Question Easy:
A 35-year-old woman presents with fatigue, weight gain, and constipation. On examination, she has dry skin and thinning hair. What is the most likely diagnosis? 🩺
A) Hyperthyroidism
B) Hypothyroidism
C) Addison’s disease
D) Cushing’s syndrome
E) Phaeochromocytoma
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: The patient’s symptoms are consistent with hypothyroidism, which is commonly characterised by fatigue, weight gain, constipation, dry skin, and thinning hair. NICE guidelines recommend checking TSH and free T4 levels to confirm the diagnosis.
Question Medium:
A 50-year-old man with a history of smoking and hypertension presents with a sudden severe headache described as the “worst headache of his life,” along with photophobia and neck stiffness. What is the most likely diagnosis? 🧠
A) Tension headache
B) Sinusitis
C) Subarachnoid haemorrhage
D) Migraine
E) Temporal arteritis
Explanations & Answers:
Question Medium Answer: C
Question Medium Explanation: The patient’s symptoms strongly suggest a subarachnoid haemorrhage (SAH), particularly the sudden onset of the “worst headache of his life,” photophobia, and neck stiffness. NICE guidelines recommend urgent CT scanning and lumbar puncture if the CT is negative but SAH is still suspected.
Question Hard:
A 28-year-old woman presents with episodes of palpitations, sweating, and headaches. Her blood pressure is consistently elevated. Urine tests reveal elevated metanephrines. What is the most likely diagnosis? 🧩
A) Hyperthyroidism
B) Phaeochromocytoma
C) Primary hyperaldosteronism
D) Cushing’s syndrome
E) Essential hypertension
Explanations & Answers:
Question Hard Answer: B
Question Hard Explanation: The presence of palpitations, sweating, headaches, and elevated blood pressure, combined with the laboratory finding of increased metanephrines, is indicative of phaeochromocytoma. According to the NHS, diagnosis is confirmed with biochemical testing for catecholamines and imaging studies to identify the adrenal or extra-adrenal tumour.
Medical fact of the day: The adrenal glands, found above the kidneys, are responsible for producing hormones like cortisol, aldosterone, and adrenaline. Phaeochromocytoma, a rare tumour of the adrenal gland, can cause life-threatening hypertension if left untreated.
Quote of the day: “In the intricate dance of healthcare, every step you take brings healing closer. Never underestimate the power of your compassionate touch. 🌟”