Question Easy:
A 45-year-old woman with a history of asthma visits her GP because she’s been feeling more tired than usual. She has also noticed some weight gain and feels cold all the time ♨️. What is the most likely diagnosis?
A) Hyperthyroidism
B) Diabetes mellitus
C) Iron deficiency anaemia
D) Hypothyroidism
E) Addison’s disease
Question Medium:
A 50-year-old man presents with episodes of sudden intense headache 😖, palpitations, sweating, and a feeling of panic. His blood pressure is found to be elevated at 180/120 mmHg during these episodes. What is the most likely diagnosis?
A) Migraine
B) Hyperthyroidism
C) Phaeochromocytoma
D) Panic disorder
E) Hypertension
Question Hard:
A patient with diabetes insipidus is unable to concentrate their urine despite normal renal function. You suspect a central cause. Which investigation is most useful to confirm a central versus nephrogenic cause of diabetes insipidus?
A) Serum osmolality
B) Water deprivation test
C) Renal ultrasound
D) MRI of the pituitary
E) 24-hour urine collection
Explanations & Answers:
Question Easy Answer:
D) Hypothyroidism
Question Easy Explanation:
The symptoms of tiredness, weight gain, and feeling cold are classic signs of hypothyroidism. According to NICE guidelines, patients with these symptoms should have their thyroid function tested to confirm the diagnosis.
Question Medium Answer:
C) Phaeochromocytoma
Question Medium Explanation:
The episodic symptoms of headache, palpitations, sweating, and hypertension suggest a phaeochromocytoma, a catecholamine-secreting tumor. NICE recommends measuring catecholamines or metanephrines for confirmation.
Question Hard Answer:
B) Water deprivation test
Question Hard Explanation:
The water deprivation test helps differentiate between central and nephrogenic diabetes insipidus. In central DI, administration of desmopressin will concentrate the urine, whereas there is no significant change in nephrogenic DI. According to the BNF, the response to synthetic ADH can aid in diagnosis.
Medical fact of the day:
Did you know that the thyroid gland produces hormones crucial for nearly all bodily functions, including metabolism, heart rate, and body temperature regulation? This makes thyroid disorders a common but important area of study in Endocrinology.
Quote of the day:
“In the quiet moments of healing, remember that small steps lead to large changes. Your compassion today shapes the medicine of tomorrow.” 🌟