Question Easy: A 30-year-old woman presents to the GP with fatigue, weight gain, and cold intolerance. On examination, you find a goitre. Which of the following is the most likely diagnosis? 🧐
A) Hyperthyroidism
B) Hypothyroidism
C) Diabetes mellitus
D) Addison’s disease
E) Cushing’s syndrome
Question Medium: A 55-year-old man experiences sudden right-sided weakness and slurred speech. Non-contrast CT scan shows no hemorrhage. What is the next immediate step in management if he’s within the therapeutic window? 🏥
A) Start aspirin
B) Administer intravenous thrombolysis
C) Perform carotid endarterectomy
D) Start clopidogrel
E) Administer intravenous heparin
Question Hard: A patient with acromegaly is scheduled to undergo transsphenoidal surgery to remove a pituitary tumor. Which of the following tests is most appropriate to confirm the diagnosis of acromegaly prior to surgery? 🔬
A) Serum prolactin
B) Random growth hormone level
C) Serum insulin-like growth factor 1 (IGF-1)
D) Cortisol level
E) Serum calcium
Explanations & Answers:
Question Easy Answer: B) Hypothyroidism
Question Easy Explanation: Fatigue, weight gain, and cold intolerance are characteristic symptoms of hypothyroidism, typically due to an underactive thyroid. A goitre might be present depending on the cause, such as Hashimoto’s thyroiditis. NICE guidelines recommend checking TSH and free T4 levels for diagnosis.
Question Medium Answer: B) Administer intravenous thrombolysis
Question Medium Explanation: In the setting of an acute ischaemic stroke, NICE guidelines advise that if no contraindications exist and the patient is within the suitable time window (4.5 hours), intravenous thrombolysis with alteplase should be considered. CT is initially used to rule out hemorrhage, facilitating the decision for thrombolysis.
Question Hard Answer: C) Serum insulin-like growth factor 1 (IGF-1)
Question Hard Explanation: IGF-1 is the most reliable marker for diagnosing acromegaly. Unlike growth hormone levels, which fluctuate throughout the day, IGF-1 levels remain stable and provide an accurate reflection of growth hormone secretion. Ensuring a definitive diagnosis before surgical intervention aligns with standard UK practice and guidelines.
Medical fact of the day: The pituitary gland, despite being just the size of a pea, plays a crucial role as the “master gland,” controlling various endocrine functions and influencing processes like growth, metabolism, and reproduction. 🎯
Quote of the day: “In the heart of care, where science meets humanity, every small act of kindness counts tenfold.” 🌟