Classic Presentations

Question 1

A teenager develops a painful throat and lethargy

Answer 1

Pharyngitis

Question 2

A patient with pharyngitis/tonsilitis/otitis media develops pain, tenderness and swelling behind the ear. They also experience otalgia, fever and headaches.

Answer 2

Mastoiditis

Question 3

A teenager develops fever, sore throat, odynophagia, halitosis, lymphadenopathy and exudates on tonsils.

Answer 3

Bacterial tonsillitis

Question 4

A patient with tonsillitis develops unilateral throat pain and odynophagia. On examination there is trismus and medial displacement of tonsil and uvula

Answer 4

Peri-tonsillar abscess (quinsy)

Question 5

A baby presents with excessive drooling, pyrexia and stridor

Answer 5

Epiglottitis

Question 6

A child presents with a severe sore throat with a grey white membrane across the pharynx

Answer 6

Diptheria

Question 7

A patient presents with white patches on top of red, raw mucous membranes in the mouth and throat that can be scraped off

Answer 7

Candida/Thrush

Question 8

A teenager presents with fever, cervical lymphadenopathy, sore throat, gross tonsillar enlargement with membranous exudate, lethargy and hepatosplenomegaly

Answer 8

Infectious mononucleosis/”glandular fever”

Question 9

A pre-school aged child presents with systemic upset, local lymphadenopathy and vesicles & ulcers on the lips, buccal mucosa and hard palate

Answer 9

Primary gingivostomatitis due to HSV1

Question 10

A pre-school aged child presents with vesicles/ulcers on the soft palate

Answer 10

Herpangina due to coxsakie virus

Question 11

A child presents with a sore throat, fever and loss of appetite. On examination you see ulcers in the mouth and a rash of flat discolored spots/blisters on the palms of the hands, soles of the feet and the buttocks

Answer 11

Hand, foot and mouth disease

Question 12

A young patient presents with a recurrent, painful ulcer in the mouth with an inflammatory halo. There are no systemic symptoms

Answer 12

Apthous ulcer

Question 13

A patient presents with earache. On examination you see a red and bulging tympanic membrane

Answer 13

Acute otitis media

Question 14

A patient presents with an itchy and painful ear. On examination you see redness and swelling of the ear canal

Answer 14

Otitis externa

Question 15

A patient with otitis externa develops pain and a headache more severe than clinical signs would suggest

Answer 15

Malignant otitis externa

Question 16

A patient presents with pain over the sinuses that is referred to the teeth. They also have purulent nasal discharge, a headache and a fever

Answer 16

Sinusitis (likely bacterial)

Question 17

A patient presents with unilateral hearing loss, tinnitus and vertigo. Examination shows the hearing loss to be sensorineural

Answer 17

Vestibular Schwannoma/ acoustic neuroma

Question 18

A woman >60 presents with a swelling of the parotid gland

Answer 18

Pleomorphic adenoma - most common salivary gland tumour

Question 19

A man >50 presents with a swelling in the parotid gland

Answer 19

Warthin’s tumour - second most common salivary gland tumour

Question 20

A patient who has just experienced high velocity trauma presents with battle sign bruising (around eyes or behind ears/back of head), hearing loss, vertigo and facial palsy

Answer 20

Temporal bone fracture

Question 21

A young boy is brought to clinic for a >3 month history of hearing loss. There is no associated pain or fever. On examination there is TM retraction, reduced TM mobility, altered TM colour and visible fluid bubbles. Testing shows conductive hearing loss

Answer 21

Glue ear/otitis media with effusion

Question 22

A patient presents with unilateral, persistent, watery, smelly ear discharge and gradual unilateral hearing loss

Answer 22

Cholesteatoma

Question 23

A patient presents with progressive hearing loss. Examination shows a normal TM and no evidence of middle ear inflammation. Tests show the hearing loss is conductive

Answer 23

Otosclerosis

Question 24

A patient complains of spells of brief vertigo that occur when moving their head quickly or changing head position. Hallpike’s tests shows nystagmus

Answer 24

Benign positional paroxysmal vertigo

Question 25

A patient presents with vertigo that has lasted for days. ‘Everything is spinning and then they throw up’. There is no associated tinnitus or hearing loss

Answer 25

Vestibular neuronitis

Question 26

A patient presents with vertigo that has lasted for days. There is associated tinnitus and hearing loss

Answer 26

Labyrinthitis

Question 27

A patient presents with with recurrent episodes of vertigo. The attacks last up to a few hours. There is associated tinnitus, hearing loss, N&V and aural fullness

Answer 27

Meniere’s disease

Question 28

A white patient >40 presents with fatigue, muscle weakness, joint pain, cough, SOB, nasal congestion, nosebleeds, crusting around the nostrils, sinusitis, earache and hearing loss. There is also nasal septal perforation and saddle nose deformity

Answer 28

Granulomatosis with polyangiitis/Wegener’s granulomatosis