MRCGP AKT Category: Ear, Nose And Throat, Speech And Hearing

AKT-1569

A father brings his 5-year-old daughter to the General Practitioner with symptoms consistent with otitis media, which have started in the last 48 hours. On examination, there is a perforation of the tympanic membrane and purulent discharge from the ear. The child has a temperature of 36.5 °C and her heart rate is within normal parameters.
What would be the most appropriate treatment in this situation?

AKT-1570

A 5-year-old girl presents with a six-month history of constant snoring and seems to ‘talk through her nose.’ Her nose seems clear on anterior examination.
What is the most appropriate management intervention?

AKT-1571

A 12-year-old boy comes to his General Practitioner with his dad, reporting that he has been unable to breathe through either nostril since he caught a cold three days ago. During examination, the doctor observes smooth pink swellings in the lower part of the lateral side of each nostril. The swellings are tender, but there is no evidence of ulceration. The boy is otherwise healthy, with no fever or facial pain, and he has never had a nosebleed before.
What is the most suitable course of action in this scenario?

AKT-1572

A 7-year-old child has a foul-smelling unilateral nasal discharge, which he has had for the last week. Nothing obvious is visible apart from discharge.
What is the most appropriate management option?

AKT-1573

A 70-year-old man has unilateral hearing loss of gradual onset, but most noticeably for the last six months. His hearing test shows 60-dB unilateral high-frequency sensorineural hearing loss.
What is the single most appropriate intervention?

AKT-1574

A 25-year-old man comes to his General Practitioner complaining of a painful discharging right ear and a mild unilateral right-sided hearing loss that has been going on for 3 days. During examination, the doctor observes an intact tympanic membrane and copious purulent liquid discharge. The patient has a normal heart rate of 70 bpm and is not running a fever.
What is the most suitable course of action for this patient?

AKT-1575

You review a patient who you diagnosed with Meniere’s disease last week. Her vertigo has settled but she still has hearing loss and tinnitus on the right side. She is still waiting to be seen by the ENT department but has a few questions about Meniere’s disease.

Which statement below regarding Meniere’s disease is correct?

AKT-1545

A 60-year-old male presents to his GP with complaints of severe ear pain. He reports experiencing pain and white discharge from his left ear for the past two weeks, along with a feeling of dulled hearing. The patient has a medical history of glaucoma, hypertension, and type two diabetes, with a recent HbA1c of 59 mmol/mol.

During the examination, the patient appears to be in discomfort. The right ear appears normal, but the left external auditory canal is swollen and painful to examine, with copious amounts of white discharge. There is no swelling or erythema affecting the pinna nor mastoid. Cranial nerve exam detects a conductive hearing loss in the left ear and a subtle inability to wrinkle the forehead on the left. The patient is afebrile with a blood pressure of 142/96 mmHg.

What is the most appropriate course of action for managing this patient’s symptoms?

AKT-1546

You encounter a 50-year-old male patient who complains of left-sided facial pain, along with left-sided hearing loss, tinnitus, and vertigo that have persisted for about a month. During the examination, you observe an absent corneal reflex on the left side. What is the most probable diagnosis that could explain these symptoms?