Question Easy:
A 28-year-old man comes to the GP with itching and redness in his left eye, which started after cycling through a park during peak pollen season 🌸. He denies any vision changes or discharge. What is the most likely diagnosis?
A) Bacterial conjunctivitis
B) Viral conjunctivitis
C) Allergic conjunctivitis
D) Keratitis
E) Iritis
Explanations & Answers:
Question Easy Answer:
C) Allergic conjunctivitis
Question Easy Explanation:
Allergic conjunctivitis is characterised by itching, redness, and watery eyes, usually in both eyes but can start in one. It often occurs during pollen season. According to the NHS, management generally includes avoiding allergens and using antihistamine or mast cell stabiliser eye drops.
—
Question Medium:
A 45-year-old woman presents with sudden onset severe vertigo, hearing loss, and tinnitus in her right ear. She reports no recent infections. What is the most likely diagnosis? 🎧
A) BPPV (Benign Paroxysmal Positional Vertigo)
B) Meniere’s disease
C) Acoustic neuroma
D) Labyrinthitis
E) Vestibular neuronitis
Explanations & Answers:
Question Medium Answer:
B) Meniere’s disease
Question Medium Explanation:
Meniere’s disease is a disorder of the inner ear that causes episodes of vertigo, tinnitus, and fluctuating hearing loss. The NICE guidelines suggest management may include lifestyle modifications and medications like betahistine, with diuretics to reduce fluid in the ear.
—
Question Hard:
A 60-year-old man complains of gradual vision loss. On examination, there is a central scotoma in his left eye and an Amsler grid test reveals metamorphopsia. Fundoscopy shows drusen deposits in the macula. What is the most likely diagnosis? 👁️
A) Retinal detachment
B) Diabetic retinopathy
C) Glaucoma
D) Age-related macular degeneration
E) Retinitis pigmentosa
Explanations & Answers:
Question Hard Answer:
D) Age-related macular degeneration
Question Hard Explanation:
Age-related macular degeneration (AMD) is a common eye condition among the elderly. The presence of drusen, central vision loss, and metamorphopsia on Amsler grid testing are indicative of AMD. According to NICE, treatment options include anti-VEGF injections for wet AMD and lifestyle changes to slow dry AMD progression.
—
Medical fact of the day: Did you know that about 1 in 5 cases of blindness in the UK is due to age-related macular degeneration? This makes AMD the leading cause of blindness in older adults, highlighting the importance of regular eye checks.
Quote of the day: “In the simplest moments of care, you may find the greatest impact. Keep the compassion in your practice and the brilliance in your heart.”