Question Easy:
A 28-year-old woman presents to the clinic with fatigue, weight gain, and cold intolerance. She also mentions her skin is quite dry and her periods have become irregular. What is the most likely diagnosis? 🩺
A) Hyperthyroidism
B) Hypothyroidism
C) Polycystic Ovary Syndrome
D) Depression
E) Cushing’s Syndrome
Explanations & Answers:
Question Easy Answer:
B) Hypothyroidism
Question Easy Explanation:
This patient’s symptoms are classic for hypothyroidism, which includes fatigue, weight gain, cold intolerance, dry skin, and menstrual irregularities. According to NICE guidelines, these are typical presentations of an underactive thyroid, and serum TSH and free T4 levels should be checked to confirm the diagnosis.
Question Medium:
A 40-year-old man presents with headache, visual disturbances, and loss of libido. On examination, he is found to have bitemporal hemianopia. What is the most likely underlying cause of his symptoms? 👁️
A) Pituitary adenoma
B) Multiple sclerosis
C) Temporal lobe epilepsy
D) Migraine
E) Cluster headache
Question Medium Answer:
A) Pituitary adenoma
Question Medium Explanation:
The symptoms and examination findings, particularly bitemporal hemianopia, are indicative of a pituitary adenoma, which is pressing on the optic chiasm. The NICE guidelines recommend an MRI of the pituitary region for further investigation in such cases. Loss of libido can occur due to hormonal imbalances caused by the adenoma affecting pituitary function.
Question Hard:
A 55-year-old male presents to the GP with a tremor that is present at rest but disappears with voluntary movement. He also describes a shuffling gait and slowness of movement. What is the most likely neurotransmitter involved in the pathophysiology of his condition? 🧠
A) Acetylcholine
B) Serotonin
C) Dopamine
D) GABA
E) Glutamate
Question Hard Answer:
C) Dopamine
Question Hard Explanation:
The presentation is suggestive of Parkinson’s disease, characterized by resting tremor, bradykinesia, and gait disturbances. This condition is primarily due to the loss of dopaminergic neurons in the substantia nigra. NICE guidelines support the management of Parkinson’s with dopamine replacement therapies, such as levodopa, to address the neurotransmitter deficit.
Medical fact of the day:
Did you know? The pituitary gland, often called the “master gland,” is only about the size of a pea but controls numerous bodily functions, from growth to metabolism to reproduction, through hormone release.
Quote of the day:
“In every patient you treat, may you find a spark of hope that ignites your passion for healing and a lesson that enriches your journey in medicine.”