symptoms.
Question Hard:
A 65-year-old woman is referred to the ENT clinic with sudden, severe vertigo, tinnitus, and hearing loss in the right ear. The symptoms began abruptly and are associated with a recent upper respiratory tract infection. Which diagnosis is most likely?
A) Meniere’s disease
B) Benign paroxysmal positional vertigo
C) Vestibular neuritis
D) Labyrinthitis
E) Acoustic neuroma
Question Hard Answer: D
Question Hard Explanation:
Labyrinthitis often follows a viral infection and presents with acute onset of severe vertigo, hearing loss, and sometimes tinnitus. Unlike vestibular neuritis, labyrinthitis includes hearing loss due to the involvement of the entire labyrinth, which affects both balance and auditory functions. Following NHS guidelines, a history of recent infections can be an important clue.
Medical fact of the day: Did you know that the human eye can distinguish approximately 10 million different colours? 👁️ In UK clinical practice, understanding the complexities of visual conditions can significantly enhance patient care.
Quote of the day: “In the midst of every challenge, let your dedication be the constant that leads to healing and hope.” 🌟