A 35 Y/O F c/o persistent, foul-smelling L ear discharge & progressive hearing loss. O/E: Otoscopy reveals a perforation in the attic region (posterosuperior quadrant) of the tympanic membrane, with white, cheesy debris visible within the middle ear.What is the most likely Dx?

A 55 Y/O M c/o sudden hearing loss in his R ear x3D, associated with tinnitus and unsteadiness. He also notes progressive R-sided facial numbness over the last month. O/E: Otoscopy is clear. Weber test lateralizes to the L ear. Cranial nerve exam reveals ↓ sensation on the R side of his face and a subtle R-sided facial droop.What is the most appropriate next investigation to establish the underlying diagnosis?

A 52 Y/O F with a Hx of hypertension, for which she is poorly compliant with medication, is brought to the ER for a 2-hour, profuse nosebleed. She c/o gagging on blood. O/E, BP is 165/95 mmHg, HR 105 bpm. Active bleeding is noted from both nares and in the posterior oropharynx. Initial attempts to control the bleeding with anterior nasal packing have failed. Coagulation studies are pending but initial Hb is 11.2 g/dL.What is the most appropriate next step in management?

A 24 Y/O university student c/o sore throat, nasal congestion, & rhinorrhea x3D. She denies fever, myalgia, or significant fatigue. O/E, T=37.4°C, HR=78/min, RR=16/min. Nasal mucosa is edematous & erythematous with clear discharge. Pharynx is mildly injected without exudates. Lungs are clear to auscultation.Which of the following is the most likely causative organism?

A 48 Y/O F presents with a 4-month Hx of unilateral otitis media with effusion and a growing mass in her neck. A biopsy of a suspicious lesion in the nasopharynx is performed. The pathologist reports sheets of undifferentiated large epithelial cells with indistinct cell borders, vesicular nuclei, and prominent eosinophilic nucleoli, admixed with a heavy, non-neoplastic infiltrate of lymphocytes and plasma cells.This characteristic histopathological pattern is best described as which of the following?

28 Y/O F c/o recurrent, episodic vertigo & nausea lasting 30 mins to a few hours, occurring several times a year. She is asymptomatic between episodes. She also reports a sensation of fullness & progressive hearing loss in her L ear. O/E: Nystagmus is absent between attacks. Audiometry shows L-sided sensorineural hearing loss.What is the most likely Dx?

A 6 Y/O M presents with fever and sore throat. O/E: T 38.3°C. Tonsils are erythematous without exudates. No tender anterior cervical lymphadenopathy is noted. The patient also has a cough. Based on the Modified Centor criteria, his score is calculated to be 2.What is the most appropriate next step in management?

A 6-month-old boy is brought to the paediatric clinic by his mother with concerns about his development. She notes that while his motor skills seem appropriate for his age and he babbles normally, he consistently fails to startle or respond to loud noises. Pregnancy Hx was unremarkable, and he was born full-term with no complications. O/E: The infant is alert, interactive, and has normal motor tone. Vitals are stable. In the absence of other risk factors or syndromic features, what is the most common underlying etiology for this patient’s suspected condition?

A 15 Y/O M presents to the ED after a direct blow to his R ear during a rugby match. He c/o significant pain and a feeling of fullness. O/E, the superior aspect of the R auricle is diffusely swollen, tender, and boggy, with loss of the normal cartilaginous landmarks. The overlying skin has a violaceous hue. The tympanic membrane is normal on otoscopy.What is the most appropriate initial management for this patient?