Question Easy:
A 7-year-old boy presents to the GP with itching and redness in his right eye. 👁️ His mother mentions he frequently rubs it and states that it gets worse during springtime. What is the most likely diagnosis?
A) Bacterial conjunctivitis
B) Viral conjunctivitis
C) Allergic conjunctivitis
D) Dry eyes
E) Iritis
Question Medium:
A 60-year-old man comes to the clinic reporting gradual hearing loss in his left ear. He also mentions a sensation of fullness in the ear at times. On examination, Weber’s test lateralises to the right ear and Rinne’s test is negative in the left ear. What is the most likely diagnosis?
A) Sensorineural hearing loss
B) Otosclerosis
C) Meniere’s disease
D) Acoustic neuroma
E) Cerumen impaction
Question Hard:
A 45-year-old woman presents with sudden onset of vertigo, tinnitus, and left-sided hearing loss. She feels like the room is spinning and episodes last several hours. She has no recent upper respiratory infections. What is the most appropriate management to reduce the frequency and severity of these episodes?
A) Betahistine
B) Amoxicillin
C) Carbamazepine
D) Prednisolone
E) Hydrochlorothiazide
Explanations & Answers:
Question Easy Answer:
C) Allergic conjunctivitis
Question Easy Explanation:
This boy’s symptoms, such as itching, redness, and seasonal pattern, strongly suggest allergic conjunctivitis. According to NICE guidelines, this condition is common in children and often exacerbated by allergens such as pollen during springtime. Treatment typically involves allergen avoidance and using antihistamine drops for symptom relief.
Question Medium Answer:
E) Cerumen impaction
Question Medium Explanation:
The findings from the Weber and Rinne tests suggest conductive hearing loss in the left ear. Cerumen impaction is a common cause of conductive hearing loss where sound conduction is blocked. Occupational or environmental factors leading to wax build-up can contribute to this issue. Management involves ear irrigation or cerumenolytics, according to NHS guidelines.
Question Hard Answer:
A) Betahistine
Question Hard Explanation:
The triad of symptoms—vertigo, tinnitus, and hearing loss—points towards Meniere’s disease. The NICE guidelines recommend betahistine as it can help reduce the frequency and intensity of vertigo episodes associated with Meniere’s disease. Lifestyle modifications, such as low-sodium diets, may also support management.
Medical fact of the day:
Did you know that the human eye can distinguish approximately 10 million different colours? In conditions like age-related macular degeneration, as prevalent in the UK, this vibrant visual capability can be diminished, affecting both visual acuity and quality of life.
Quote of the day:
“In the silence of night and the chaos of day, every act of care you give is a light that leads the way.”