12/07/2024 – Special senses

Question Easy:
A 50-year-old woman presents with a sudden, painless loss of vision in her right eye. She describes it as a “curtain coming down” over her eye. What is the most likely diagnosis?
A) Retinal detachment
B) Glaucoma
C) Cataract
D) Age-related macular degeneration (AMD)
E) Diabetic retinopathy

Question Medium:
A 55-year-old man complains of ringing in his ears 🛎️ and some loss of hearing. He also mentions a feeling of fullness in the affected ear and occasional dizziness. Which of the following is the most likely diagnosis?
A) Labyrinthitis
B) Meniere’s disease
C) Acoustic neuroma
D) Otitis media
E) Chronic otitis externa

Question Hard:
A 26-year-old woman presents with bilateral eye pain, decreased visual acuity, and photophobia. She has a history of Crohn’s disease 🌾. On examination, there is conjunctival injection and keratic precipitates. Which of the following is the most likely diagnosis?
A) Uveitis
B) Conjunctivitis
C) Keratitis
D) Glaucoma
E) Retinitis pigmentosa

Explanations & Answers:

Question Easy Answer: A
Question Easy Explanation: The description of a “curtain coming down” over the eye is classic for a retinal detachment. It is a medical emergency and requires prompt ophthalmological intervention to prevent permanent vision loss.

Question Medium Answer: B
Question Medium Explanation: Meniere’s disease is characterized by episodic vertigo, tinnitus, a sensation of fullness in the ear, and hearing loss. The symptoms described fit this profile well.

Question Hard Answer: A
Question Hard Explanation: The patient’s symptoms of bilateral eye pain, decreased visual acuity, and photophobia are indicative of uveitis, particularly given her history of Crohn’s disease, which is associated with this condition. Conjunctival injection and keratic precipitates further support this diagnosis.

Medical fact of the day: The United Kingdom has a higher prevalence of age-related macular degeneration (AMD) compared to many other countries, partly due to its aging population. AMD is the leading cause of blindness in individuals over 50 years old in the UK.

Quote of the day: “In the face of adversity, our strength as healthcare workers is measured not by what we endure, but by how we inspire hope and healing in others.” 🌟