Question Easy:
A 65-year-old woman presents with fatigue, palpitations, and slightly pale skin. Her recent blood tests show haemoglobin at 10 g/dL, mean corpuscular volume (MCV) of 68 fL, and serum ferritin of 8 mcg/L. What is the most likely diagnosis?
A) Megaloblastic anaemia
B) Sickle cell anaemia
C) Iron deficiency anaemia
D) Thalassemia
E) Chronic disease anaemia
Question Medium:
A 55-year-old man presents with calf pain during walking that resolves with rest. On examination, his pulses are diminished in the affected leg, and an ankle-brachial pressure index (ABPI) test is done. Which ABPI result is most likely in this patient, considering a diagnosis of peripheral arterial disease (PAD)?
A) 0.5
B) 1.0
C) 1.3
D) 2.0
E) 0.9
Question Hard:
A 42-year-old man with a history of recurrent slurred speech, headaches, and erythromelalgia presents for evaluation. His complete blood count reveals the following: high haematocrit, elevated white blood cell count, and increased platelets. Bone marrow biopsy shows hypercellularity. Which genetic mutation is most commonly associated with this condition?
A) JAK2 V617F
B) BCR-ABL
C) MPL W515L
D) CALR
E) FLT3
Explanations & Answers:
Question Easy Answer:
C) Iron deficiency anaemia
Question Easy Explanation:
The patient’s symptoms and lab results indicate iron deficiency anaemia. The low MCV (microcytic) and low serum ferritin levels are characteristic of this condition. According to NICE guidelines, iron deficiency is a common cause of anaemia and usually presents with low haemoglobin and low MCV. 🍏
Question Medium Answer:
A) 0.5
Question Medium Explanation:
In peripheral arterial disease, the ABPI is typically less than 0.9. A value of 0.5 indicates moderate to severe PAD. NICE guidelines suggest using ABPI as a diagnostic tool, where normal values range from 1.0 to 1.4.
Question Hard Answer:
A) JAK2 V617F
Question Hard Explanation:
The presented case describes symptomatic polycythaemia vera, a myeloproliferative neoplasm most commonly associated with the JAK2 V617F mutation. This mutation is found in more than 95% of cases according to current NHS guidelines. It’s characterized by increased red blood cell mass, which can lead to hyperviscosity symptoms. 🎯
Medical fact of the day: Did you know? Peripheral arterial disease is often underdiagnosed because its symptoms can be mistaken for general leg discomfort in aging individuals. Screening with ABPI can be a simple yet effective tool for early diagnosis and management.
Quote of the day: “In the pursuit of healing others, we often find a path to healing ourselves. Keep your heart open and your mind strong.” 🌟