Question Easy:
A 25-year-old woman presents with fatigue, pallor, and mild breathlessness on exertion. Blood tests reveal a haemoglobin level of 9 g/dL and a mean corpuscular volume (MCV) of 70 fL. Which of the following is the most likely cause of her anaemia? 🌼
A) Vitamin B12 deficiency
B) Iron deficiency anaemia
C) Thalassaemia
D) Aplastic anaemia
E) Chronic kidney disease
Question Medium:
A 60-year-old man with a history of peripheral vascular disease presents to the clinic with a painful, cold foot. On examination, there is reduced sensation and absent dorsalis pedis and posterior tibial pulses. What is the next step in management? 🚑
A) Oral anticoagulation
B) CT angiography
C) Urgent surgical revascularisation
D) Graduated compression stockings
E) Intravenous antibiotics
Question Hard:
A 35-year-old woman presents with a history of recurrent deep vein thrombosis (DVT) and pulmonary embolism (PE). Genetic testing reveals a mutation. Considering UK guidelines, which genetic mutation is most associated with increased risk for venous thromboembolism (VTE)? 🧬
A) JAK2 mutation
B) Prothrombin gene mutation (G20210A)
C) HFE gene mutation
D) Factor V Leiden mutation
E) MTHFR mutation
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: This young woman’s lab results show microcytic anaemia, often due to iron deficiency. This is common in females of reproductive age likely due to menstrual losses. NICE guidelines support checking ferritin levels to confirm this diagnosis.
Question Medium Answer: C
Question Medium Explanation: The clinical presentation suggests critical limb ischaemia, characterized by pain, coldness, and absent pulses requiring urgent surgical revascularisation to preserve limb function according to NHS protocols.
Question Hard Answer: D
Question Hard Explanation: The Factor V Leiden mutation is the most common inherited thrombophilia, significantly raising the risk of venous thromboembolism (VTE) in many European populations, including the UK. NICE guidelines recommend considering this diagnosis in patients with recurrent DVT or PE.
Medical fact of the day: Did you know that the aorta is the largest artery in the human body? It is about an inch in diameter and distributes oxygen-rich blood from the heart to the rest of the body. In the UK, abdominal aortic aneurysms (AAA) are screened for in men aged 65 using an abdominal ultrasound as recommended by the NHS.
Quote of the day: “In the intricate weave of care, the threads of compassion and patience are seamless, holding the fabric of healing together.”