Question Easy: 🌟
A 45-year-old woman presents with increased thirst and urination. She has a history of frequent headaches. Routine blood tests reveal high serum calcium and low phosphate levels. Which condition is most likely causing these symptoms?
A) Diabetes mellitus
B) Diabetes insipidus
C) Hyperparathyroidism
D) Addison’s disease
E) Cushing’s syndrome
Explanations & Answers:
Question Easy Answer: C) Hyperparathyroidism
Question Easy Explanation: Hyperparathyroidism is characterized by excess parathyroid hormone (PTH) production, leading to hypercalcemia. Symptoms include increased thirst and urination, and it can result in kidney stones and bone pain. Low phosphate is also typical due to renal excretion promoted by elevated PTH.
Question Medium: 🤔
A 30-year-old man is brought to the emergency department after a suspected seizure. He has a history of migraines and is currently on valproic acid. On examination, he is confused, and his tongue is bitten. Which investigation is the most appropriate next step?
A) EEG
B) CT head without contrast
C) MRI brain
D) Lumbar puncture
E) Serum valproic acid level
Explanations & Answers:
Question Medium Answer: A) EEG
Question Medium Explanation: An EEG is crucial to identify ongoing epileptiform activity and to help differentiate seizure types. Although neuroimaging can be considered to evaluate structural causes, in a typical post-seizure presentation, EEG provides diagnostic clarity and assists with management planning.
Question Hard: 🧠
A 65-year-old man presents with sudden difficulty speaking and right-sided weakness lasting for 2 hours. He has a history of hypertension and atrial fibrillation. In the ambulance, his BP is 180/100 mmHg and ECG shows atrial fibrillation. What is the most appropriate immediate management in the emergency department?
A) Administer intravenous labetalol to lower blood pressure
B) Start aspirin 300 mg immediately
C) Administer alteplase intravenous bolus
D) Start anticoagulation with warfarin
E) Perform urgent carotid Doppler ultrasound
Explanations & Answers:
Question Hard Answer: C) Administer alteplase intravenous bolus
Question Hard Explanation: The clinical presentation is consistent with an acute ischemic stroke with a clear onset time. Given his symptoms started within 2 hours, he is within the 4.5-hour window for thrombolysis with alteplase, provided there are no contraindications. This treatment optimizes his chances of neurological recovery.
Medical fact of the day: Did you know that in the UK, idiopathic intracranial hypertension is most common among young women with obesity, and weight loss is one of the most effective long-term treatments to relieve symptoms and prevent vision loss?
Quote of the day: “In the vast mosaic of healing, every compassionate moment shapes a brighter future, not just for patients, but for practitioners who hold the light of care.” 🌟