11/10/2024 – Special senses

Question Easy:
An elderly patient presents with sudden painless loss of vision in one eye. The retina appears pale with a cherry-red spot at the fovea. What is the most likely diagnosis? 😟
A) Retinal detachment
B) Central retinal artery occlusion
C) Optic neuritis
D) Age-related macular degeneration
E) Vitreous hemorrhage

Question Medium:
A 50-year-old man presents with progressively worsening hearing loss and tinnitus. Examination reveals a normal tympanic membrane, and Rinne’s test shows air conduction greater than bone conduction bilaterally. What is the most likely diagnosis? 🤔
A) Presbycusis
B) Otosclerosis
C) Acoustic neuroma
D) Noise-induced hearing loss
E) Meniere’s disease

Question Hard:
A 26-year-old woman presents with double vision and difficulty swallowing. On examination, she has ptosis and weak proximal limb muscles. The symptoms worsen with exercise and improve with rest. What is the most likely diagnosis? 🤓
A) Multiple sclerosis
B) Myasthenia gravis
C) Botulism
D) Guillain-Barre syndrome
E) Lambert-Eaton myasthenic syndrome

Explanations & Answers:

Question Easy Answer: B) Central retinal artery occlusion
Question Easy Explanation: Central retinal artery occlusion is characterized by a sudden painless loss of vision, often with a pale retina and cherry-red spot. This condition is a medical emergency that requires urgent referral to an ophthalmologist as recommended by NICE guidelines.

Question Medium Answer: C) Acoustic neuroma
Question Medium Explanation: Acoustic neuroma, or vestibular schwannoma, often presents with unilateral hearing loss and tinnitus. Rinne’s test showing air conduction greater than bone suggests sensorineural hearing loss, aligning with NICE guidance for suspected acoustic neuroma cases.

Question Hard Answer: B) Myasthenia gravis
Question Hard Explanation: Myasthenia gravis is marked by muscle weakness that worsens with activity and improves with rest. Ptosis and diplopia are common. The NICE guidelines recommend testing for acetylcholine receptor antibodies to confirm the diagnosis.

Medical fact of the day: Did you know that age-related macular degeneration (AMD) is the most common cause of blindness in the UK? Early detection and modification of risk factors like smoking can slow its progression.

Quote of the day: “In the rush of everyday tasks, let us not forget that healing is both a science and an art, rooted in compassion and perseverance.” 🌱