Question Easy: A 45-year-old man visits his GP with sudden hearing loss in his left ear after a flight. He describes feeling pressure in the ear, accompanied by mild pain and reduced hearing. There is no discharge or fever. What is the most likely diagnosis? 🛫👂
A) Otitis media
B) Barotrauma
C) Acoustic neuroma
D) Cerumen impaction
E) Meniere’s disease
Question Medium: A 26-year-old woman presents to the emergency department with severe vertigo, nausea, and vomiting that began suddenly two hours ago. She also complains of tinnitus and hearing loss in her right ear. There is a history of recent upper respiratory tract infection. What is the most probable diagnosis? 🚑🤢
A) Vestibular neuritis
B) Labyrinthitis
C) Benign paroxysmal positional vertigo (BPPV)
D) Meniere’s disease
E) Migraine-associated vertigo
Question Hard: A 65-year-old diabetic male presents to his GP with distorted vision and difficulty reading. On slit-lamp examination, the ophthalmologist notes drusen and retinal pigment epithelial changes. What is the most likely diagnosis? 👁️🔎
A) Diabetic retinopathy
B) Retinal detachment
C) Age-related macular degeneration
D) Glaucoma
E) Cataracts
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: The most likely diagnosis is barotrauma, which occurs due to changes in pressure experienced during flights, leading to discomfort and hearing loss. This is usually temporary. NICE guidelines recommend considering this diagnosis in cases of sudden hearing changes following altitude changes.
Question Medium Answer: B
Question Medium Explanation: Labyrinthitis is indicated by the combination of vertigo, hearing loss, and tinnitus, often following a viral upper respiratory infection. NHS resources state that labyrinthitis involves both auditory and vestibular components, unlike vestibular neuritis, which typically affects balance only.
Question Hard Answer: C
Question Hard Explanation: Age-related macular degeneration (AMD) leads to central vision distortion and reading difficulty, marked by drusen and changes in the retinal pigment epithelium. This is a common condition in older adults as per BNF guidelines.
Medical fact of the day: The human ear can detect sounds as quiet as -9 decibels, which is below the threshold of silence, showcasing its extraordinary sensitivity. Regular auditory assessments can be crucial in detecting early signs of hearing loss.
Quote of the day: “In the symphony of healthcare, every act of kindness is a note that brings harmony to the healing journey.”