Question Easy:
👂 A 25-year-old woman presents with a sudden onset of vertigo, tinnitus, and hearing loss in the right ear. She is otherwise healthy with no medication use. What is the most likely diagnosis?
A) Acute otitis media
B) Meniere’s disease
C) Benign paroxysmal positional vertigo (BPPV)
D) Vestibular neuritis
E) Acoustic neuroma
Question Medium:
👁️ A 67-year-old man is referred to you by his optician due to concerns about his left eye. On examination, there is an increased cup-to-disc ratio. Which of the following would be the primary treatment option to manage this condition, according to NICE guidelines?
A) Laser trabeculoplasty
B) Topical beta-blockers
C) Topical prostaglandin analogues
D) Surgical trabeculectomy
E) Oral carbonic anhydrase inhibitors
Question Hard:
👃 A 45-year-old man with a history of chronic rhinosinusitis presents with nasal polyps and complains of anosmia. Despite treatment with nasal corticosteroids, he shows no improvement. According to NICE guidelines, what is the next best step in managing this condition?
A) Continue nasal corticosteroids
B) Refer for allergen testing
C) Prescribe oral corticosteroids
D) Endoscopic sinus surgery
E) Prescribe long-term antibiotics
Explanations & Answers:
Question Easy Answer: B) Meniere’s disease
Question Easy Explanation: Meniere’s disease typically presents with a triad of vertigo, tinnitus, and sensorineural hearing loss. It is often recurrent, and management may include lifestyle adaptations like a low-salt diet and medications such as betahistine.
Question Medium Answer: C) Topical prostaglandin analogues
Question Medium Explanation: An increased cup-to-disc ratio is indicative of glaucoma, most commonly primary open-angle glaucoma. NICE guidelines recommend prostaglandin analogues as the first-line treatment due to their efficacy in lowering intraocular pressure.
Question Hard Answer: C) Prescribe oral corticosteroids
Question Hard Explanation: For patients with nasal polyps and chronic rhinosinusitis who do not respond adequately to nasal corticosteroids, NICE guidelines suggest a short course of oral corticosteroids as the next step before considering surgical options.
Medical fact of the day: The human eye can distinguish approximately 10 million different colours! However, conditions like glaucoma can severely limit this ability, highlighting the importance of regular eye examinations.
Quote of the day: “In the tapestry of care, every thread—no matter how small—contributes to the greater fabric of healing and hope.”