Question Easy:
👶 A 6-month-old baby presents to the GP with an upper respiratory tract infection and associated pyrexia. The parents are concerned as the baby keeps tugging at their ear. Which condition are you most likely to suspect?
A) Otitis externa
B) Otitis media
C) Foreign body in ear
D) Eustachian tube dysfunction
E) Mastoiditis
Question Medium:
🧒 A 12-year-old boy visits the clinic with a history of recurrent blocked noses and mouth breathing. Examination reveals red, swollen nasal turbinates and an inflamed throat. What is the most likely diagnosis?
A) Rhinitis medicamentosa
B) Chronic sinusitis
C) Nasal polyposis
D) Allergic rhinitis
E) Deviated nasal septum
Question Hard:
👩⚕️ A 45-year-old male presents with sudden onset vertigo, tinnitus, and hearing loss in the left ear. These symptoms have recurred several times over several months. Which condition does this presentation best describe?
A) Vestibular neuronitis
B) Benign paroxysmal positional vertigo (BPPV)
C) Ménière’s disease
D) Acoustic neuroma
E) Labyrinthitis
Explanations & Answers:
Question Easy Answer: B)
Question Easy Explanation: In children, ear pulling combined with symptoms of an upper respiratory infection often suggests otitis media. It is common for infants to develop middle ear infections following a cold due to their narrower Eustachian tubes compared to adults, leading to fluid accumulation. NICE recommends treating uncomplicated cases with analgesia and observing unless symptoms persist or worsen.
Question Medium Answer: D)
Question Medium Explanation: Allergic rhinitis presents with nasal congestion, rhinorrhea, sneezing, and often involves swollen, inflamed nasal turbinates. It’s common in children and can lead to mouth breathing due to nasal blockage. NICE guidelines suggest treatment with antihistamines and nasal corticosteroids as first-line interventions.
Question Hard Answer: C)
Question Hard Explanation: Ménière’s disease is characterised by episodes of vertigo, unilateral tinnitus, and fluctuating hearing loss, aligning with this patient’s presentation. It involves endolymphatic hydrops affecting the inner ear. Management includes dietary modifications, diuretics, and vestibular rehabilitation, with NICE advising more advanced interventions in refractory cases.
Medical fact of the day: The human ear can distinguish over 400,000 different sounds! Due to the ear’s intricate structure involving the outer, middle, and inner ear, sound discrimination is crucial for communication, spatial awareness, and detecting environmental changes, which is why hearing assessments are vital components of routine health checks.
Quote of the day: “In the heart of healthcare is a desire to make a difference; every day you step forward with courage, compassion, and a caring hand, you change the world one patient at a time.”