Question Easy:
A 24-year-old woman presents with sudden onset of reduced vision in her right eye and pain on eye movement. She has a history of multiple sclerosis. What is the most likely diagnosis?
A) Retinal detachment
B) Optic neuritis
C) Glaucoma
D) Cataract
E) Conjunctivitis
Question Medium:
A 55-year-old man with a long history of type 2 diabetes complains of hearing difficulties and balance issues over the past few months. Which cranial nerve is most likely affected?
A) Cranial Nerve II
B) Cranial Nerve V
C) Cranial Nerve VIII
D) Cranial Nerve IX
E) Cranial Nerve X
Question Hard:
A 32-year-old man presents with vertigo, tinnitus, and progressive hearing loss in his left ear. An MRI brain shows a cerebellopontine angle mass. What is the most likely diagnosis?
A) Meniere’s disease
B) Acoustic neuroma
C) Labyrinthitis
D) Migraine-associated vertigo
E) Cholesteatoma
Explanations & Answers:
Question Easy Answer:
B) Optic neuritis
Question Easy Explanation:
Optic neuritis is characterised by sudden vision loss and eye pain, especially during movement, and is commonly associated with multiple sclerosis. According to NICE guidelines, optic neuritis is a common initial presentation of MS in patients. 👁️
Question Medium Answer:
C) Cranial Nerve VIII
Question Medium Explanation:
The vestibulocochlear nerve (Cranial Nerve VIII) is responsible for hearing and balance. In patients with diabetes, microvascular damage can affect cranial nerves, leading to sensorineural hearing loss and balance problems. The BNF notes that such neuropathic complications can arise in diabetic patients. 👂
Question Hard Answer:
B) Acoustic neuroma
Question Hard Explanation:
Acoustic neuroma, also known as vestibular schwannoma, is a benign tumour of the 8th cranial nerve and often presents with the classic triad of symptoms: hearing loss, tinnitus, and balance dysfunction. An MRI showing a cerebellopontine angle mass is typical for this diagnosis, aligning with NHS guidelines on this condition. 🧠
Medical fact of the day: Did you know that the cochlea, a spiral-shaped organ in our inner ear, can distinguish between sounds as quiet as a whisper and the roar of a jet engine? This is thanks to the hair cells lining the cochlea, which are so sensitive they can detect movements of less than a billionth of a metre! 🎶
Quote of the day: “In the rhythm of caring for others, find a moment to care for yourself.” 🌟