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Ophthalmology and ENT Flashcards

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  1. A 65-year-old presents with gradual painless vision loss. Fundoscopy shows a cup-to-disc ratio of 0.8 and intraocular pressure is 28 mmHg bilaterally. What is the most likely diagnosis?

    Answer: Primary open-angle glaucoma

    Primary open-angle glaucoma presents with elevated IOP, increased cup-to-disc ratio, and gradual painless peripheral vision loss due to progressive optic nerve damage.

  2. A 50-year-old presents with sudden severe eye pain, nausea, vomiting, and halos around lights. The eye is red with a mid-dilated fixed pupil and corneal haze. What is the immediate first-line management?

    Answer: Oral acetazolamide and topical beta-blockers

    Acute angle-closure glaucoma is an emergency requiring immediate IOP reduction with systemic acetazolamide and topical agents such as beta-blockers and pilocarpine to prevent permanent vision loss.

  3. A 72-year-old complains of central vision distortion and sees straight lines as wavy (metamorphopsia). Fundoscopy reveals drusen deposits and pigmentary changes in the macula. What is the most likely diagnosis?

    Answer: Age-related macular degeneration

    Age-related macular degeneration presents with central vision distortion, metamorphopsia, and drusen deposits on fundoscopy, predominantly affecting patients over 60 years.

  4. A 38-year-old with recurrent sinusitis presents with nasal polyps, bronchial asthma, and develops bronchospasm after taking aspirin for a headache. What is this triad called?

    Answer: Samter's triad (aspirin-exacerbated respiratory disease)

    Samter's triad (aspirin-exacerbated respiratory disease) consists of asthma, nasal polyps, and aspirin/NSAID sensitivity caused by aberrant arachidonic acid metabolism.

  5. A 2-year-old presents with fever, ear pain, and a bulging erythematous tympanic membrane. There is no perforation. What is the most appropriate first-line management?

    Answer: Amoxicillin for 10 days

    Children under 2 years with acute otitis media should receive antibiotics (amoxicillin) because they have a higher risk of complications and less ability to mount an adequate immune response.

  6. A 55-year-old presents with sudden painless monocular vision loss described as a 'curtain descending from above.' There is no pain or redness. What is the most likely diagnosis?

    Answer: Retinal detachment

    Retinal detachment classically presents as a shadow or 'curtain' advancing across the visual field, representing progressive separation of the retina from the underlying retinal pigment epithelium.

  7. A 28-year-old presents with unilateral progressive sensorineural hearing loss, constant tinnitus, and mild vertigo. MRI reveals an enhancing lesion at the right cerebellopontine angle. What is the most likely diagnosis?

    Answer: Vestibular schwannoma (acoustic neuroma)

    Vestibular schwannoma presents with unilateral progressive sensorineural hearing loss, tinnitus, and vertigo, and appears as an enhancing cerebellopontine angle mass on gadolinium-enhanced MRI.