A 17-year-old boy presents to the emergency department with severe sore throat, fever, difficulty swallowing, and a muffled ‘potato’ voice. Physical examination reveals unilateral swelling of the left tonsillar pillar, uvular edema, and deviation of the uvula to the right. The patient also has trismus (difficulty opening the mouth). Which of the following is the most likely causative organism?
A 6-month-old female presents for a routine well-baby check. She was born at 28 weeks of gestation with a birth weight of 1300 g. Her neonatal course was complicated by respiratory distress syndrome requiring mechanical ventilation, and she received gentamicin during her NICU stay. The parents are concerned about her delayed response to sounds. You explain that her history places her at risk for a hearing deficit. Which of the following is the most significant risk factor for this child’s hearing deficit?
A 58-year-old male presents to your office to discuss an incidentally discovered 0.4 cm enhancing mass in the right cerebellopontine angle on an MRI of the brain, consistent with an acoustic neuroma (vestibular schwannoma). Currently he has no symptoms related to this tumor. What is the preferred treatment for this condition?
Ruth, a 48-year-old female, presents with a six-month history of progressive hearing loss in her right ear. She also reports persistent ringing in the same ear and occasional unsteadiness when walking. She denies vertigo, facial numbness, or weakness but expresses concern about the impact of these symptoms on her daily activities. There is no history of head trauma, fever, or recent infections. Medical History: No significant past medical conditions. No family history of hearing loss, neurological disorders, or Neurofibromatosis Type 2 (NF2). Social History: Works as an accountant, no exposure to loud noises or ototoxic substances. Nonsmoker and moderate alcohol use. Physical Examination: Cranial Nerves: •Decreased hearing in the right ear on Weber and Rinne tests. •Intact facial nerve function (cranial nerve VII). •Balance/Gait: Slight unsteadiness noted during tandem walking. •General Exam: Normal, with no signs of systemic illness. Diagnostic Workup: Audiometry: Confirms unilateral sensorineural hearing loss in the right ear. You suspect acoustic neuroma in this patient. Which imaging modality is the gold standard for diagnosing acoustic neuroma?
A 58-year-old male presents to your office to discuss an incidentally discovered enhancing mass in the right cerebellopontine angle on an MRI of the brain, consistent with an acoustic neuroma (vestibular schwannoma). What is the most common initial symptom associated with this condition?
