Question Easy:
A 63-year-old man presents to his GP with complaints of dizziness, fatigue, and shortness of breath. On examination, he is found to have a pale appearance. His full blood count reveals a haemoglobin level of 8.2 g/dL. What is the most likely diagnosis?
A) Iron-deficiency anaemia
B) Vitamin B12 deficiency
C) Sickle cell anaemia
D) Acute leukaemia
E) Thalassaemia
Explanations & Answer:
Question Easy Answer: A
Question Easy Explanation: The patient’s presentation and blood test results are consistent with iron-deficiency anaemia, which is common in older adults and presents with symptoms of dizziness, fatigue, and pallor. According to NICE guidelines, a detailed history and further tests such as serum ferritin should confirm the diagnosis and guide treatment.
Question Medium:
A 45-year-old woman presents with sudden onset of pain, swelling, and redness in her left calf. She recently returned from a long-haul flight and has a family history of clotting disorders. What is the most appropriate initial investigation to confirm the diagnosis?
A) D-dimer test
B) Duplex ultrasound
C) MRI of the leg
D) CT scan of the leg
E) Venography
Explanations & Answer:
Question Medium Answer: B
Question Medium Explanation: The patient’s symptoms suggest deep vein thrombosis (DVT). According to NICE guidelines, a duplex ultrasound is the appropriate initial imaging modality for confirming the diagnosis of DVT owing to its high sensitivity and specificity.
Question Hard:
A 28-year-old woman, 32 weeks pregnant, presents with severe epigastric pain, headache, and visual disturbances. Her blood pressure is 170/110 mmHg, and urinalysis shows significant proteinuria. She is diagnosed with pre-eclampsia. Which of the following is the definitive treatment for her condition?
A) Antihypertensive medication
B) Steroid therapy
C) Delivery of the baby
D) Magnesium sulphate
E) Bed rest
Explanations & Answer:
Question Hard Answer: C
Question Hard Explanation: According to NHS guidelines, pre-eclampsia in pregnancy is a serious condition that poses significant risks to both the mother and the baby. The definitive treatment is the delivery of the baby, especially when the symptoms are severe, to prevent further complications.
Medical fact of the day: Did you know that venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is one of the most common preventable causes of hospital death in the UK?
Quote of the day: “Every small step in patient care creates a ripple of healing and hope. Keep walking, keep caring. 🌟”