Week 1

Question 1

Primary child presents with ulceration of the areas around his mouth, he has some lymphadenopathy. Vesicles are present particularly in the corner of his mouth. Likley diagnosis and treatment?

Answer 1

Herpes simplex virus (cold sore)

Aciclovir oral

Question 2

Herpangina usually presents with vesicles and ulcers in what area?

Answer 2

Soft palate

Question 3

Young kid presents with blisters on his hands and mouth. What is the likely diagnosis?

Answer 3

Hand foot and mouth disease

Question 4

Young man presents with painless ulcer in the inner aspect of his lip and on his genitals. It is quite a thick looking ulcer. Diagnosis and treatmetn?

Answer 4

Primary syphilis

Penicillin

Question 5

Man presents with recurring ulcers of his mouth. They are oval looking and have an inflammatory halo. Likely diagnosis?

Answer 5

Apthous ulcer

Question 6

If someone is getting recurrent painful mouth ulcers what underlying conditions would you suspect?

Answer 6

Behcets disease
Gluten sensitive enteropathy 
IBD
Reiters disease (reactive arthritis)
Drug reactions
Skin disease (lichen planus, pemphigoid)

Question 7

What is the most common pathogen causing acute pharyngitis?

Answer 7

Virus

Question 8

What is the treatment for acute pharyngitis?

Answer 8

Self care- regular analgesia, medicated losengers

Question 9

Under what circumstances would you send a patient to hospital or to a specialist when they have acute pharyngitis?

Answer 9

If stridor or resp difficulty

On DMARD, carbimazole, chemo, have asplenia, HIV- urgent FBC and refer

Question 10

Man presents with a white covering of the back of his throat, he has recently been to russia. Lilkey diagnosis? Treatment?

Answer 10

Diptheria (more common in russia)

Supportive, ANTITOXIN

Question 11

Young university student presents with a fever, large cervical nodes, a sore throat, lethargy and malaise. On examination he has red spots on his hard palate that wont blanch. likely diagnosis and treatment?

Answer 11

Glandular fever

Antivirals not effective so bed rest, paracetamol

(Dont give steroids as can make virus worse)

Question 12

You do a blood film and there is lymphocytosis and atypical lymphocytes on blood film. Patient had a fevere and sore throat. What would be your differential ?

Answer 12

Glandular fever
HIV test

Both cause lymphocytosis

Question 13

What are some of the complications of glandular fever?

Answer 13

Splenic rupture, anameia, thrombocytaemia

Question 14

What is the treatment for oral candida

Answer 14

Antifungals like nystatin fluconazole

Question 15

By what time should symptoms of acute pharyngitis clear?

Answer 15

3 days

Question 16

Child after upper resp infection now has an extremely sore ear. On examination the typanic membrane looks swollen. What is the likely diagnosis?

Answer 16

Acute otitis media

Question 17

What is the treatment for otitis media?

Answer 17

Should resolve spontaneously in 4 days

If do require it then amoxicillin first line then erythromycin

Question 18

Man with known diabetes presents with pain in his ear that is completely unproportional to the red area on his outer ear. He also has a headache. What is the likely diagnosis?

Answer 18

Malignant otitis

Question 19

What is ageusia? How is it caused?

Answer 19

Loss of taste function

Nerve damage, inflammation (glossitis, radiation, tobacco), endocrine disorders

Question 20

What is hypogeusia? How is it caused?

Answer 20

Reduced taste function

Chemotherapy, medications

Question 21

What is dysgeusia? How is it caused?

Answer 21

Distortion of taste function

Glossitis, gum infection, reflux, upper resp infections, medications, neoplam, chemo, zinc deficiency

Question 22

What is so special about olfactory reeptors?

Answer 22

They are specialised endings of renewable afferent neurons in the olfactory mucosa

(They are replaced by the basal cells in the supporting cells

Question 23

What is anosmia? What can cause it

?

Answer 23

Inability to smell

Viral infections, allergies, nasal polyps, head injury

Question 24

What is hyposmia? What can cause it

?

Answer 24

Reduced ability to smell

Can be early sign of parkinsons diseaes

Question 25

What is dysosmia?

Answer 25

Altered sense of smell

Question 26

You ask a patient to say ‘aahhhhh’ when you look in their mouth their uvula is deviated to the patients left. What nerve is dysfunctional?

Answer 26

The right vagus nerve

Question 27

You ask the patient to stick their tongue straight out. It is deviated to the patients right. Wheat nerve is dysfunctional?

Answer 27

Right hypoglossal nerve