A 43-year-old male accountant visits the clinic with a persistent hoarseness that has been bothering him for the past 4 weeks. He reports that this is affecting his work performance. He denies experiencing any sore throat, difficulty swallowing, or cough. He has been smoking 20 cigarettes daily for the last 25 years and drinks a glass of beer every day. Apart from this, he is in good health. What is the best course of action for managing his condition?
A 35-year-old man complains of pain in his left ear. He was using cotton buds to clean his ears earlier today and experienced a sharp pain during the process. He now has slightly reduced hearing in his left ear. The patient reports no discharge and is in good health otherwise.
All of the patient’s vital signs are normal. Upon examination of the left ear, a small perforation in the tympanic membrane is observed. There is no discharge or redness in the ear, and the ear canal is dry. The cranial nerve examination is unremarkable.
What is the next best course of action for managing this patient’s condition?
A 75-year-old man visits his doctor with worries about a tiny spot on his inner, lower lip. The spot has been there for about a month and has not shown any changes during this time. He reports no pain. He used to smoke but quit a decade ago. During the examination, his oral hygiene appears to be good, and there is a small, white patch less than 1 cm in size on the inner surface of his lower lip.
What is the best course of action for this patient?
A 53-year-old male smoker presents to the emergency department with a sore throat that has been bothering him for a day. He reports feeling generally unwell and has a hoarse voice, but no cough. He has been unable to swallow for the past three hours and is spitting out saliva. During examination, he has a temperature of 38ºC and trismus. There are no obvious abnormalities in his oropharynx, and his tonsils appear normal. Additionally, he has bilateral cervical lymphadenopathy.
What is the most appropriate course of action for managing this patient?
A 68-year-old male visits his primary care physician with a complaint of persistent left-sided ear pain for over a month. He reports no hearing loss or discharge and feels generally healthy. He has a history of hypertension and currently smokes 15 cigarettes a day. Otoscopy reveals no abnormalities in either ear. What is the best course of action to take?
A 79-year-old man presents to the emergency department with persistent left-sided epistaxis following a fall and hitting his nose on a door. He has a medical history of hypertension managed with amlodipine, atrial fibrillation managed with apixaban, stroke, and type 2 diabetes managed with metformin. On examination, he has active bleeding from the left anterior nasal septum and is spitting blood. Despite attempting to control the bleeding by squeezing his nose for 30 minutes and inserting a Rapid Rhino, the bleeding persists. What is an indication for surgical intervention in this case?
During a standard cranial nerve assessment, the subsequent results are noted:
Rinne’s test: Air conduction > bone conduction in both ears
Weber’s test: Localises to the right side
What is the significance of these test outcomes?
A 44-year-old man visits his GP with complaints of vertigo. He had a cough and sore throat last week and has been experiencing a spinning sensation since then. The vertigo can last for hours and causes significant nausea, making it difficult for him to leave the house and go to work as a teacher. During an ENT examination, the GP observes horizontal nystagmus and intact tympanic membranes with no hearing loss. What is the best course of treatment?
A 39-year-old man complains of nasal obstruction and loud snoring. He reports that these symptoms have been gradually worsening over the past two months. Specifically, he feels that his left nostril is blocked while his right nostril feels normal. He denies any history of nosebleeds and reports feeling generally healthy. Upon examination, a large nasal polyp is observed in the left nostril. What is the best course of action?
A 55-year-old woman with a history of diabetes complains of left-sided ear pain and discharge. During examination, her temperature is recorded at 37.9ºC and there is red discharge in the ear canal. The tympanic membrane is partially visible and appears normal. Despite visiting the out of hours clinic twice and using different ear drops for two weeks, her symptoms persist. What course of treatment should be recommended?