Question Easy:
A 45-year-old man presents to the GP with fatigue, palpitations, and shortness of breath. On examination, he has conjunctival pallor. Blood tests reveal a haemoglobin level of 9 g/dL. What is the most likely diagnosis?
A) Iron deficiency anaemia
B) Chronic kidney disease
C) Vitamin B12 deficiency
D) Aplastic anaemia
E) Acute lymphoblastic leukaemia
Question Easy Answer:
A) Iron deficiency anaemia
Question Easy Explanation:
Iron deficiency anaemia is the most common cause of anaemia and is often characterised by fatigue, pallor, and shortness of breath. The low haemoglobin level supports this diagnosis. NICE guidelines recommend confirming with further tests, including ferritin levels.
Question Medium:
A 60-year-old woman presents with a painful, swollen left leg. She has recently had surgery and has been bedridden for a week. What is the initial imaging modality of choice to investigate suspected deep vein thrombosis (DVT)?
A) Chest X-ray
B) CT Pulmonary Angiography
C) Doppler ultrasound
D) MRI scan
E) Venogram
Question Medium Answer:
C) Doppler ultrasound
Question Medium Explanation:
Doppler ultrasound is the first-line imaging test for diagnosing DVT according to NICE and NHS guidelines. It is non-invasive and has high sensitivity and specificity for detecting thrombi in the leg veins.
Question Hard:
A 35-year-old patient with a history of essential thrombocythaemia presents with a sudden onset of chest pain, shortness of breath, and a high fever. Blood cultures come back positive for Staphylococcus aureus. What is the most likely diagnosis?
A) Chronic myeloid leukaemia
B) Polycythaemia vera
C) Myocardial infarction
D) Infective endocarditis
E) Stable angina
Question Hard Answer:
D) Infective endocarditis
Question Hard Explanation:
The presence of chest pain, shortness of breath, fever, and positive blood cultures for Staphylococcus aureus in a patient with essential thrombocythaemia makes infective endocarditis the most likely diagnosis. According to NICE guidelines, this condition requires prompt identification and treatment, often confirmed with echocardiography.
Medical fact of the day: Did you know that chronic venous insufficiency, a condition that affects around 40% of people aged over 50 in the UK, is often underdiagnosed? It can lead to complications like varicose veins, leg ulcers, and venous eczema.
Quote of the day: “Healing is an art. It requires a heart full of empathy, hands skilled in practice, and a mind open to continuous learning.” 🌟