A 20-year-old woman presents with a painful throat. She has been experiencing a sore throat and painful swallowing for the past few days, but her symptoms have worsened over the last 24 hours. She now has neck pain and difficulty opening her mouth fully.
Upon examination, her temperature is 38.9 °C and her throat shows a displaced uvula, an enlarged right tonsil, and swelling around the right tonsil.
What is the best initial management strategy for this patient?
A 28-year-old female, originally from Malta, presents with complaints of oral and genital ulcers. She has a history of recurrent ulcers and scarring from previous episodes. Other than the ulcers, she appears to be in good health. Upon reviewing her medical records, it is noted that she has a history of arthritis and anterior uveitis. What is the most probable diagnosis that connects all of these symptoms?
A 42-year-old woman comes to the clinic with a left facial palsy. She reports that the weakness developed gradually over a few days. She is waiting for a referral to the hospital for a nodular swelling in the left parotid salivary gland, suspected to be caused by a stone. Her husband is currently taking oral aciclovir for shingles.
During the examination, a hard nodular mass is found over the tail of the left parotid gland, along with a lower motor neurone seventh nerve palsy.
What is the most appropriate next step?
A 5-year-old girl attends surgery with a febrile illness. Her mother tells you that she has been unwell for almost 24 hours and has been complaining of right-sided ear pain. The child is usually healthy with no significant past medical history.
On examination you find a temperature of 38.5°C and the right eardrum is red and bulging. The rest of the clinical examination is unremarkable.
What is the most suitable course of action?
What is a true statement about mumps infection?
A 12-year-old girl is brought in for an urgent appointment with her mother. She has been experiencing a sore throat, fever, malaise, and headache for the past two days. Yesterday, she complained of pain in her right ear, which has now spread to both ears. She has difficulty eating and drinking due to discomfort.
During the examination, bilateral swelling is observed, which is obstructing the angle of the jaw on both sides. When attempting to open her mouth to examine her throat, she experiences discomfort.
The patient has no significant medical history, and her mother is unsure if she has received all of her scheduled vaccinations.
What is the incubation period for this infection?
What is the correct option regarding nasal polyps?
A 48-year-old man presents to the clinic for follow-up. He is worried about some discoloration of the oral mucosa that he has noticed while brushing his teeth. These have been present for three weeks and have not been associated with any bleeding.
He has a history of hypertension for which he takes medication, but is otherwise healthy. He smokes six cigarettes per day and drinks a glass of wine each evening.
On examination, there are several patches within the oral mucosa that have either increased reddening or pallor. The diagnosis of erythroplakia is made. There is no lymphadenopathy, but the examination is otherwise unremarkable.
Investigations reveal:
– Hb 140 g/L (135-180)
– WCC 8.9 ×109/L (4.5-10)
– PLT 310 ×109/L (150-450)
– Na 140 mmol/L (135-145)
– K 4.2 mmol/L (3.5-5.5)
– Cr 90 µmol/L (70-110)
What is the most appropriate next step?
You see a 50-year-old man who was seen by a colleague three days ago for unilateral ear pain and yellow discharge, with reduction in hearing that side. He was given amoxicillin 500mg TDS to treat this but has come to see you today as the symptoms have not improved. He has previously had a renal transplant for which he is on medications for but he is otherwise well in himself.
Which is the most appropriate next step in management?
You see a 30-year-old man who reports an acute onset of reduced hearing in his left ear. This started suddenly yesterday. He is otherwise well with no ear pain, fevers or systemic upset. Examination of ears and cranial nerves were unremarkable.
Which is the most appropriate next step in management?