Question Easy:
A 60-year-old woman presents with gradual vision loss and difficulty seeing at night. On examination, the fundus shows drusen deposits and pigmentary changes in the macula. What is the most likely diagnosis?
A) Diabetic retinopathy
B) Central retinal vein occlusion
C) Age-related macular degeneration
D) Retinitis pigmentosa
E) Glaucoma
Question Medium:
A 45-year-old man complains of sudden severe pain in his right ear, followed by bloody otorrhea after a recent flight. He also reports reduced hearing in the same ear. What is the most likely diagnosis?
A) Otitis externa
B) Barotrauma
C) Acute otitis media
D) Cholesteatoma
E) Eustachian tube dysfunction
Question Hard:
A 30-year-old woman presents with a 2-month history of right-sided facial pain, a blocked nose, and a reduced sense of smell. An MRI scan shows a mass eroding the right ethmoid sinus and extending into the orbit. What is the most likely diagnosis?
A) Nasopharyngeal carcinoma
B) Olfactory neuroblastoma
C) Sinonasal squamous cell carcinoma
D) Orbital pseudotumor
E) Mucocele
Explanations & Answers:
Question Easy Answer:
C) Age-related macular degeneration
Question Easy Explanation:
Age-related macular degeneration (AMD) is a common cause of vision loss in older adults. The presence of drusen and pigmentary changes in the macula are characteristic findings. Management involves lifestyle modifications, such as smoking cessation and the use of specific vitamins to slow progression, based on NICE guidelines.
Question Medium Answer:
B) Barotrauma
Question Medium Explanation:
Barotrauma is damage caused by a change in pressure, and it often occurs during flights. Symptoms like ear pain, bloody otorrhea, and conductive hearing loss are typical. Treatment involves decongestants and pain relief, with severe cases potentially requiring surgical intervention, as recommended by NHS guidelines.
Question Hard Answer:
B) Olfactory neuroblastoma
Question Hard Explanation:
Olfactory neuroblastoma, also known as esthesioneuroblastoma, is a rare malignancy originating in the olfactory epithelium. It often presents with unilateral nasal obstruction, facial pain, and anosmia, with MRI findings essential for diagnosis. Management includes surgical resection followed by radiotherapy or chemotherapy per BNF guidelines.
Medical fact of the day:
Did you know that tinnitus affects about 1 in 10 adults in the UK? It’s not just a ‘ringing in the ears’; it can significantly impact quality of life and is a common reason for GP consultations.
Quote of the day:
“The compassionate care you give today plants seeds of hope you may never see but that will grow in the hearts of many.”