Question Easy:
A 45-year-old woman presents with fatigue, weight gain, and dry skin. Her thyroid function tests reveal an elevated TSH and low free T4. What is the most likely diagnosis?
A) Hyperthyroidism
B) Hypothyroidism
C) Subclinical hyperthyroidism
D) Euthyroid sick syndrome
E) Thyroid cancer
Question Medium:
A 66-year-old man is brought to the emergency department following a fall. He is confused, has a headache, and is found to have a blood pressure of 180/110 mmHg. A CT scan reveals a small bleed in the right basal ganglia. Which underlying condition is most likely responsible for these findings?
A) Cerebral amyloid angiopathy
B) Hypertensive arteriopathy
C) Arteriovenous malformation
D) Cavernous haemangioma
E) Ruptured berry aneurysm
Question Hard:
A 31-year-old female presents with episodes of sweating, palpitations, and headaches. She has a family history of similar symptoms. A 24-hour urinary collection reveals elevated levels of catecholamines. Which genetic mutation is most commonly associated with her condition?
A) RET
B) NF1
C) VHL
D) SDH
E) MEN1
Explanations & Answers:
Question Easy Answer:
B) Hypothyroidism
Question Easy Explanation:
The symptoms and laboratory results are consistent with hypothyroidism, a condition characterized by an underactive thyroid gland resulting in elevated TSH and low free T4. The NICE guidelines recommend thyroid hormone replacement therapy for management.
Question Medium Answer:
B) Hypertensive arteriopathy
Question Medium Explanation:
The clinical presentation and CT findings suggest a hypertensive hemorrhage. Hypertensive arteriopathy, characterized by chronic high blood pressure leading to small vessel disease, is the most common cause of spontaneous intracerebral haemorrhage in the basal ganglia area.
Question Hard Answer:
A) RET
Question Hard Explanation:
The symptoms and family history align with pheochromocytoma, a condition often associated with multiple endocrine neoplasia type 2 (MEN 2), which commonly involves mutations in the RET proto-oncogene. The NICE pathways guide the genetic testing process for affected families.
Medical fact of the day:
In the UK, primary brain tumours have one of the lowest survival rates among cancers. However, early detection and treatment advancements are continually improving outcomes. Stay vigilant to subtle neurological changes in your patients, as early intervention can make a significant difference.
Quote of the day:
“In the heart of healing lies a relentless spirit, woven with compassion and unyielding resilience. Let your dedication shine as a beacon of hope for those you care for.”