Question Easy:
🚑 A 55-year-old gentleman presents with increased urination, excessive thirst, and unexplained weight loss. Blood tests reveal elevated blood glucose levels. What is the most likely diagnosis?
A) Type 1 Diabetes Mellitus
B) Type 2 Diabetes Mellitus
C) Diabetes Insipidus
D) Hyperthyroidism
E) Addison’s Disease
Question Medium:
🌡️ A 35-year-old woman complains of fatigue, muscle weakness, and palpitations. She is found to have a high blood pressure of 160/95 mmHg. Blood tests show hypokalaemia. What is the most likely underlying cause of her symptoms?
A) Addison’s Disease
B) Phaeochromocytoma
C) Primary Hyperaldosteronism
D) Cushing’s Syndrome
E) Hyperparathyroidism
Question Hard:
🧠 A 62-year-old woman has a history of recurrent severe unilateral headaches accompanied by nausea, vomiting, and photophobia. Each episode lasts between 4 to 72 hours. She also experiences a tingling sensation in her hand before the headache starts. What is the most likely diagnosis?
A) Tension-type Headache
B) Cluster Headache
C) Migraine with Aura
D) Temporal Arteritis
E) Trigeminal Neuralgia
Explanations & Answers:
Question Easy Answer: B) Type 2 Diabetes Mellitus
Question Easy Explanation: The symptoms described are classic of diabetes mellitus, particularly Type 2, which often presents in middle-aged or older adults with a combination of polyuria, polydipsia, and weight loss. NICE guidelines recommend confirming the diagnosis with HbA1c or fasting plasma glucose tests.
Question Medium Answer: C) Primary Hyperaldosteronism
Question Medium Explanation: The combination of hypertension and hypokalaemia is suggestive of primary hyperaldosteronism (Conn’s syndrome). This condition is due to excess production of aldosterone, an adrenal hormone causing sodium and water retention, with potassium loss. Management aligns with the BNF’s guidelines, including the use of mineralocorticoid receptor antagonists.
Question Hard Answer: C) Migraine with Aura
Question Hard Explanation: The presentation of recurrent headaches with prodromal sensory symptoms such as tingling (aura) is characteristic of a migraine with aura. NICE guidelines suggest lifestyle modification and pharmacologic options such as triptans for acute management.
Medical fact of the day: Did you know that the UK’s NICE guidelines recommend the use of structured education for all newly diagnosed patients with Type 2 diabetes to promote self-management and reduce complications? This highlights the importance of early intervention and education in chronic disease management.
Quote of the day: “In the tapestry of health care, every gentle touch, every reassuring word, weaves hope into healing.”