Question Easy:
👂 A 25-year-old woman attends the GP with sudden onset dizziness and hearing loss in her left ear, accompanied by a ringing sensation. She remembers having a cold last week. What is the most likely diagnosis?
A) Otitis media
B) Labyrinthitis
C) Meniere’s disease
D) Acoustic neuroma
E) Presbycusis
Explanations & Answers:
Question Easy Answer: B) Labyrinthitis
Question Easy Explanation: Labyrinthitis is often preceded by a viral illness and typically presents with sudden vertigo, hearing loss, and tinnitus. This aligns with the patient’s history of a recent cold.
Question Medium:
😎 A 36-year-old man complains of unilateral facial pain, forehead numbness, and excessive tearing from the right eye. There is no significant medical history. What is the most likely affected cranial nerve?
A) CN V – Maxillary division
B) CN VII – Facial nerve
C) CN V – Mandibular division
D) CN V – Ophthalmic division
E) CN III – Oculomotor nerve
Explanations & Answers:
Question Medium Answer: D) CN V – Ophthalmic division
Question Medium Explanation: The description is characteristic of trigeminal neuralgia affecting the ophthalmic division of the trigeminal nerve (CN V), resulting in pain and symptoms related to the eye such as tearing.
Question Hard:
👁️ A 68-year-old woman with diabetes presents with sudden loss of vision in her right eye. Fundoscopy reveals retinal hemorrhage and a pale retina. Which condition is the most likely cause?
A) Central retinal artery occlusion
B) Retinal detachment
C) Central retinal vein occlusion
D) Diabetic retinopathy
E) Optic neuritis
Explanations & Answers:
Question Hard Answer: C) Central retinal vein occlusion
Question Hard Explanation: Central retinal vein occlusion presents with sudden vision loss, retinal hemorrhages, and a “blood and thunder” appearance on fundoscopy. It is often linked to systemic diseases like diabetes. Although a pale retina might suggest an arterial occlusion, patients with this typically depict a “cherry-red spot” rather than retinal hemorrhages.
Medical fact of the day: In the UK, the most common cause of vision loss in people over 50 is age-related macular degeneration (AMD), which affects the macula, a small but crucial part of the retina.
Quote of the day: “In the field of health, caring holistically means seeing beyond symptoms—unlocking the full picture of humanity one diagnosis at a time.”