Question Easy:
A 32-year-old woman presents to the GP with easy bruising and petechiae. Blood tests reveal a platelet count of 10 x 10^9/L. What is the most likely diagnosis?
A) Iron deficiency anemia
B) Immune thrombocytopenic purpura (ITP)
C) Factor V Leiden
D) Hemophilia A
E) Vitamin K deficiency
Question Medium:
A 45-year-old man is experiencing chest pain radiating to his left arm and jaw, along with shortness of breath. His troponin levels are elevated. Which of the following drugs is primarily used to dissolve the clot causing the myocardial infarction?
A) Aspirin
B) Clopidogrel
C) Warfarin
D) Alteplase
E) Enoxaparin
Question Hard:
A 60-year-old woman with a long-standing history of deep vein thrombosis (DVT) presents with sudden onset of breathlessness. Her blood pressure is 100/60 mmHg, heart rate is 120 bpm, and respiratory rate is 30/min. What is the most appropriate initial management according to current guidelines?
A) Oxygen supplementation
B) Intravenous fluids
C) Immediate thrombolysis
D) Oral anticoagulation
E) High-dose aspirin
Explanations & Answers:
Question Easy Answer:
B) Immune thrombocytopenic purpura (ITP)
Question Easy Explanation:
ITP is a condition characterized by low platelet counts, often causing easy bruising and petechiae. Unlike other options, ITP directly explains the symptoms and lab findings. According to NICE guidelines, ITP is often managed based on symptoms, and acute cases may require treatment such as corticosteroids.
Question Medium Answer:
D) Alteplase
Question Medium Explanation:
Alteplase is a thrombolytic agent used to dissolve thrombi in acute myocardial infarction, in line with NHS guidelines. It works by converting plasminogen to plasmin, breaking down fibrin clots. Its use is timed strictly due to associated risks, emphasizing the importance of early intervention.
Question Hard Answer:
C) Immediate thrombolysis
Question Hard Explanation:
In cases of massive pulmonary embolism with hemodynamic instability, such as hypotension, immediate thrombolysis is indicated according to NICE guidelines. Thrombolysis rapidly restores pulmonary perfusion, which is crucial given the severity of the patient’s presentation.
Medical fact of the day:
The UK has a unique program called the NHS Blood and Transplant (NHSBT) service that not only manages blood donations but also facilitates organ transplants and research into blood disorders, highlighting the integrated approach to patient care and transfusion medicine.
Quote of the day:
“Every heartbeat and every kind gesture counts; you are the pulse of hope and healing for those in your care.”