Question Easy:
A 45-year-old woman is experiencing sudden hearing loss in her left ear. She also reports a feeling of fullness and mild dizziness. What is the most appropriate initial management in primary care? 🎧
A) Antibiotics
B) Oral corticosteroids
C) Antihistamines
D) Referral to audiology for a hearing test
E) Emergency MRI of the brain
Question Medium:
A 30-year-old man presents with persistent nasal congestion, decreased sense of smell, and facial pressure for several weeks. He has a history of allergic rhinitis. Which of the following medications is most appropriate to address his current symptoms? 👃
A) Oral antihistamines
B) Intranasal corticosteroids
C) Nasal decongestants
D) Oral corticosteroids
E) Saline nasal irrigation
Question Hard:
A 55-year-old man with poorly controlled hypertension presents with a sudden painless loss of vision in his right eye. Fundoscopy reveals a pale retina with a cherry-red spot in the macula. What is the most likely diagnosis? 👁️
A) Retinal detachment
B) Central retinal artery occlusion
C) Central retinal vein occlusion
D) Age-related macular degeneration
E) Glaucoma
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: Sudden sensorineural hearing loss is an otologic emergency. According to NICE guidelines, oral corticosteroids should be initiated within 72 hours to improve the chances of hearing recovery. Referral for audiometric evaluation is also recommended, but starting corticosteroids should not be delayed. Antibiotics, unless there is a clear indication of infection, are not appropriate.
Question Medium Answer: B
Question Medium Explanation: Intranasal corticosteroids are the treatment of choice for nasal congestion associated with chronic rhinosinusitis and allergic rhinitis. They help reduce inflammation and improve symptoms such as nasal congestion and loss of smell. Oral antihistamines are less effective for nasal congestion, while nasal decongestants can cause rebound congestion if used long-term.
Question Hard Answer: B
Question Hard Explanation: The presentation of a pale retina with a cherry-red spot is characteristic of central retinal artery occlusion (CRAO), an ophthalmic emergency that results from an interruption of blood flow to the retina. Immediate management is required to restore vision, although the chances of recovery decrease significantly after a few hours.
Medical fact of the day: Did you know that the human eye can distinguish approximately 10 million different colours? This is due to the presence of photoreceptor cells called cones which are sensitive to different wavelengths of light. Most humans have three types of cones which allow for this extensive colour perception. 🔍
Quote of the day: “In the tapestry of healthcare, every thread of care weaves hope, resilience, and strength into the lives we touch.” 🌟