Question Easy:
A 55-year-old man presents with fatigue, pallor, and glossitis. He has recently become vegan and does not take any supplements. What is the most likely deficiency resulting in these symptoms? 🌱
A) Vitamin C
B) Iron
C) Vitamin B12
D) Folic acid
E) Vitamin D
Explanations & Answers:
Question Easy Answer: C) Vitamin B12
Question Easy Explanation: This patient’s symptoms are consistent with vitamin B12 deficiency, which can occur with a vegan diet lacking supplementation, as B12 is primarily found in animal products. This type of deficiency can lead to megaloblastic anaemia, presenting with fatigue, pallor, and glossitis.
Question Medium:
A 32-year-old woman presents with a swollen, painful leg and is diagnosed with a deep vein thrombosis (DVT). Which of the following is the most appropriate initial treatment?
A) Low molecular weight heparin (LMWH)
B) Aspirin
C) Warfarin
D) Clopidogrel
E) Thrombolytic therapy
Explanations & Answers:
Question Medium Answer: A) Low molecular weight heparin (LMWH)
Question Medium Explanation: NICE guidelines recommend LMWH as the initial treatment for a confirmed DVT. It is fast-acting and provides effective anticoagulation, reducing the risk of clot propagation, while the patient is transitioned to an oral anticoagulant if needed.
Question Hard:
A 67-year-old man with hypertension and a history of smoking presents with a pulsatile abdominal mass and back pain. Which of the following investigations is most appropriate to confirm the suspected diagnosis of an abdominal aortic aneurysm (AAA)?
A) Chest X-ray
B) CT abdomen
C) MRI abdomen
D) Abdominal ultrasound
E) Angiography
Explanations & Answers:
Question Hard Answer: D) Abdominal ultrasound
Question Hard Explanation: An abdominal ultrasound is the recommended initial investigation for screening and diagnosing an AAA, as per UK guidelines. It is non-invasive, does not involve radiation, and is highly effective at visualising the abdominal aorta to confirm the presence and size of an aneurysm.
Medical fact of the day: The red blood cell count in a human body is approximately 20-30 trillion, enough to circle the Earth if laid end to end! This underlines the importance of maintaining proper haemostasis in healthcare practices. 🩸
Quote of the day: “Every patient is a new window into the pursuit of knowledge; open it with curiosity, compassion, and the promise of hope.” 🌈