AKT-1528
Samantha is a 7-year-old girl who has presented with impacted earwax which has failed to improve with olive oil drops. Ear irrigation has been recommended.
Which of the following would be a contraindication to this?
MRCGP AKT Category: Ear, Nose And Throat, Speech And Hearing
AKT-1513
A 56-year-old woman visits the General Practitioner for a check-up. She mentions that her friends have informed her about her bad breath. From where is this patient’s issue most likely originating?
AKT-1514
A 6-year-old with Down’s syndrome presents to your clinic for a routine check-up. His parents have noticed that he has been having difficulty hearing for the past few weeks. Upon otoscopy, you observe indrawn tympanic membranes with fluid levels and loss of light reflexes in both ears. There are no signs of inflammation, and examinations of the nose and throat are normal.
What would be the most suitable course of action for this patient?
AKT-1515
Which of the following is MOST LIKELY to be a feature of uncomplicated cholesteatoma in elderly patients?
AKT-1516
A 55-year-old man presents to his General Practitioner (GP) with multiple symptoms affecting his nose and throat. He has long-standing nasal congestion, but over the past week has also been suffering from a painful lesion in his mouth, sore throat and hoarse voice. On examination, he has bilateral, grey nasal swellings, a solitary yellow ulcer of 4 mm diameter on the oral mucosa, a multinodular goitre and unilateral parotid enlargement. He states that the parotid lump has been there for a few months, at least. His GP suspects cancer.
Which of the following presentations warrants specialist referral under the 2-week rule?
AKT-1517
A 6-year-old girl has been unwell with earache and a fever. The earache has improved since her ear started discharging. The eardrum is not visible because of the amount of discharge. She is prescribed an antibiotic and given advice about symptom control.
Select from the list the single most appropriate further management option.
AKT-1518
A 45-year-old woman comes to your GP clinic complaining of recurrent episodes of dizziness, which she describes as a sensation of the room spinning. She has experienced five such episodes in the past month, each lasting for one or two days and accompanied by nausea, which has prevented her from going to work. She reports no symptoms between episodes and has a history of migraines in her 20s but is otherwise healthy. During these episodes, she is sensitive to loud noises but denies any hearing loss or tinnitus. Neurological examination, Dix-Hallpike, and examination of both ear canals are unremarkable. What is the most likely diagnosis?
AKT-1519
You assess a 65-year-old heavy smoker who has just been diagnosed with cancer and is hesitant to undergo surgery. He is interested in exploring the option of radiotherapy. Which tumour from the following list is most suitable for potentially curative treatment with RADIOTHERAPY ALONE? Choose only ONE option.
AKT-1520
A 47-year-old man visits his primary care physician with concerns about a persistent ulcer on his tongue that has been growing for a few weeks. He is a heavy smoker, consuming 30 cigarettes a day, and drinks alcohol regularly. Upon examination, the physician notes bilateral submandibular lymphadenopathy, multiple dental caries, and a 1-cm ulcer on the lateral border of his tongue. What is the most suitable course of action for managing this patient?
AKT-1521
A 50-year-old woman presents with a large thyroid swelling, difficulty breathing on lying flat and slight dysphagia. What is the most appropriate investigation to delineate the size and extent of the goitre?