Question Easy:
A 25-year-old male presents with fatigue, pallor, and shortness of breath on exertion. His blood tests reveal a haemoglobin level of 9.0 g/dL (normal range: 13.8-17.2 g/dL) and a mean corpuscular volume (MCV) of 70 fL (normal range: 80-100 fL). What is the most likely diagnosis? 😊
A) Sickle cell anaemia
B) Vitamin B12 deficiency
C) Iron deficiency anaemia
D) Thalassaemia major
E) Acute myeloid leukaemia
Question Medium:
A 67-year-old woman with a history of hypertension and diabetes mellitus presents with a painful, swollen left leg. On examination, the leg is erythematous, warm, and tender. A Doppler ultrasound confirms the diagnosis of deep vein thrombosis (DVT). What is the best initial treatment for this patient?
A) Aspirin
B) Warfarin
C) Rivaroxaban
D) Clopidogrel
E) Low molecular weight heparin
Question Hard:
A 40-year-old man presents with episodes of severe, sharp chest pain that radiates to his back. His blood pressure is 190/110 mmHg, and he is found to have a weak pulse in his left arm. A chest x-ray shows a widened mediastinum. What is the most likely diagnosis, and what is the immediate management? 🚑
A) Pulmonary embolism; initiate anticoagulation
B) Myocardial infarction; administer thrombolysis
C) Aortic dissection; control blood pressure and urgent surgical consultation
D) Pneumothorax; insert chest drain
E) Esophageal rupture; initiate antibiotics and surgical consultation
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The patient’s blood tests indicate a low haemoglobin level and microcytic anaemia (low MCV). The most common cause of microcytic anaemia is iron deficiency anaemia, characterized by insufficient iron, often due to poor diet, blood loss, or malabsorption. This is also a very common condition. 😊
Question Medium Answer: E
Question Medium Explanation: For an acute deep vein thrombosis (DVT), the initial management typically involves the use of low molecular weight heparin (LMWH). LMWH acts quickly and effectively to prevent further clot formation and embolization. NICE guidelines recommend this as first-line treatment before transitioning to oral anticoagulants if indicated.
Question Hard Answer: C
Question Hard Explanation: The symptoms, including severe chest pain radiating to the back, hypertension, and a widened mediastinum on chest x-ray, are indicative of an aortic dissection. Immediate management involves tightly controlling blood pressure with intravenous medications and urgent surgical consultation. This is an emergency that requires swift action to prevent catastrophic outcomes.
Medical fact of the day: Did you know that in the UK, aortic dissection is a relatively rare condition but one that requires immediate diagnosis and treatment? Timely management dramatically improves survival rates, highlighting the importance of recognising its symptoms early.
Quote of the day: “In the heart of medicine lies a commitment to each other—every step taken in unison towards health and healing.” 🌟