A 45-year-old patient has been prescribed a topical antibiotic for an ear infection. What is the correct way to administer this medication?

Choice A Reason:

Methimazole is an antithyroid medication that inhibits the synthesis of thyroid hormones. It is commonly used to manage hyperthyroidism, especially in patients who are not candidates for radioactive iodine therapy or surgery. Methimazole is effective in reducing thyroid hormone levels and controlling symptoms, but it requires long-term use and regular monitoring of thyroid function tests.

Choice B Reason:

Levothyroxine is a synthetic form of thyroxine (T4) used to treat hypothyroidism, not hyperthyroidism. Administering levothyroxine to a patient with hyperthyroidism would exacerbate the condition by increasing thyroid hormone levels. Therefore, it is not an appropriate treatment for managing hyperthyroidism.

Choice C Reason:

Radioactive iodine is a widely used treatment for hyperthyroidism. It works by destroying overactive thyroid cells, thereby reducing the production of thyroid hormones. This treatment is particularly effective for patients with Graves’ disease, toxic multinodular goiter, or toxic adenoma. Radioactive iodine is a definitive treatment that can lead to a permanent resolution of hyperthyroidism, although it may result in hypothyroidism, which can be managed with levothyroxine.

Choice D Reason:

Propranolol is a beta-blocker that helps manage the symptoms of hyperthyroidism, such as palpitations, tremors, and anxiety. While it is useful for symptomatic relief, it does not address the underlying cause of hyperthyroidism. Propranolol is often used in conjunction with other treatments, such as antithyroid medications or radioactive iodine, to provide immediate symptom control.

Choice A: Optic Neuritis

Optic neuritis is an inflammation of the optic nerve that can cause pain and vision loss. The pain typically worsens with eye movement, and vision loss usually occurs in one eye. Symptoms include temporary vision loss, visual field loss, loss of color vision, and flashing lights. However, optic neuritis does not typically cause nausea or seeing halos around lights, and the pupil reaction to light is usually preserved.

Choice B: Macular Degeneration

Macular degeneration primarily affects central vision and is more common in older adults. It can cause blurred or reduced central vision, difficulty recognizing faces, and visual distortions such as straight lines appearing bent. However, it does not cause sudden onset eye pain, nausea, or seeing halos around lights. The pupil reaction to light remains normal in macular degeneration.

Choice C: Narrow Angle Glaucoma

Narrow angle glaucoma, also known as acute angle-closure glaucoma, is a medical emergency characterized by a sudden increase in intraocular pressure. Symptoms include severe eye pain, nausea, vomiting, seeing halos around lights, and a mid-dilated, non-reactive pupil. This condition occurs when the drainage angle between the iris and cornea becomes blocked, leading to a rapid rise in eye pressure. Immediate treatment is necessary to prevent permanent vision loss.

Choice D: Cataract

Cataracts cause clouding of the lens, leading to symptoms such as blurred vision, difficulty seeing at night, sensitivity to light, and seeing halos around lights. However, cataracts develop gradually and do not cause sudden onset eye pain or nausea. The pupil reaction to light is also typically normal in cataract patients.