AKT-1501

As a GP visiting a residential home patient, you encounter a 74-year-old female with a 4 week history of oral ulceration. The patient reports experiencing pain and bleeding due to the condition. She also mentions that her dentures have not been fitting well, leading her to stop using them. Additionally, she has lost a few kilograms in weight over the past few weeks. Based on NICE guidelines for suspected cancer, which aspects of this patient’s history would necessitate referral (within 2 weeks) for oral cancer?

AKT-1502

A 57-year-old male patient complains of intense pain deep in his right ear accompanied by dizziness and a sensation of the room spinning. Upon clinical examination, he displays a partial facial nerve paralysis on the right side and vesicular lesions on the anterior two-thirds of his tongue. What condition is the most probable diagnosis?

AKT-1503

A 23-year-old male patient complains of experiencing tinnitus in his left ear for the past two weeks. He describes the sound as a buzz but denies any other accompanying ear symptoms. Upon examination, Otoscopy, Rinne, and Weber tests are all normal. What is the recommended course of action for management?

AKT-1504

A 3-year-old boy has been unwell and crying during the night and this has continued during the day with some benefit from paracetamol and ibuprofen. He has a cold. His temperature is 38C and both tympanic membranes are inflamed but not bulging.
Select from the list the single most appropriate management option.

AKT-1505

You see a 28-year-old female patient with painful mouth ulcers. She has been experiencing coryzal symptoms for the past week. The patient has around 5 small shallow ulcers scattered around her gums and inside her cheeks. The ulcers have been present for 2 days, and she is having difficulty eating and drinking. The patient has no significant medical history and is generally healthy. She smokes 5-10 cigarettes daily.

What is the accurate statement about aphthous mouth ulcers?

AKT-1506

A 50-year-old man presents with classic symptoms of benign paroxysmal positional vertigo (BPPV) and is concerned about the likelihood of recurrence. He reports multiple episodes of the room spinning when he moves his head, lasting 30 seconds to 1 minute. You explain that while symptoms often resolve without treatment over several weeks, the Epley manoeuvre can be offered to alleviate symptoms. The patient, who is a driver, is disabled by his symptoms and would like to know the chances of recurrence over the next 3-5 years.

AKT-1507

A 25-year-old man presents to the General Practitioner with a swollen ear. He plays amateur rugby and was punched during a match the previous day. The upper pinna is fluctuant and mildly erythematous, but there are no other injuries. What is the most suitable management option?

AKT-1508

A 67-year-old male comes to the GP with a history of hearing loss for 6 months due to ototoxicity from furosemide. Upon examination, he has severe bilateral sensorineural hearing loss and can only hear spoken words if they are within 10 cm of him. He has been using hearing aids for 4 months, but they are not very effective. What aspect of his history indicates that cochlear implantation may be necessary?

AKT-1509

Samantha is a 50-year-old factory worker whose hearing has been gradually declining over the past 4 years. She has been exposed to loud noises in her workplace for many years.

Samantha finally decided to visit her doctor 3 months ago, as she was hesitant to seek help, and her hearing has now severely deteriorated. After undergoing audiology testing, she was diagnosed with bilateral sensorineural hearing loss.

What would be the most suitable course of action for managing Samantha’s condition?

AKT-1510

A 26-year-old male presents with benign paroxysmal positional vertigo that has persisted for 3 weeks after a recent upper respiratory tract infection. He requests the Epley manoeuvre to alleviate his symptoms as he is currently unable to operate a vehicle. What is the success rate of the Epley manoeuvre in patients with this condition?