Mata dan THT
Core concepts
Ophthalmology: red eye triage (conjunctivitis, keratitis, acute angle-closure glaucoma, uveitis, scleritis), sudden painless vision loss (retinal artery occlusion, vitreous haemorrhage, retinal detachment), and painful vision loss (angle closure, optic neuritis). Know diabetic and hypertensive retinopathy screening, and the emergency nature of chemical injury and open globe. ENT: otitis media and externa, hearing loss (conductive versus sensorineural), vertigo (peripheral versus central), epistaxis management, tonsillitis and peritonsillar abscess, and the red flags of head and neck cancer such as persistent hoarseness and unilateral nasal symptoms.
Traps
Examiners test the red eye that is not conjunctivitis: reduced vision, photophobia, and a fixed mid-dilated pupil suggest acute angle-closure glaucoma, which needs urgent pressure-lowering and ophthalmology review. Do not prescribe topical steroids for an undiagnosed red eye. Vertigo with neurological signs is central, not benign positional vertigo. Do not pack the nose blindly in posterior epistaxis; it may need specialist cautery or packing.
Worked example
A 65-year-old has sudden painless loss of vision in one eye, and fundoscopy shows a pale retina with a cherry-red spot. Diagnosis: central retinal artery occlusion. Rule of thumb: this is a stroke-equivalent emergency - refer immediately, and assess for cardiovascular risk factors such as atrial fibrillation and carotid disease.