Question Easy:
A 45-year-old woman presents to the clinic with fatigue, weight gain, and constipation. Blood tests reveal low free T4 and elevated TSH. What is the most likely diagnosis? 🩺
A) Graves’ disease
B) Hashimoto’s thyroiditis
C) Subclinical hypothyroidism
D) Euthyroid sick syndrome
E) Iodine deficiency
Question Medium:
A 66-year-old man is brought to the emergency department after experiencing a sudden onset of weakness on the right side of his body and speech difficulties. A CT scan of the head is performed. Which of the following arteries is most likely occluded? 🧠
A) Anterior cerebral artery
B) Middle cerebral artery
C) Posterior cerebral artery
D) Basilar artery
E) Vertebral artery
Question Hard:
A 30-year-old woman presents with episodes of palpitations, sweating, and headaches. On examination, she has a blood pressure of 180/110 mmHg. Urinary catecholamines are significantly elevated. Which genetic syndrome is she most likely associated with? 🤔
A) Von Hippel-Lindau disease
B) Multiple endocrine neoplasia type 1 (MEN1)
C) Multiple endocrine neoplasia type 2 (MEN2)
D) Neurofibromatosis type 1
E) Tuberous sclerosis
Explanations & Answers:
Question Easy Answer: B) Hashimoto’s thyroiditis
Question Easy Explanation: This patient’s symptoms and lab findings are indicative of primary hypothyroidism, with Hashimoto’s thyroiditis being the most common cause. The presence of low free T4 and elevated TSH confirms the diagnosis, as per NICE guidelines on thyroid dysfunction.
Question Medium Answer: B) Middle cerebral artery
Question Medium Explanation: The sudden onset of right-sided weakness and speech difficulties suggests a stroke in the left hemisphere. The middle cerebral artery is most commonly involved in such presentations, supplying areas responsible for motor control and language, in line with NHS stroke protocols.
Question Hard Answer: C) Multiple endocrine neoplasia type 2 (MEN2)
Question Hard Explanation: The classic triad of symptoms—palpitations, sweating, and headaches—along with elevated urinary catecholamines, suggests a pheochromocytoma. This is often associated with MEN2, as reflected in BNF guidelines on genetic syndromes involving endocrine tumours.
Medical fact of the day: Did you know that the hypothalamus, a small region at the base of the brain, controls many hormonal processes and is crucial in maintaining body homeostasis? It acts as a bridge between the endocrine and nervous systems, regulating hunger, sleep, and stress responses.
Quote of the day: “In the quiet courage of healing, lies the strength to change lives. Keep the spirit of compassion alive in every patient encounter.” 🌟