Question Easy:
A 25-year-old woman visits her GP with complaints of fatigue, shortness of breath, and pale skin. You suspect iron deficiency anaemia. Which of the following blood tests would most likely confirm the diagnosis? 🩸
A) Elevated serum ferritin
B) Reduced serum ferritin
C) Elevated C-reactive protein
D) Reduced platelet count
E) Elevated vitamin B12 levels
Question Medium:
A 68-year-old man with a history of smoking and hypertension presents with sudden onset of severe abdominal pain and a pulsatile abdominal mass is detected on examination. What is the most likely diagnosis?
A) Acute pancreatitis
B) Splenic rupture
C) Abdominal aortic aneurysm rupture
D) Mesenteric ischaemia
E) Diverticulitis
Question Hard:
A 45-year-old woman is on warfarin therapy for a mechanical heart valve replacement. She has recently started on an antibiotic for a urinary tract infection. Two days later, she presents with excessive bruising and bleeding gums. Which of the following antibiotics is most likely to have interacted with her warfarin therapy?
A) Amoxicillin
B) Nitrofurantoin
C) Ciprofloxacin
D) Azithromycin
E) Trimethoprim
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: Iron deficiency anaemia is characterised by low serum ferritin levels, indicating depleted iron stores. Serum ferritin is a sensitive test for iron deficiency when the patient is otherwise healthy and there is no inflammation. This aligns with NICE guidelines, which recommend checking serum ferritin as part of the diagnosis of iron deficiency anaemia.
Question Medium Answer: C
Question Medium Explanation: The presentation of a pulsatile abdominal mass with severe abdominal pain in an older male with risk factors such as smoking and hypertension suggests an abdominal aortic aneurysm (AAA) rupture. According to NHS guidelines, AAA is a critical emergency, and immediate medical intervention is required.
Question Hard Answer: C
Question Hard Explanation: Ciprofloxacin can potentiate the effect of warfarin by altering its metabolism, which can increase the INR and the risk of bleeding. According to the BNF, interactions between warfarin and certain antibiotics, like ciprofloxacin, necessitate close monitoring of INR levels and possibly adjusting the warfarin dose.
Medical fact of the day: Did you know that sickle cell disease is one of the most common genetic disorders in the UK, predominantly affecting people of African and Caribbean descent? The NHS offers comprehensive screening programmes to improve early diagnosis and treatment outcomes. 🌍🏥
Quote of the day: “In the heart of medicine lies a passion for healing. We may not always cure, but care and compassion are as boundless as the journey we undertake.” 💪💙