Question Easy:
A 30-year-old woman presents to the GP with itchy, watery eyes and sneezing 🤧, particularly during the spring months. What is the most likely diagnosis?
A) Conjunctivitis
B) Allergic rhinitis
C) Acute sinusitis
D) Dry eye syndrome
E) Blepharitis
Question Medium:
A 55-year-old man is seen at the ophthalmology clinic with sudden painless loss of vision in his left eye. On examination, his left retina shows a “cherry red spot” at the fovea. What is the most likely diagnosis?
A) Retinal detachment
B) Central retinal artery occlusion
C) Central retinal vein occlusion
D) Acute glaucoma
E) Age-related macular degeneration
Question Hard:
A 45-year-old male reports hearing loss and a sensation of fullness in his right ear, which worsens when flying. An otoscopy reveals a retracted tympanic membrane and fluid behind it. What is the most appropriate initial management?
A) Myringotomy
B) Oral antibiotics
C) Intranasal corticosteroids
D) Valsalva manoeuvre
E) Tympanostomy tube insertion
Explanations & Answers:
Question Easy Answer:
B) Allergic rhinitis
Question Easy Explanation:
The symptoms described—itchy, watery eyes, and sneezing during spring—are classic signs of allergic rhinitis, often linked to pollen exposure in the UK. According to NICE guidelines, allergen avoidance and antihistamines are the first line treatments.
Question Medium Answer:
B) Central retinal artery occlusion
Question Medium Explanation:
The “cherry red spot” at the fovea is characteristic of central retinal artery occlusion. This condition requires urgent attention, as per NHS guidelines, due to the risk of permanent vision loss. Immediate interventions may include ocular massage or intra-arterial thrombolysis.
Question Hard Answer:
D) Valsalva manoeuvre
Question Hard Explanation:
The presentation suggests eustachian tube dysfunction, often associated with barometric pressure changes, such as during flying. The Valsalva manoeuvre is a simple technique to equalize ear pressure and can help resolve the fluid build-up, as recommended by clinical guidelines.
Medical fact of the day:
Did you know? In the UK, age-related macular degeneration is the leading cause of blindness in people over 60. Early detection and treatment are crucial to managing this condition effectively.
Quote of the day:
“In every heartbeat, every breath lies the potential to change a life. Persevere, because the world needs your healing hands.” 🌟