An 80-year-old man presents to the emergency department with worsening pain and fever following a dental extraction 5 days ago. He is usually in good health. On examination, he has a tender swelling in the left submandibular region and mild trismus. His tongue is slightly displaced upwards and he is unable to protrude it. There is no respiratory distress or stridor. What is the best course of action for management?
Which of the following patients is most likely to develop nasal polyps?
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?
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?
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?
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?
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?
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?
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?
You encounter a 50-year-old woman during your afternoon clinic. She reports experiencing sudden episodes where the room spins uncontrollably, accompanied by nausea and occasional vomiting. Additionally, she feels as though her hearing is impaired on the right side and experiences a ringing sound and a feeling of fullness on that side. Based on these symptoms, you suspect that she may have Meniere’s disease. What is a true statement about this condition?