Question Easy:
A 67-year-old man presents with gradual loss of vision in his right eye over the last year. He denies pain or redness. On examination, his visual acuity is reduced, and the red reflex is diminished. What is the most likely diagnosis? 🔍
A) Glaucoma
B) Age-related macular degeneration
C) Cataract
D) Retinal detachment
E) Diabetic retinopathy
Explanations & Answers:
Question Easy Answer:
C) Cataract
Question Easy Explanation:
A cataract is a common cause of gradual, painless loss of vision in older individuals. The diminished red reflex is a key clue. According to NICE guidelines, cataracts are characterized by opacification of the lens, leading to visual impairment, particularly in the elderly.
—
Question Medium:
A 45-year-old woman comes to the GP with an acute onset of vertigo, tinnitus, and hearing loss in her left ear. These attacks last several hours and are becoming more frequent. What is the most appropriate initial management? 🎧
A) Prescribe oral prednisolone
B) Suggest positional exercises
C) Refer to ENT for possible Meniere’s disease
D) Prescribe a diuretic
E) Recommend a low-salt diet
Explanations & Answers:
Question Medium Answer:
E) Recommend a low-salt diet
Question Medium Explanation:
Meniere’s disease is characterized by episodes of vertigo, tinnitus, and hearing loss. NICE guidelines recommend dietary changes, particularly a low-salt diet, as part of the initial management strategy to help reduce endolymphatic fluid pressure.
—
Question Hard:
A 3-year-old child is brought to the ophthalmology clinic with parents concerned about a white pupillary reflex in photographs. On examination, red reflex is absent in the left eye and a mass is noted in the retina. What is the most likely diagnosis? 👁️
A) Congenital cataract
B) Retinitis pigmentosa
C) Retinoblastoma
D) Coats’ disease
E) Persistent hyperplastic primary vitreous
Explanations & Answers:
Question Hard Answer:
C) Retinoblastoma
Question Hard Explanation:
A white pupillary reflex (leukocoria) in a child is concerning for retinoblastoma, a malignant tumor of the retina. The absence of the red reflex and the presence of a retinal mass further suggest this diagnosis. According to NHS guidelines, early detection is critical for management and visual preservation.
—
Medical fact of the day: Did you know that the sense of smell can significantly impact memory and emotional experiences? The olfactory system has direct connections to the brain’s limbic system, which is why certain scents can evoke vivid memories or feelings.
Quote of the day: “In caring for the senses, we enrich the soul. Let each patient be a reminder of the gift we hold—the power to heal and to hear, to see and to soothe.” 🌟