Question Easy:
A 45-year-old woman presents with fatigue, weight gain, hair loss, and cold intolerance. She has a past medical history of type 1 diabetes mellitus. Which hormone deficiency is most likely responsible for her symptoms? 🩺
A) Cortisol
B) Insulin
C) Thyroxine
D) Growth hormone
E) Aldosterone
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The symptoms described are characteristic of hypothyroidism. The patient’s history of type 1 diabetes mellitus increases her risk of developing other autoimmune conditions, including autoimmune thyroiditis, which can lead to hypothyroidism. NICE guidelines recommend checking thyroid function tests in patients presenting with such symptoms.
Question Medium:
A 63-year-old man presents with a resting tremor, bradykinesia, and rigidity. His symptoms are more pronounced on the right side. MRI of the brain shows no structural abnormalities. What is the most likely diagnosis? 🧠
A) Multiple Sclerosis
B) Parkinson’s Disease
C) Huntington’s Disease
D) Amyotrophic Lateral Sclerosis
E) Essential Tremor
Explanations & Answers:
Question Medium Answer: B
Question Medium Explanation: The classic triad of resting tremor, bradykinesia, and rigidity strongly suggests Parkinson’s Disease. NICE guidelines recommend starting treatment with Levodopa for managing motor symptoms in newly diagnosed patients. Essential tremor, while also causing tremors, usually presents with action tremor rather than resting tremor and does not typically involve bradykinesia or rigidity.
Question Hard:
A 30-year-old woman visits the clinic with sudden, severe headaches described as “the worst headache of her life,” photophobia, neck stiffness, and vomiting. Fundoscopy reveals papilloedema. An emergent CT scan shows a subarachnoid hemorrhage (SAH). What is the most appropriate next step in management?🚨
A) Start oral nimodipine
B) Arrange a lumbar puncture
C) Urgent neurosurgical consultation
D) Start high-dose corticosteroids
E) Begin intravenous ceftriaxone
Explanations & Answers:
Question Hard Answer: C
Question Hard Explanation: The patient’s presentation is classic for a subarachnoid hemorrhage. Management includes stabilisation, urgent neurosurgical consultation, and supportive care. Nimodipine may be initiated to prevent vasospasm, but definitive management requires neurosurgical intervention. Starting high-dose corticosteroids or ceftriaxone is inappropriate, and lumbar puncture is unnecessary as the diagnosis has already been confirmed by CT.
Medical fact of the day:
Did you know that acromegaly, a condition caused by excessive secretion of growth hormone, commonly results from pituitary adenomas? Early diagnosis and management are crucial to prevent complications including diabetes mellitus and cardiovascular disease, in line with NICE guidelines.
Quote of the day:
“In the depths of challenges, the strength and compassion of healthcare workers illuminate the path to recovery and hope. Keep shining your light.” 🌟