As a general practice registrar, you are reviewing a patient who was referred to ENT and has a history of acoustic neuroma on the right side. The patient, who is in their mid-50s, returned 2 months ago with pulsatile tinnitus in the left ear and was diagnosed with a left-sided acoustic neuroma after undergoing an MRI scan. Surgery is scheduled for later this week. What is the probable cause of this patient’s recurrent acoustic neuromas?
A 75-year-old man complains of persistent ringing in his left ear for the past 4 months. He has also noticed a decline in hearing from his left ear over the past 2 weeks. During the examination, Rinne’s test reveals that air conduction is louder than bone conduction in the left ear, and Weber’s test shows lateralisation to the right ear. Which of the following conditions is likely to present with unilateral tinnitus and hearing loss?
A 49-year-old woman presents to the acute medical unit with a sudden onset of dizziness, describing the sensation of the room spinning around her. The dizziness persists and does not improve with rest, accompanied by severe nausea and vomiting. She reports hearing loss in her left ear and has recently experienced a cough and coryza episode. The patient has no prior medical history.
Upon examination, Rinne’s test reveals air conduction greater than bone conduction in both ears, and Weber’s test lateralizes to her right ear. The patient displays normal eye movements with mild horizontal nystagmus on lateral gaze and intact coordination.
What is the most likely diagnosis?
A 47-year-old man visits the GP clinic complaining of sudden vertigo, nausea, and vomiting that started this morning. He also mentions experiencing reduced hearing in his left ear. He has been recovering from a cold for the past week and has no other symptoms. During the examination, otoscopy shows no abnormalities. However, there is a spontaneous, uni-directional, and horizontal nystagmus. The head impulse test is impaired, and Rinne’s and Weber’s tests reveal a sensorineural hearing loss on the left side.
What is the most probable diagnosis?
A 53-year-old woman presents to her GP with sudden hearing loss in her left ear. She reports no pain or discharge and denies any history of dizziness or tinnitus. Upon examination, the GP notes the presence of wax in the left ear but no other abnormalities in the external auditory meatus or tympanic membranes bilaterally. The Weber test lateralises to the right side, and the Rinne test shows air conduction louder than bone conduction bilaterally. What is the most suitable course of action?
A 6-year-old girl is brought to her pediatrician by her father. He is worried that his daughter has been refusing to eat for 3 days and has been more irritable than usual. When asked, the girl points to her neck and complains of soreness. She has no significant medical history and is up to date with her vaccinations.
During the examination, the girl has a temperature of 38.7ºC. Her tonsils are enlarged and inflamed, and her throat is red. There are palpable lymph nodes in the anterior cervical chain that are tender to the touch. The rest of her examination is normal, and Kernig’s sign is negative.
What is the most appropriate treatment to prescribe for this 6-year-old girl?
A 54-year-old woman comes to the clinic complaining of dizziness when she changes position in bed for the past two weeks. She describes the sensation of the room spinning around her. Upon examination, there are no abnormalities found in her ears and cranial nerves. Assuming that she has benign paroxysmal positional vertigo, what is the best course of action for management?
A 32-year-old male with a history of eczema and asthma complains of rhinorrhoea and nasal congestion for the past six months. His asthma is currently well managed and he rarely uses his blue inhaler. He occasionally feels pressure in his sinuses. What is the first-line treatment option available?
A 50-year-old female comes to the doctor’s office complaining of progressive paraesthesia in her fingers, toes, and peri-oral area for the past two weeks. She also experiences muscle cramps and spasms. The patient had a thyroidectomy for Graves’ disease recently but has no other health issues or drug allergies. What can be expected from this patient’s ECG results, considering the probable diagnosis?
A 28-year-old woman presents to her GP with complaints of weight gain, hair loss, constipation, feeling cold all the time, and absence of menstrual periods. She also had difficulty breastfeeding after giving birth. Her medical history is unremarkable except for a previous episode of hypovolaemic shock due to significant blood loss during delivery, which required a prolonged hospital stay. What is the most probable diagnosis for her symptoms?