Hearing loss in one ear for two days - GP

CurtinYear 510 min + 2 min readingENT & ophthalmologyStandardPre-internship
  • Focused examination (ears (otoscopy and tuning fork tests) and cranial nerves)
  • Dx + differentials
  • Initial Mx
  • Summary to examiner

Ready

2 min reading, 10 min station, warning at 2 min

Focus the timer and press Space to start or pause.

Station - Instructions for candidate

You are a junior doctor working in a general practice in Perth.

Eleni Papadopoulos, a 46-year-old violinist and music teacher, has booked an urgent appointment because she woke two days ago with her left ear feeling blocked and a ringing sound in it, and she cannot hear properly on that side. She has no ear pain. An otoscope, a 512 Hz tuning fork and a pen torch are on the table.

Observations (practice nurse)BP 124/78 mmHg, HR 72 /min, temperature 36.8 degrees C
From the booking noteLeft ear blocked and ringing since waking on Monday. Wants it syringed. No pain.

Your tasks are to:

  1. Perform a focused examination of her ears, including otoscopy and tuning fork tests, and a screening examination of the relevant cranial nerves. Verbalise each step to the examiner; findings will be provided as you perform them.
  2. Summarise your findings to the examiner and state your most likely diagnosis and the differential diagnoses.
  3. Outline your initial management plan to the examiner.
  • You do NOT need to take a full history; the relevant history is in the booking note and the patient will answer brief clarifying questions.
  • Please verbalise your examination to the examiner.
  • You do not need to write a prescription or referral letter in this station.

This is a 10-minute station, with 2 minutes of reading time.

Ask the examiner

Say what you want out loud, then open it below. Each result stays hidden until you reveal it.

Investigations

Ask for a category the way you would in the station: β€œCan I have the obs and a set of bloods?”

Examination

Say what you would examine and how; the examiner reports what you would find.

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