A 35-year-old man visits his GP complaining of nasal congestion, facial pain, a runny nose, and a decreased sense of smell that has been ongoing for three months. He has a history of seasonal allergies. Upon palpation of the maxillofacial area, tenderness is noted. No visible nasal polyps are present.
What are the primary symptoms of chronic sinusitis?
A 32-year-old man visits his GP complaining of a sore throat, runny nose, cough, feeling feverish and generally unwell for the past week. He reports no difficulty eating or drinking.
Upon examination, his temperature is 37.2°C, and his chest is clear, but he has a dry cough. His tonsils are inflamed, but there is no exudate. He has no significant medical history.
Based on his Fever PAIN score, what would be the most appropriate course of action?
A 50-year-old woman presents to her GP on the same day with a sudden onset of hearing loss in her right ear while having breakfast. She reports feeling well otherwise and denies any ear pain, discharge, or previous ENT issues. The patient has no significant medical history and is not taking any regular medications. Otoscopy reveals no abnormalities, and tuning fork tests confirm a sensorineural loss. What is the best course of action for managing this patient’s condition?
A 25-year-old female is scheduled for middle ear prosthesis implantation to treat her sensorineural hearing loss. She has a history of appendectomy, during which she experienced intense postoperative nausea and vomiting. Which anaesthetic agent would be the most suitable for her procedure?
As the GPST1 in the emergency department, you are requested to assess a 34-year-old woman who fell and struck her head while drinking three hours ago. Your consultant instructs you to confirm the absence of any clinical indications of a base of skull fracture. Which of the following is not linked to a base of skull injury?
A 30-year-old woman presents to surgery with a complaint of not having a regular menstrual cycle for the past year, despite a negative pregnancy test. You order initial tests to establish a baseline. Which of the following is not included in your list of possible diagnoses?
A 58-year-old man undergoes routine screening tests as part of his NHS health check. His results show an HbA1C level of 52 mmol/mol (<42), eGFR of >90 ml/min (>90), blood pressure of 130/84 mmHg, and a QRISK-3 score of 24.3%. After a repeat measurement, he is diagnosed with type 2 diabetes mellitus (T2DM) and decides to make lifestyle changes and take medication. However, he experiences significant gastrointestinal side effects with metformin, even after switching to a modified-release preparation.
What would be the most appropriate class of drug to switch to?
A 55-year-old man presents to his General Practitioner after experiencing buzzing sounds in both ears intermittently over the past two weeks. He claims that this occurs suddenly, lasts for a few seconds and is not associated with his pulse. He reports no change in his hearing or other symptoms. Ear and cranial nerve examinations are unremarkable.
Which of the following investigations are necessary?
A 32-year-old construction worker visits his doctor complaining of hay fever symptoms. He is experiencing frequent sneezing and a runny nose and is seeking medication to alleviate his discomfort. Considering his job, which antihistamine would be safe for him to use?
A 45-year-old man presents to surgery with several weeks of intermittent vertigo, tinnitus, and decreased hearing on the right side. You suspect Ménière’s disease.
Which of the following is the most appropriate management option for this patient?