Question Easy:
👂 A 65-year-old patient presents to their GP with gradual hearing loss in both ears. They have spent most of their life working in a noisy factory environment. What is the most likely diagnosis?
A) Otosclerosis
B) Presbycusis
C) Noise-induced hearing loss
D) Meniere’s disease
E) Acoustic neuroma
Explanations & Answers:
Question Easy Answer: B) Presbycusis
Question Easy Explanation: Presbycusis is the age-related hearing loss that typically affects the elderly. While noise-induced hearing loss is common among people exposed to loud environments, presbycusis is more directly related to age. According to NICE guidelines, it presents as bilateral sensorineural hearing loss, usually affecting high frequencies first.
Question Medium:
👓 A 40-year-old woman presents with diplopia and difficulty reading due to eyestrain. She has Graves’ disease. What eye condition is most likely responsible for these symptoms?
A) Cataracts
B) Myopia
C) Keratoconus
D) Thyroid eye disease
E) Retinal detachment
Question Medium Answer: D) Thyroid eye disease
Question Medium Explanation: Thyroid eye disease, associated with Graves’ disease, can cause symptoms such as diplopia due to muscle involvement and can lead to exophthalmos. NICE guidelines outline the management of ocular symptoms in hyperthyroid patients, which is often supportive and may require ophthalmology referral.
Question Hard:
👁️ A 50-year-old patient experiences sudden painless loss of vision in one eye while golfing. On examination, a pale retina with a cherry-red spot is noted. Immediate management includes attempting to lower intraocular pressure. What is the most likely diagnosis?
A) Central retinal vein occlusion
B) Retinal detachment
C) Central retinal artery occlusion
D) Vitreous hemorrhage
E) Optic neuritis
Question Hard Answer: C) Central retinal artery occlusion
Question Hard Explanation: Central retinal artery occlusion (CRAO) presents as sudden and painless loss of vision, and the fundoscopic exam often reveals a pale retina with a cherry-red spot at the fovea. It is a serious ophthalmic emergency. According to NHS guidelines, immediate actions might include ocular massage and lowering intraocular pressure to potentially dislodge the occlusion.
Medical fact of the day: Did you know that age-related macular degeneration is the leading cause of blindness in the UK? Regular eye exams are crucial for early detection and management, as recommended by the Royal National Institute of Blind People (RNIB).
Quote of the day: “Health care is like a grand symphony. Every note, however small, contributes to the harmony of healing.” 🌟