Question Easy:
A 50-year-old woman presents with a sudden onset of painless loss of vision in her right eye. She describes it as looking through a curtain. Fundoscopy reveals a pale retina with a cherry-red spot at the fovea. What is the most likely diagnosis? 👁️
A) Retinal detachment
B) Central retinal artery occlusion
C) Acute angle-closure glaucoma
D) Vitreous haemorrhage
E) Optic neuritis
Explanations & Answers:
Question Easy Answer:
B) Central retinal artery occlusion
Question Easy Explanation:
Central retinal artery occlusion (CRAO) typically presents with sudden, painless monocular vision loss and is commonly described as “looking through a curtain.” A classic finding on fundoscopy is a pale retina with a cherry-red spot at the fovea. NICE guidelines recommend early ophthalmologist referral and managing underlying risk factors such as atherosclerosis or emboli.
Question Medium:
A 65-year-old man reports progressive bilateral hearing loss over the past year and tinnitus, predominantly in the right ear. He denies any pain or discharge. His history is significant for prolonged noise exposure during his years working in construction. Otoscopy is unremarkable. What is the most likely diagnosis? 🎧
A) Otitis media
B) Noise-induced hearing loss
C) Acoustic neuroma
D) Presbycusis
E) Meniere’s disease
Explanations & Answers:
Question Medium Answer:
D) Presbycusis
Question Medium Explanation:
Presbycusis, or age-related hearing loss, is the most common cause of progressive bilateral hearing loss in the elderly. It’s typically associated with a gradual loss of hearing, especially high-frequency sounds, and may also include tinnitus. It’s important to rule out other causes, including noise-induced hearing loss and acoustic neuroma, but the age and bilateral nature in the absence of other ear symptoms make presbycusis most likely. Management includes hearing aids and addressing any contributing factors according to NHS and NICE guidelines.
Question Hard:
A 30-year-old woman presents with recurrent episodes of vertigo, fluctuating hearing loss, aural fullness, and tinnitus in her left ear. The vertigo episodes last from 20 minutes to several hours. What is the most likely diagnosis? 🌪️
A) Labyrinthitis
B) Vestibular neuritis
C) Benign paroxysmal positional vertigo (BPPV)
D) Meniere’s disease
E) Acoustic neuroma
Explanations & Answers:
Question Hard Answer:
D) Meniere’s disease
Question Hard Explanation:
Meniere’s disease is characterised by recurrent episodes of vertigo, fluctuating sensorineural hearing loss, aural fullness, and tinnitus, typically affecting one ear initially. The episodic nature of vertigo lasting minutes to hours is also hallmark of the disorder. Diagnosis is clinical, and management according to NICE guidelines includes lifestyle modifications, medical therapy, and sometimes surgical interventions for severe cases.
Medical fact of the day:
Did you know? In the UK, the most common cause of preventable blindness is diabetic retinopathy. This underscores the importance of regular eye screenings for diabetic patients, as recommended by NHS guidelines.
Quote of the day:
“Caring for others is an act of strength in the face of adversity. Every patient you help is a testament to your dedication and resilience.”