Question Easy: A 30-year-old woman presents to her GP with symptoms of tiredness, weight gain, and cold intolerance. 🥶 On examination, she has dry skin and bradycardia. Which of the following is the most likely diagnosis?
A) Cushing’s syndrome
B) Hyperthyroidism
C) Addison’s disease
D) Hypothyroidism
E) Pheochromocytoma
Question Medium: A 60-year-old man presents with a sudden onset of right-sided weakness and difficulty speaking. 🧠🚨 He has a history of hypertension and smoking. CT scan shows an ischaemic stroke. Which area of the brain is most likely affected?
A) Left parietal lobe
B) Right frontal lobe
C) Left frontal lobe
D) Right parietal lobe
E) Cerebellum
Question Hard: A 45-year-old woman presents with episodes of palpitations, sweating, and headaches. 📈🔍 Her blood pressure is consistently elevated. Initial investigations show elevated catecholamines. Which of the following tests is most appropriate to confirm the diagnosis?
A) Serum cortisol
B) 24-hour urinary metanephrines
C) Serum TSH
D) Plasma aldosterone
E) Serum calcium
Explanations & Answers:
Question Easy Answer: D) Hypothyroidism
Question Easy Explanation: The symptoms described—tiredness, weight gain, cold intolerance, dry skin, and bradycardia—are classic for hypothyroidism. According to NICE guidelines, these clinical features are consistent with underactive thyroid function, which is confirmed by elevated TSH and low free T4.
Question Medium Answer: A) Left parietal lobe
Question Medium Explanation: The described symptoms of right-sided weakness and speech difficulty indicate a problem in the left hemisphere, typically involving the parietal lobe region, affecting motor and possibly language areas, which aligns with the NICE guidelines on stroke presentations.
Question Hard Answer: B) 24-hour urinary metanephrines
Question Hard Explanation: This woman’s episodic symptoms and elevated catecholamines suggest pheochromocytoma. According to NICE and NHS guidelines, a 24-hour urinary metanephrines test is the most sensitive screening tool for pheochromocytoma diagnosis.
Medical fact of the day: The pituitary gland, often called the “master gland,” plays a crucial role in controlling other hormonal glands in the body, including the thyroid and adrenals. It helps regulate various body functions, from growth to metabolism!
Quote of the day: “In the quiet moments of a bustling hospital, remember: every small act of kindness you do creates ripples of healing. Let your compassion be your guide.”