Question Easy:
A 25-year-old man presents with sudden onset pain, swelling, and redness in his left calf. He recently returned from a long-haul flight from Australia. What is the most likely diagnosis? 🛩️
A) Cellulitis
B) Deep vein thrombosis (DVT)
C) Muscle strain
D) Baker’s cyst rupture
E) Superficial thrombophlebitis
Question Medium:
A 65-year-old lady with a history of hypertension and hyperlipidaemia presents with intermittent claudication. Which of the following is an appropriate first-line treatment to improve her symptoms according to NICE guidelines?
A) Aspirin
B) Atorvastatin
C) Clopidogrel
D) Exercise training
E) Warfarin
Question Hard:
A 45-year-old man presents with symptoms of anemia and splenomegaly. Blood tests reveal an elevated white blood cell count and low red blood cell count. Bone marrow biopsy shows hypercellularity with predominant megakaryocytes. What is the most likely diagnosis? 🔬
A) Chronic myeloid leukemia (CML)
B) Essential thrombocythemia
C) Polycythemia vera
D) Myelofibrosis
E) Acute lymphoblastic leukemia
Explanations & Answers:
Question Easy Answer: B) Deep vein thrombosis (DVT)
Question Easy Explanation:
DVT is characterised by the sudden onset of pain, swelling, and redness in the limb, commonly after long periods of immobility, such as a long-haul flight. NICE guidelines recommend a Wells score assessment and D-dimer testing for suspected DVT.
Question Medium Answer: D) Exercise training
Question Medium Explanation:
According to NICE guidelines, supervised exercise training is recommended as the first-line treatment for intermittent claudication to improve walking distance and overall symptoms. Medical therapy with antiplatelet agents like clopidogrel may also be considered but not as a first-line treatment.
Question Hard Answer: D) Myelofibrosis
Question Hard Explanation:
Myelofibrosis is a type of chronic leukaemia characterised by splenomegaly and anemia, with bone marrow biopsy showing hypercellularity and proliferation of megakaryocytes. The other options, such as CML, essential thrombocythemia, and polycythemia vera, also fall under myeloproliferative disorders but present differently.
Medical fact of the day:
Sickle cell disease is one of the most common genetic disorders in the UK, and it predominantly affects individuals of African or Caribbean descent. Early diagnosis through the NHS newborn blood spot screening program is crucial for effective management.
Quote of the day:
“Every patient’s healing journey is a chance for us to learn, to serve, and to grow. Never underestimate the impact of a kind word and a compassionate heart.” 🌟