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Hearing Loss/Tinnitus :: PLAB 2 Symptomatic Differential Stations

  • Acoustic neuroma

    • Other presenting symptoms: 

      • DVT+cranial nerve palsy

      • Unilateral chronic hearing loss

      • Balance problems

      • Dizziness

      • Tinnitus

      • Pain/fullness in the ear

    • Past history and PMAFTOSA: 

      • Family history

    • Social:

      • Life effects

      • Living situation

      • DVLA

    • Exam and Invs:

      • GPE, vitals

      • Routine bloods, ESR, CRP

      • Ear examination

      • Cerebellar examination

      • Cranial nerve examination

      • MRI brain

    • Referral:

      • Immediate ENT referral

    • Treatment: 

      • Specialist treatment:

        • Surgery if required

    • Warning signs:

      • FAST

      • Severe headache, loss of vision

  • Acute idiopathic sensorineural hearing loss

    • Other presenting symptoms: 

      • Sudden hearing loss in one ear

    • Past history and PMAFTOSA: 

      • Rule out FAST

    • Social:

    • Exam and Invs:

      • GPE, vitals

      • Routine bloods 

      • Ear examination

    • Referral:

      • Immediate ENT referral

    • Treatment: 

      • Audiometry and treat underlying cause

      • Hearing aids

    • Warning signs:

      • FAST

  • Ear wax

    • Other presenting symptoms: 

      • Slight ear pain

      • Hearing loss in one ear

      • Recent swimming history

    • Past history and PMAFTOSA: 

    • Social:

      • Work

    • Exam and Invs:

      • GPE, vitals

      • Ear examination

    • Referral:

      • None

    • Treatment: 

      • Ear drops

      • General advice:

        • Avoid ear buds

        • Cover ears while swimming

    • Warning signs:

      • Ear pain increasing

      • Headache, Fever

  • Noise trauma

    • Other presenting symptoms: 

      • Chronic bilateral tinnitus

      • Worse when sleeping

      • Noise exposure history

    • Past history and PMAFTOSA: 

    • Social:

      • Life effects

      • work

    • Exam and Invs:

      • GPE, vitals

      • Ear examination

    • Referral:

      • None

    • Treatment: 

      • General advice:

        • Sound therapy (backgorund noise while sleeping etc.)

    • Warning signs:

      • Worsening symptoms

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