Question Easy: A 45-year-old woman presents with weight gain, fatigue, and feeling cold all the time. She also reports constipation and dry skin. Which of the following is the most likely diagnosis? 😊
A) Addison’s disease
B) Hyperthyroidism
C) Hypothyroidism
D) Diabetes Mellitus
E) Polycystic Ovary Syndrome
Question Medium: A 65-year-old man presents with bradykinesia, resting tremor, and rigidity. His symptoms are progressively worsening, affecting his daily activities. Which one of the following medications is considered first-line treatment for his condition?
A) Amantadine
B) Pramipexole
C) Levodopa
D) Selegiline
E) Entacapone
Question Hard: A patient with a history of Cushing’s syndrome due to an ACTH-secreting pituitary adenoma has undergone surgery. Post-operatively, she reports severe fatigue, muscle weakness, and dizziness. Her serum sodium is 128 mmol/L. Which of the following is the most appropriate next step in management?
A) Fluid restriction
B) Intravenous hydrocortisone
C) Oral dexamethasone
D) Desmopressin acetate
E) Hypertonic saline
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The symptoms of weight gain, fatigue, feeling cold, constipation, and dry skin are characteristic of hypothyroidism. According to NICE guidelines, these are common presentations of an underactive thyroid, a condition more prevalent in middle-aged women. Initial management includes checking serum TSH and free T4 levels.
Question Medium Answer: C
Question Medium Explanation: The presentation is suggestive of Parkinson’s disease, characterized by bradykinesia, resting tremor, and rigidity. NICE guidelines recommend levodopa as a first-line treatment, particularly in older patients or when motor symptoms significantly impact quality of life. It helps replenish striatal dopamine, improving motor symptoms.
Question Hard Answer: B
Question Hard Explanation: Post-operative patients with a history of Cushing’s syndrome might have secondary adrenal insufficiency due to suppression of the hypothalamic-pituitary-adrenal axis. Symptoms such as fatigue, muscle weakness, and hyponatremia indicate adrenal insufficiency, which requires prompt treatment with intravenous hydrocortisone as per NHS guidelines.
Medical fact of the day: Did you know that Cushing’s syndrome can sometimes be diagnosed using a simple midnight salivary cortisol test? It is a convenient and non-invasive test that can be done at home, ensuring accurate assessment of cortisol production when it’s expected to be at its lowest.
Quote of the day: “In the world of healing, every small act of kindness becomes a monumental step towards making a lasting impact.”