Question Easy:
A 40-year-old woman presents with fatigue, pallor, and a craving for ice. You suspect iron deficiency anaemia. What would you expect to see on her blood tests?
A) High serum ferritin
B) Low serum iron
C) High transferrin saturation
D) Low total iron binding capacity (TIBC)
E) High mean corpuscular volume (MCV)
Question Medium:
A 55-year-old man with a history of hypertension presents with sudden onset of severe chest pain radiating to his back. His blood pressure is significantly different between the two arms. What is the most likely diagnosis?
A) Myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Tension pneumothorax
E) Pericarditis
Question Hard:
A 30-year-old woman presents with transient vision loss in one eye, headache, and a high ESR. Which condition is most likely given her symptoms and age?
A) Giant cell arteritis
B) Takayasu’s arteritis
C) Multiple sclerosis
D) Systemic lupus erythematosus
E) Temporal arteritis
Explanations & Answers:
Question Easy Answer: B) Low serum iron
Question Easy Explanation: In iron deficiency anaemia, you would expect to see low serum iron, low serum ferritin, and high total iron binding capacity (TIBC). Craving for ice, known as pagophagia, is a common symptom. According to NICE guidelines, the main characteristic is low serum iron, aligning with NHS and BNF standards.
Question Medium Answer: C) Aortic dissection
Question Medium Explanation: Aortic dissection typically presents with sudden onset severe chest pain and can cause unequal blood pressures in the arms due to the involvement of the arterial branches, fitting his presentation. This condition requires urgent diagnosis and management to prevent fatal outcomes, as outlined by NHS guidelines.
Question Hard Answer: B) Takayasu’s arteritis
Question Hard Explanation: Takayasu’s arteritis often affects young women and can present with systemic symptoms such as headache, visual disturbances, and elevated inflammatory markers like ESR. It is different from giant cell arteritis, which usually affects older adults, confirming the age-specific presentation in the question, in alignment with NICE guidelines.
Medical fact of the day: Did you know that Takayasu’s arteritis, also known as “pulseless disease,” is more common in women under 40 and can lead to diminished or absent pulses due to vascular involvement? Monitoring and managing inflammatory markers can significantly impact patient outcomes.
Quote of the day: “In the heart of every caregiver is a life filled with purpose, hope, and compassion, igniting wellness one heartbeat at a time.”