A 27-year-old female comes to the clinic with a nodule in her neck that she has noticed for the past month.
Upon examination, a non-tender, 3.5 cm nodule is found on the right side of her neck, deep to the lower half of the right sternocleidomastoid. The nodule moves upwards on swallowing, and no other masses are palpable in the neck.
What is the nature of this mass?
A 42-year-old man presents with a ‘neck lump’ that he has noticed over the past two months. On examination, you palpate a diffuse midline swelling which moves with swallowing but not with tongue protrusion. There are no other neck lumps or focal nodules, and the patient’s voice is normal with no hoarseness. There is no cervical lymphadenopathy or stridor. The patient has no significant past medical history or family history.
He reports feeling slightly more fatigued and has gained some weight over the past few months but otherwise feels well. He notes that the swelling in his neck has not changed in size since he first noticed it.
Thyroid function tests reveal hypothyroidism. What is the most appropriate management plan?
You are reviewing a patient who presented to a colleague about eight weeks ago. He is a 65-year-old male with mild to moderate symptoms of nasal congestion and persistent feeling of a blocked nose. He reports ongoing problems of a similar nature. He informs you that as well as the above he gets intermittent clear nasal discharge which can alternate between nostrils and he has had periods of nasal and ocular ‘itch’.
At his last appointment he was prescribed a daily non-sedating antihistamine which he has been using regularly. He was also given advice on nasal douching. Despite these measures he is still suffering from persistent nasal symptoms. He has heard that steroid medication can be used to treat his symptoms and asks for a prescription.
Which of the following is the most appropriate next pharmacological option to add in to his treatment in trying to manage his symptoms?
A 50-year-old woman comes in with complaints of hearing loss. Tuning fork tests are performed, revealing a Rinne-positive result on both sides (air conduction heard better than bone conduction) and lateralisation of the Weber test to the left ear. How should these tuning fork test results be interpreted?
A 25-year-old woman comes in with complaints of hearing loss. She appears to be in good health and there are no noticeable abnormalities during otoscopy. Tuning fork tests are conducted, revealing a negative Rinne test on the right side (bone conduction is better than air conduction) and a positive Rinne test on the left side. The Weber test shows lateralisation to the right ear. How should these tuning fork test results be interpreted?
What is a true statement about tuning fork tests used for hearing?
A 20-year-old, previously healthy, female presents with a nine day history of fever, sore throat and fatigue.
On examination of her throat, there are palatal petechiae and white tonsillar exudates. Two days ago, another doctor prescribed amoxicillin, and she has since developed a widespread maculopapular rash.
What is the diagnosis?
A 5-year-old child presents with a sore throat and polymorphous rash. He has had a fever for five to six days. He is well, drinking fluids, not vomiting, and passing urine normally.
On examination, he is alert, well hydrated with no photophobia or neck stiffness. His temperature is 38.7°C, HR 140, RR 30, and CRT<2 sec. His chest is clear. He has generalised blanching macular rash and bilateral conjunctival injection. His lips are dry and chapped, tonsils are erythematous with no exudate. His eardrums look normal and he has moderate cervical lymphadenopathy. Urine dipstick is positive for protein and leucocytes. What is the most appropriate management?
A 48-year-old factory machine operator is seen with recent onset hearing difficulties. He has had a hearing test done via a private company and has brought the result of his pure tone audiometry in to show you.
Which of the following audiogram findings would most suggest he has early noise-induced hearing loss?
You see a 26-year-old man with a five day history of a sore throat. He has been feverish and has had a marked sore throat with pain when swallowing. He tells you that he has felt progressively worse over the last five days.
On examination, he has a temperature of 38.2°C and bilateral tonsillar exudates. There is some tender cervical lymphadenopathy present.
You discuss with him the role of antibiotic treatment and feel that his condition warrants treatment. He has no allergies and you prescribe a course of phenoxymethylpenicillin.
What duration of antibiotic treatment should you prescribe?