24/11/2024 – Haem and Vascular

Sure! Here are the questions:

Question Easy:
A 32-year-old woman presents to your GP clinic with new onset bruising and fatigue. Her blood tests reveal a low platelet count. You suspect Immune Thrombocytopenic Purpura (ITP). Which of the following treatments is most commonly used first-line in managing ITP in adults? 😊
A) Intravenous immunoglobulin (IVIG)
B) Splenectomy
C) Prednisolone
D) Rituximab
E) Azathioprine

Explanations & Answers:

Question Easy Answer:
C) Prednisolone

Question Easy Explanation:
According to NICE guidelines, the first-line treatment for adult ITP is corticosteroids, typically prednisolone, to help increase platelet count. IVIG is used in more severe cases, and splenectomy is considered for chronic cases.

Question Medium:
A 55-year-old man is diagnosed with deep vein thrombosis (DVT) following a long-haul flight. He is started on rivaroxaban. What is the minimum recommended duration for anticoagulation therapy in the treatment of a DVT, assuming it is his first episode and no underlying provoking factors are found?
A) 3 months
B) 6 weeks
C) 6 months
D) 1 month
E) Indefinitely

Question Medium Answer:
A) 3 months

Question Medium Explanation:
NICE guidelines recommend a minimum of 3 months of anticoagulation for a first unprovoked DVT. The duration can be extended based on risk factors or recurrence, but initially, 3 months is standard for a first episode.

Question Hard:
A 45-year-old woman with a history of recurrent miscarriages and hypertension is found to have a prolonged APTT and a positive lupus anticoagulant test. What is the most likely diagnosis?
A) Von Willebrand disease
B) Hemophilia A
C) Antiphospholipid syndrome
D) Idiopathic thrombocytopenic purpura
E) Disseminated intravascular coagulation

Question Hard Answer:
C) Antiphospholipid syndrome

Question Hard Explanation:
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by recurrent thrombosis, pregnancy complications, a prolonged APTT, and positive antiphospholipid antibodies, such as lupus anticoagulant. This fits the clinical and laboratory findings in the scenario.

Medical fact of the day:
The most common inherited bleeding disorder is von Willebrand disease, which affects approximately 1 in 100 people in the UK, often going undiagnosed due to mild symptoms.

Quote of the day:
“In the practice of medicine, the art of compassion holds as much power as the science of healing. Let every heartbeat remind you of the lives you touch.”