A 24-year-old man is diagnosed with gonorrhea. He is treated with ceftriaxone. He returns a few days later and states that he still has symptoms of dysuria and discharge. His urine microscopy shows no organisms.
What is the likely cause of his symptoms?
Correct Answer A: It is a standard guideline to always treat a patient with Gonorrhea for both Gonorrhea and Chlamydia. Chlamydia is the most prevalent STD. It is most common among people in their late teens and early twenties and can coexist with gonorrhea.
Treatment options include for Gonorrhea: Ceftriaxone 125 mg IM single dose, for Chlamydia: Doxycycline 100 mg Bid for 7 days or Azithromycin 1 gram orally as a single dose. In patient’s that are pregnant, avoid doxycycline. The patient should also be advised to have his sexual partner treated.
A passenger on a bus sustains an injury to his eye with the newspaper of a neighboring person. His vision becomes blurry and he develops redness and pain in his eye.
What is the likely diagnosis?
Correct Answer A: Corneal abrasion is the most common type of injury involving the cornea. Contact with dust, dirt, sand, wood shavings, metal particles or even an edge of a piece of paper can scratch or cut the cornea. Because the cornea is extremely sensitive, abrasions can be painful. In case of such an injury, prompt medical care should be obtained.
The most common cause of sensorineural hearing loss in the elderly is:
Correct Answer D: The most common cause of hearing impairment in the elderly is presbycusis which is hearing loss that occurs in the high frequency range (4000Hz to 8000Hz).
Meneiere’s disease is a combination of vertigo, tinnitus and hearing loss. Ototoxic drugs such as aminoglycosides and loop diuretics can cause hearing loss in elderly also.
A 22-year-old male, working as a waiter in a nightclub, noticed a gradual hearing loss. He admitted that the noise level in his job is very high and that he was not advised to wear ear protection.
Which one of the following does he most likely suffer from?
Correct Answer D: When we are exposed to harmful noise, sounds that are too loud or loud sounds that last a long time, sensitive structures in our inner ear can be damaged, causing noise-induced hearing loss (NIHL).
Continuous exposure to loud noise also can damage the structure of hair cells, resulting in hearing loss and tinnitus, although the process occurs more gradually than for impulse noise.
NIHL is 100 percent preventable. All individuals should understand the hazards of noise and how to practice good hearing health in everyday life. To protect your hearing: Know which noises can cause damage (those at or above 85 decibels). Wear earplugs or other hearing protective devices when involved in a loud activity.
A 74-year-old man presents with bilateral symmetrical sensorineural hearing loss. Physical exam is otherwise normal.
What is the most likely diagnosis?
Correct Answer C: Presbycusis, or age-related hearing loss, is the cumulative effect of aging on hearing. Also known as presbyacusis, it is defined as a progressive bilateral symmetrical age-related sensorineural hearing loss. The hearing loss is confined to higher frequencies. Presbycusis is the most common cause of hearing losing in elderly.
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