Question Easy:
A 25-year-old woman presents to the GP complaining of chronic fatigue and shortness of breath on exertion. Her blood test results indicate a hemoglobin of 9.5 g/dL, mean corpuscular volume (MCV) of 70 fL, and serum ferritin of 8 ng/mL. What is the most likely diagnosis? 🌥️
A) Vitamin B12 deficiency
B) Iron deficiency anemia
C) Thalassemia trait
D) Anemia of chronic disease
E) Sickle cell anemia
Explanations & Answers:
Question Easy Answer: B) Iron deficiency anemia
Question Easy Explanation: The symptoms and lab results indicate microcytic hypochromic anemia, characterized by low MCV and low serum ferritin. This pattern is classic for iron deficiency anemia, as guided by NICE. 🚀
Question Medium:
A 62-year-old man with a history of hypertension and smoking presents to the emergency department with sudden, severe pain in his abdomen radiating to his back. On examination, he is hypotensive and tachycardic. Which of the following is the most likely diagnosis? 📈
A) Myocardial infarction
B) Pulmonary embolism
C) Mesenteric ischemia
D) Ruptured abdominal aortic aneurysm (AAA)
E) Acute pancreatitis
Question Medium Answer: D) Ruptured abdominal aortic aneurysm (AAA)
Question Medium Explanation: The presentation of acute, severe abdominal and back pain, along with hypotension in a patient with these risk factors, strongly suggests a ruptured AAA, as corroborated by NHS guidelines.
Question Hard:
A 45-year-old woman is being evaluated for recurrent venous thromboembolism (VTE). She has a strong family history of clotting disorders. Her blood tests reveal a decrease in protein C activity. Which hereditary thrombophilia is most likely responsible for her condition? 🌐
A) Factor V Leiden
B) Protein C deficiency
C) Antithrombin III deficiency
D) Protein S deficiency
E) Prothrombin G20210A mutation
Question Hard Answer: B) Protein C deficiency
Question Hard Explanation: This patient’s recurrent VTE and decreased protein C activity are indicative of protein C deficiency. According to BNF guidance, this is an autosomal dominant disorder associated with a high risk of thromboembolism. 🌊
Medical fact of the day: In the UK, about 1 in 2,000 people have an abdominal aortic aneurysm (AAA), and it’s more common in men over 65. Ultrasound screening is offered to men when they turn 65 to reduce the risk of rupture.
Quote of the day: “In the quiet moments of care, we stitch small threads of hope, creating a tapestry that blankets the world in healing.” 🌟