Question Easy:
A 26-year-old woman presents to the GP with itchy, watery eyes and a runny nose every spring. She has no significant past medical history. What is the most likely diagnosis? 🌸
A) Perennial rhinitis
B) Allergic conjunctivitis
C) Viral conjunctivitis
D) Chlamydial conjunctivitis
E) Bacterial conjunctivitis
Explanations & Answers:
Question Easy Answer: B) Allergic conjunctivitis
Question Easy Explanation: This patient presents with symptoms that are classic for allergic conjunctivitis, often linked to seasonal allergies, unlike perennial rhinitis which occurs year-round. NICE guidelines recommend considering the time of year and symptom correlation when diagnosing such conditions.
—
Question Medium:
A 44-year-old man presents with gradual hearing loss. He describes it as worse in his right ear and mentions a ringing sensation. Upon examination, the Weber test lateralizes to the left ear, and the Rinne test shows air conduction is better than bone conduction bilaterally. What is the likely diagnosis? 🎧
A) Otosclerosis
B) Presbycusis
C) Noise-induced hearing loss
D) Ménière’s disease
E) Acoustic neuroma
Question Medium Answer: E) Acoustic neuroma
Question Medium Explanation: This scenario suggests a sensorineural hearing loss in the right ear, given the Weber test result and the Rinne test showing air conduction is better than bone conduction. Acoustic neuroma should be suspected with asymmetric sensorineural hearing loss and tinnitus, consistent with NICE guidelines for managing such cases.
—
Question Hard:
A 58-year-old woman presents with sudden onset of visual disturbances, including flashing lights and floaters. She reports that a shadow seems to be spreading across the visual field of her left eye. What is the most appropriate immediate action? 👀
A) Reassure and review in 2 weeks
B) Prescribe antibiotic eye drops
C) Immediate referral to ophthalmology
D) Advise use of over-the-counter eye lubricants
E) Order a routine optometrist appointment
Question Hard Answer: C) Immediate referral to ophthalmology
Question Hard Explanation: The patient’s symptoms are suggestive of retinal detachment, a medical emergency. NICE guidelines emphasize the importance of urgent referral to ophthalmology for any signs of retinal detachment to prevent potential loss of vision. Rapid intervention is crucial.
—
Medical fact of the day: Did you know that approximately 10% of the UK population suffers from tinnitus at some point in their life? This common condition is often associated with hearing loss or damage, and treatment may include sound therapy or cognitive behavioural therapy as recommended by the NHS.
Quote of the day: “In the tapestry of healing, each thread of care we weave spins a story of hope, resilience, and renewal.”