Question Easy:
A 40-year-old woman presents with fatigue, pallor, and shortness of breath. Blood tests reveal microcytic hypochromic anemia. She has a long history of menorrhagia. Which of the following is the most likely diagnosis?
A) Vitamin B12 deficiency anemia
B) Iron deficiency anemia
C) Folate deficiency anemia
D) Hemolytic anemia
E) Sickle cell anemia
Explanations & Answers:
Question Easy Answer: B) Iron deficiency anemia
Question Easy Explanation: This patient’s history of menorrhagia, along with the laboratory findings of microcytic hypochromic anemia, suggests iron deficiency anemia. According to NICE guidelines, the most common cause of microcytic anemia is iron deficiency, often due to chronic blood loss.
Question Medium:
A 65-year-old man with a history of COPD presents with calf pain and swelling. A doppler ultrasound confirms a deep vein thrombosis (DVT). Which of the following is the preferred initial anticoagulation therapy according to current guidelines?
A) Aspirin
B) Warfarin
C) Rivaroxaban
D) Heparin
E) Dabigatran
Question Medium Answer: C) Rivaroxaban
Question Medium Explanation: In accordance with NHS guidelines, direct oral anticoagulants (DOACs) like Rivaroxaban are often used as the first-line treatment for acute DVTs because they do not require routine monitoring and have fewer dietary restrictions compared to Warfarin. DOACs can be administered in fixed doses without the need for initial loading with Heparin, simplifying patient management.
Question Hard:
A 55-year-old woman with hypertension and hyperlipidemia presents with sudden onset chest pain radiating to her back. Her blood pressure is significantly higher in her right arm than her left. An urgent CT angiogram reveals an intimal tear in the aortic arch. What is the most appropriate initial management?
A) Urgent surgical repair
B) Initiate thrombolysis
C) IV antibiotics
D) Beta-blockers and blood pressure control
E) Antiplatelet therapy
Question Hard Answer: D) Beta-blockers and blood pressure control
Question Hard Explanation: This clinical scenario describes an aortic dissection. According to NICE guidelines, immediate management involves controlling heart rate and blood pressure to reduce the stress on the aortic wall, typically with beta-blockers. Urgent surgical intervention may be required for type A dissections or when there are complications. However, initial medical management focuses on preventing further propagation of the dissection.
Medical fact of the day: Did you know? The average adult body contains about 5 to 6 litres of blood, which circulates through the entire vascular system every 45 seconds! Anemia is one of the most common hematological conditions managed in the UK, especially in women of reproductive age due to menstrual blood loss.
Quote of the day: “In every moment of care, a little kindness can ignite a spark of healing. Your compassion is a beacon in the lighthouse of medicine.”