A 3-year-old boy is brought to the General Practitioner (GP) by his parents for a consultation. He has been diagnosed with otitis media with effusion (OME), or ‘glue ear’. Insertion of ventilation tubes (grommets) has been recommended. His parents are unsure whether to proceed and ask the GP about the benefits.
According to the National Institute for Health and Care Excellence (NICE), which of the following is most improved due to this procedure?
A 30-year-old female patient complains of recurrent episodes of ‘dizziness’. These episodes usually last for 30-60 minutes and happen every few days. The patient experiences a sensation of the room spinning and often feels nauseous during these attacks. Additionally, there is a ‘roaring’ sensation in the left ear. Otoscopy shows no abnormalities, but Weber’s test indicates localization to the right ear. What is the probable diagnosis?
A 20-year-old woman has been experiencing recurrent painful mouth ulceration for several years. The ulcers typically heal in just over a week, and she remains symptom-free until the next recurrence. She denies any associated symptoms or rash, and her father had a similar history as a teenager. She doesn’t smoke and denies excessive alcohol use or drug use. Although there is no dental or periodontal disease, she has three discrete, 4-mm-round ulcers with inflammatory haloes on the buccal mucosa.
What is the most likely diagnosis?
You see a 28-year-old man who complains of painful mouth ulcers. He is in good health otherwise.
During the examination, you notice around 5 small and shallow aphthous ulcers on the inner lining of his mouth.
What is the accurate statement about aphthous mouth ulcers?
A 25-year-old man presents with an obvious broken nose and an inability to breathe through either nostril. Examination reveals a cherry-red swelling in both nasal airways.
What is the best course of action for management?
A 63-year-old woman comes in with bilateral tinnitus. She denies any changes in her hearing or other ear-related symptoms. Upon examination, there are no abnormalities found in her ears or cranial nerves. Which medication is she likely to have started taking recently?
A five-year-old boy presents with a three-day history of right ear pain. He is feeling well otherwise, with no fever and normal fluid intake. His mother has been giving him paracetamol for pain relief. During examination, his left tympanic membrane appears normal, but his right tympanic membrane is inflamed, erythematous, and bulging. He has a temperature of 36.5ºC. There is no significant medical history, but he has a penicillin allergy. What is the most appropriate treatment option for the likely diagnosis?
A 27 year-old male patient complains of sudden hearing loss in his right ear without any prior symptoms of cold, fever, headache or earache. Upon examination, his ear canal and tympanic membrane appear to be normal. Weber testing indicates left-sided localization. What is the recommended course of action?
A 65-year-old woman presents with a painful face that started gradually over the past day and has now become severe. The pain is localized around one of her lower molars, which is tender to touch and sensitive to temperature. Upon examination, an abscess is visible around the affected tooth and the surrounding tissues are inflamed. The patient has a temperature of 37.1 ºC and is otherwise healthy with no medication use or allergies.
What is the initial treatment approach for this patient?
A 27-year-old man urgently books an appointment at your clinic. He complains of left-sided facial pain and malaise that has been ongoing for two weeks. He mentions that his symptoms initially improved after a week, but then worsened again, and he now feels worse than he did initially. He has no significant medical history.
During the examination, you note a low-grade fever of 37.9 degrees, but all other observations are normal. Anterior rhinoscopy reveals a purulent discharge from the left middle meatus, but there are no abnormalities in the eyes or periorbital tissues.
What is the most probable diagnosis?