Question Easy:
A 30-year-old woman is diagnosed with hyperthyroidism. Which of the following symptoms is most commonly associated with this condition?
A) Bradycardia
B) Weight loss
C) Constipation
D) Cold intolerance
E) Hypoglycemia
Explanations & Answers:
Question Easy Answer:
B) Weight loss
Question Easy Explanation:
Hyperthyroidism typically results in an increased metabolic rate, which can cause weight loss even when appetite and caloric intake are normal or increased. This is in line with NICE guidelines on hyperthyroidism management.
Question Medium:
A 65-year-old man presents to the ED with sudden onset severe headache described as “the worst headache of his life” and photophobia. His blood pressure is 180/100 mmHg. What is the most likely diagnosis?
A) Migraine
B) Tension-type headache
C) Subarachnoid hemorrhage
D) Cluster headache
E) Sinusitis
Explanations & Answers:
Question Medium Answer:
C) Subarachnoid hemorrhage
Question Medium Explanation:
The “thunderclap” nature of the headache and its sudden severe onset, accompanied by photophobia and high blood pressure, strongly suggest subarachnoid hemorrhage. According to NICE, sudden severe headache should prompt immediate assessment for potential subarachnoid hemorrhage via CT scan.
Question Hard:
A 27-year-old man presents with frequent episodes of excessive thirst and urination. His serum sodium level is 150 mmol/L, while his plasma osmolality is 312 mOsm/kg. His urine osmolality remains low despite fluid restriction. What is the most likely diagnosis?
A) Type 1 Diabetes Mellitus
B) Nephrogenic Diabetes Insipidus
C) Syndrome of Inappropriate Antidiuretic Hormone
D) Primary Polydipsia
E) Addison’s Disease
Explanations & Answers:
Question Hard Answer:
B) Nephrogenic Diabetes Insipidus
Question Hard Explanation:
The patient’s serum sodium and plasma osmolality are elevated while urine osmolality remains low even with fluid restriction, suggesting a defect in the kidney’s response to antidiuretic hormone (ADH). Nephrogenic diabetes insipidus is characterized by the kidneys’ inability to respond to ADH, in accordance with BNF guidelines on fluid balance disorders.
Medical fact of the day:
The UK has specific screening programs for thyroid dysfunction during pregnancy due to its high prevalence and impact on maternal and fetal health. NICE recommends considering thyroid function tests in early pregnancy for those with a history of thyroid disease or symptoms suggestive of thyroid dysfunction.
Quote of the day:
“Every patient’s smile is a victory.🌟 Keep pushing forward, for they depend on your strength and compassion to heal.”