Question Easy:
A 45-year-old man presents with sudden, painful vision loss in one eye. On examination, there is conjunctival injection, a mid-dilated non-reactive pupil, and an intraocular pressure of 50 mmHg. What is the most likely diagnosis?
A) Retinal detachment
B) Acute angle-closure glaucoma
C) Central retinal artery occlusion
D) Optic neuritis
E) Age-related macular degeneration
Question Medium:
A 30-year-old woman presents with vertigo, tinnitus, and hearing loss in one ear. She reports that these episodes last several hours and are often accompanied by a feeling of fullness in the affected ear. What is the most likely diagnosis?
A) Benign paroxysmal positional vertigo
B) Meniere’s disease
C) Acoustic neuroma
D) Labyrinthitis
E) Vestibular neuritis
Question Hard:
A 55-year-old woman with a longstanding history of rheumatoid arthritis presents with a one-week history of dry eyes and dry mouth. She also reports joint pain and fatigue. Upon examination, her parotid glands are enlarged. What is the most likely diagnosis?
A) Sarcoidosis
B) Scleroderma
C) Sjogren’s syndrome
D) Systemic lupus erythematosus
E) Wegener’s granulomatosis
Explanations & Answers:
Question Easy Answer:
B
Question Easy Explanation:
Acute angle-closure glaucoma 👁️ is characterised by a sudden rise in intraocular pressure, leading to painful vision loss, a red eye, and a mid-dilated, non-reactive pupil. This is a medical emergency and requires prompt treatment to prevent permanent vision loss.
Question Medium Answer:
B
Question Medium Explanation:
Meniere’s disease involves episodes of vertigo, tinnitus, hearing loss, and aural fullness, typically affecting one ear. This condition can significantly impact quality of life and is managed based on symptom severity and frequency in accordance with NICE guidelines.
Question Hard Answer:
C
Question Hard Explanation:
Sjogren’s syndrome is an autoimmune disorder commonly associated with rheumatoid arthritis and is characterised by dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia). The presence of enlarged parotid glands along with systemic features like joint pain and fatigue supports this diagnosis.
Medical fact of the day: The most common cause of sudden painless vision loss in adults in the UK is branch retinal vein occlusion (BRVO), which primarily affects individuals over 50 years of age.
Quote of the day: “The care you provide is not just a profession, but a vocation. Each day you heal, inspire, and touch lives in ways that echo beyond your own horizons. 🌟”