14/07/2024 – Haem and Vascular

Question Easy:
Which of the following is the first-line treatment for iron deficiency anaemia in an adult aged 30 years?
A) Iron dextran infusion
B) Oral ferrous sulfate
C) Vitamin B12 injections
D) Erythropoietin therapy
E) Blood transfusion

Question Easy Answer: B) Oral ferrous sulfate
Question Easy Explanation: The first-line treatment for iron deficiency anaemia is oral iron supplementation, typically with ferrous sulfate. This is in line with NICE guidelines, which recommend oral iron as the initial treatment to replenish iron stores and to correct anaemia. Blood transfusions or intravenous iron are reserved for severe cases or when oral iron is not tolerated or ineffective.

Question Medium:
A 50-year-old male presents with a swollen, painful leg and is diagnosed with deep vein thrombosis (DVT). According to NICE guidelines, what is the recommended duration of anticoagulant therapy for a first DVT in the absence of an identifiable risk factor?
A) 3 months
B) 6 months
C) 12 months
D) Indefinitely
E) Until symptoms resolve

Question Medium Answer: B) 6 months
Question Medium Explanation: NICE guidelines recommend that patients with a first episode of DVT and no identifiable risk factors should receive anticoagulant therapy for 6 months. This duration helps to reduce the risk of recurrence and is considered optimal for balancing the benefits and risks of anticoagulation.

Question Hard:
A 68-year-old female with a history of hypertension presents with abdominal pain. Imaging reveals an abdominal aortic aneurysm (AAA) measuring 5.8 cm. According to current NHS guidelines, what is the recommended management for this patient?
A) Immediate open surgical repair
B) Elective endovascular aneurysm repair (EVAR)
C) 3-monthly ultrasound monitoring
D) 6-monthly CT angiography
E) Watchful waiting with lifestyle modifications

Question Hard Answer: B) Elective endovascular aneurysm repair (EVAR)
Question Hard Explanation: Current NHS guidelines recommend elective endovascular aneurysm repair (EVAR) for patients with asymptomatic abdominal aortic aneurysms larger than 5.5 cm, due to the increased risk of rupture. EVAR is favoured due to its less invasive nature over open surgical repair, especially in patients with comorbidities such as hypertension.

Medical fact of the day: Did you know that the UK’s National Abdominal Aortic Aneurysm Screening Programme has been successful in reducing mortality from AAA-related ruptures by identifying aneurysms early in men aged 65 and over?

Quote of the day: “Every patient you see is a life you have the chance to impact – remember to treat them with the care and respect they deserve.” 🌟