AKT-1491
A 50-year-old man complains of dizziness and loss of hearing on the right side during his visit to the GP. Which test is most likely to suggest the presence of an acoustic neuroma?
MRCGP AKT Category: Ear, Nose And Throat, Speech And Hearing
AKT-1492
A 47-year-old woman visits her GP complaining of constant right-sided hearing difficulty, tinnitus, and vertigo that have been present for the past two months and have worsened recently. Upon examination, there is no wax in either auditory canal, and the tympanic membranes appear normal.
What would be the most suitable course of action for management?
AKT-1493
A 50-year-old chef presents for a follow-up appointment after experiencing a left-sided Bell’s palsy three months ago. The patient was treated with prednisolone and has seen some improvement in their facial weakness, but still experiences some weakness in their left facial muscles (power 4/5). The patient is interested in knowing if there are any additional tests or referrals that could be beneficial.
What is the most suitable next step?
AKT-1494
A 2-year-old girl is brought to the clinic by her mother. She has a history of recurrent otitis media and has been touching her right ear frequently for the past 3 days. She was restless and had a fever overnight, and now has a red, boggy swelling behind her right ear that is more prominent than on the left. During the examination, the child appears unhappy, with a temperature of 39.2ºC, a heart rate of 170 beats/minute, and a respiratory rate of 28 breaths/minute. Due to her distress, it is difficult to examine her ears, but the left ear canal and tympanic membrane appear normal, while the right ear canal and tympanic membrane appear red. What is the most probable diagnosis?
AKT-1495
A 35-year-old sales representative comes in for a routine check-up and reports a 2-week history of a droopy left eyelid with forehead weakness. Upon examination, the symptoms are confirmed and there are no abnormalities found in the eyes or ears.
What is a crucial aspect of the treatment plan?
AKT-1481
A 43-year-old man presents to you with complaints of tinnitus and hearing loss for the past few weeks. He has a history of chronic obstructive pulmonary disease and is currently on medications including salbutamol inhaler, azithromycin, beclomethasone-formoterol (Fostair) inhaler, tiotropium inhaler, and glycopyrronium bromide.
Upon examination, you note a positive Rinne test bilaterally with reduced hearing on both sides, worse on the left. The Weber test lateralizes to the right, and otoscopy is normal. You suspect a sensorineural hearing loss and urgently refer the patient to an ENT specialist.
Which medication from his current regimen may be contributing to his symptoms and should be discontinued?
AKT-1482
You are evaluating a middle-aged woman who has come in with sudden onset of facial weakness on one side. What is the most significant risk factor for developing Bell’s palsy in this patient?