Question Easy:
A 25-year-old woman presents with sudden onset hearing loss in her right ear after a recent upper respiratory tract infection. She reports no ear pain or discharge. Which is the most likely diagnosis?
A) Otitis media
B) Labyrinthitis
C) Sensorineural hearing loss
D) Otosclerosis
E) Earwax impaction
Question Medium:
A 60-year-old man complains of progressive bilateral vision loss. He has difficulty with night vision and reports seeing halos around lights. His intraocular pressure is elevated. What is the most likely diagnosis?
A) Cataracts
B) Acute angle-closure glaucoma
C) Age-related macular degeneration
D) Chronic open-angle glaucoma
E) Diabetic retinopathy
Question Hard:
A 40-year-old woman presents with vertigo, tinnitus, and hearing loss in her left ear, all of which occur intermittently. There is no history of trauma or recent infections. What is the most likely diagnosis?
A) Ménière’s disease
B) Vestibular neuritis
C) Benign paroxysmal positional vertigo (BPPV)
D) Acoustic neuroma
E) Vestibular migraine
Explanations & Answers:
Question Easy Answer: C) Sensorineural hearing loss
Question Easy Explanation: This case is suggestive of sudden sensorineural hearing loss, often idiopathic or post-viral. NICE guidelines recommend prompt audiological assessment and consider urgent treatment with corticosteroids to improve the prognosis.
Question Medium Answer: D) Chronic open-angle glaucoma
Question Medium Explanation: The clinical features of progressive vision loss, difficulty with night vision, and halos around lights, along with elevated intraocular pressure, suggest chronic open-angle glaucoma. This condition requires monitoring and treatment to prevent further vision loss, as per NICE guidelines.
Question Hard Answer: A) Ménière’s disease
Question Hard Explanation: Ménière’s disease is characterized by episodes of vertigo, tinnitus, and fluctuating sensorineural hearing loss, often unilateral. Management includes lifestyle modifications, diuretics, or ENT referral for further intervention, following NICE recommendations.
Medical fact of the day: 👂 Did you know that Ménière’s disease affects approximately 1 in 1,000 people in the UK? Though the exact cause is unknown, it often strikes adults in their 40s to 60s and can have a significant impact on quality of life.
Quote of the day: “In the tapestry of life, each fiber counts. Remember, dear healthcare worker, your compassion threads through the very fabric that heals.”