Question Easy:
A 25-year-old woman visits the GP complaining of itchy, red, and watery eyes. She mentions that this occurs every spring and is accompanied by sneezing 🤧. Which of the following is the most appropriate first-line treatment?
A) Chlorphenamine
B) Sodium cromoglicate eye drops
C) Olopatadine eye drops
D) Artificial tears
E) Betamethasone eye drops
Explanations & Answers:
Question Easy Answer: B) Sodium cromoglicate eye drops
Question Easy Explanation: According to NICE guidelines, topical sodium cromoglicate is a first-line treatment for allergic conjunctivitis, especially when symptoms are seasonal. It helps to stabilize mast cells and reduce histamine release, thereby alleviating symptoms like itching and redness.
Question Medium:
A 45-year-old man presents with sudden unilateral hearing loss and a feeling of fullness in the affected ear. Examination reveals a bulging tympanic membrane. What is the most likely diagnosis?
A) Acute otitis externa
B) Otosclerosis
C) Meniere’s disease
D) Acute otitis media
E) Presbycusis
Question Medium Answer: D) Acute otitis media
Question Medium Explanation: Acute otitis media is characterized by rapid onset of ear pain, hearing loss, and sometimes fever, with examination typically showing a bulging tympanic membrane. It is often accompanied by a feeling of fullness in the ear and is usually caused by a viral or bacterial infection following an upper respiratory tract infection.
Question Hard:
A 56-year-old woman visits your clinic with deteriorating vision over the last year. She has difficulty with night vision and notes halos around lights. She also reports difficulty reading small print 📚. On examination, you find an increased cup-to-disc ratio in her optic nerves. What is the most likely diagnosis?
A) Age-related macular degeneration
B) Cataracts
C) Glaucoma
D) Diabetic retinopathy
E) Retinitis pigmentosa
Question Hard Answer: C) Glaucoma
Question Hard Explanation: The symptoms described, including halos around lights and difficulty with night vision, along with the finding of an increased cup-to-disc ratio, are indicative of glaucoma. NICE guidelines recommend regular screening to detect elevated intraocular pressure and optic nerve damage to manage glaucoma effectively and prevent significant vision loss.
Medical fact of the day: The human ear is capable of hearing sounds as low as 20 Hz and as high as 20,000 Hz, but sensitivity to high frequencies decreases with age—a process known as presbycusis. This highlights the importance of regular hearing assessments in older adults to maintain communication abilities and overall quality of life.
Quote of the day: “Every life you touch with your care and compassion is a life uplifted. Your dedication is the quiet strength that shapes the future of health.”