Short answer: DHA lists common eye and ENT problems and common skin problems as separate content areas for General Practice. Most cases are benign, so exams reward spotting the few red flags: painful red eye with reduced vision, sudden vision loss, giant cell arteritis, sudden hearing loss, an evolving mole and shingles near the eye.
Why red flags carry the marks
DHA’s General Practice entry includes common eye and ENT problems and common skin problems among twelve areas, with no weights. These areas are mostly common and harmless, so a question usually hides one dangerous feature. Your job is to find it. Meddex is independent and is not connected to the Dubai Health Authority (DHA) or Prometric.
This is exam-preparation revision, not clinical advice. In practice, follow your own organisation’s policies and the current guideline, and check every dose and threshold against them.
Red eye: safe or not
A typical conjunctival picture has a gritty or itchy red eye with discharge, normal vision and no severe pain. Allergic cases itch, viral cases are watery and often follow a cold, and bacterial cases have sticky discharge. Most settle with hygiene and simple measures.
Warning features are reduced vision, significant pain, photophobia, a fixed or irregular pupil, a cloudy cornea, a contact lens wearer with pain, and any chemical splash. Acute angle-closure glaucoma gives a painful red eye, blurred vision, haloes around lights, a fixed mid-dilated pupil, a hard eye and sometimes vomiting, and needs same-day ophthalmology. A chemical splash needs immediate, copious irrigation before anything else.
Sudden loss of vision
Painless sudden loss of vision is an emergency. Flashes, new floaters and a curtain over the vision suggest retinal detachment. A sudden painless loss in one eye with a pale retina suggests central retinal artery occlusion. In a patient over 50 with a new headache, scalp tenderness, jaw pain on chewing, or visual symptoms, think of giant cell arteritis. Check inflammatory markers but start high-dose corticosteroid without waiting, because delay risks blindness in the second eye, and arrange urgent specialist review.
Nosebleed and sore throat
First aid for a nosebleed is to sit leaning forward, pinch the soft part of the nose and keep pressing without checking for about 10 to 15 minutes. Persistent, heavy, recurrent or posterior bleeding needs further care, and so do patients on anticoagulants. Blood from one side with a nasal mass or other warning signs calls for referral.
For sore throat, scoring tools such as the Centor criteria help decide who might need antibiotics: tonsillar exudate, tender anterior neck nodes, fever and no cough. Red flags are drooling, stridor, muffled “hot potato” voice with trismus and a deviated uvula, which suggest a peritonsillar abscess, and a toxic child who prefers to sit upright, which suggests epiglottitis. These need airway-focused urgent care.
Ear, hearing and face
Most acute otitis media settles, and analgesia is the first step. Otitis externa is treated with topical therapy. Sudden hearing loss in one ear over hours to days, with no obvious blockage, is treated as urgent, and corticosteroids and specialist review are usually started promptly. Unilateral hearing loss or a neck mass in a smoker needs referral for a head and neck cancer assessment, and so does hoarseness lasting more than three weeks.
Facial weakness that spares the forehead suggests a stroke, while weakness that includes the forehead suggests a lower motor neurone lesion such as Bell’s palsy. Early oral corticosteroid is commonly used in Bell’s palsy, and eye protection matters if the eye does not close. Vertigo with a brief spinning triggered by head position and no neurological signs fits benign positional vertigo, which is treated with a repositioning manoeuvre. New vertigo with neurological signs, severe headache or inability to walk needs urgent assessment for a central cause.
Skin: the lesions that matter
For a pigmented lesion, the ABCDE checks are asymmetry, border irregularity, colour variation, diameter above about 6 mm and evolution. A changing mole is the most important feature, and suspected melanoma is referred urgently without biopsy in primary care. A pearly, rolled-edge nodule with telangiectasia suggests basal cell carcinoma. A scaly, crusted, rapidly growing lesion on sun-exposed skin suggests squamous cell carcinoma.
Scabies causes intense itch that is worse at night, burrows and spares the face in adults. Treat the patient and close contacts at the same time. Shingles is a painful, dermatomal vesicular rash. Antivirals are most useful if started within about 72 hours, and a rash on the tip of the nose suggests involvement of the eye branch, so the eye needs checking. A widespread painful rash with mouth and eye erosions one to three weeks after starting a new drug suggests Stevens-Johnson syndrome, so stop the drug and arrange emergency care. Pain out of proportion to the look of skin raises concern for necrotising infection.
Example: pick the red flag
Example, written by Meddex. A 66-year-old woman has had two weeks of temporal headache and now reports a short episode of blurred vision in one eye. Her jaw aches when she chews. Options include reassurance for tension headache, a topical eye drop, an urgent blood test with immediate corticosteroid and specialist referral, or routine follow-up. The best answer is the third, because the features suggest giant cell arteritis and the aim is to prevent loss of vision.
How to practise
Make one card per system with three headings: safe, needs a plan, urgent. Move each condition to a heading, then check it. Use the DHA physician exam subject map to see where these areas fit, and the single best answer technique for the stem habits that help with red-flag questions.
Frequently asked questions
This article is general educational guidance, not official advice. Exam rules, fees and timelines are set by the Dubai Health Authority and the test provider and can change, so always confirm the latest details on their official channels. Review of Meddex content by named, licensed clinicians is not complete yet. See how we write and check our content.
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