Question Easy:
A 25-year-old woman presents with fatigue, pallor, and shortness of breath. Her blood tests reveal a haemoglobin level of 9 g/dL and low mean corpuscular volume (MCV). Which of the following is the most likely diagnosis? 🩸
A) Vitamin B12 deficiency
B) Iron deficiency anaemia
C) Sickle cell anaemia
D) Haemolytic anaemia
E) Thalassaemia
Explanations & Answers:
Question Easy Answer:
B) Iron deficiency anaemia
Question Easy Explanation:
The clinical presentation combined with the laboratory findings of low haemoglobin and low MCV suggests microcytic anaemia. In the UK, the most common cause of microcytic anaemia, especially in young women, is iron deficiency anaemia. NICE guidelines recommend checking ferritin levels to confirm iron deficiency.
Question Medium:
A 68-year-old man presents with intermittent claudication and a history of smoking. Which of the following is the first-line management for this condition according to UK guidelines? 🚶♂️🚬
A) Statin therapy
B) Angioplasty
C) Supervised exercise programme
D) Smoking cessation
E) Aspirin therapy
Explanations & Answers:
Question Medium Answer:
C) Supervised exercise programme
Question Medium Explanation:
According to NICE guidelines, the first-line management for intermittent claudication is a supervised exercise programme. This has been shown to improve symptoms. Smoking cessation is also crucial, but the exercise programme is the initial specific intervention recommended.
Question Hard:
A 50-year-old female with a prosthetic heart valve presents with signs of anaemia. Her blood tests show a haemoglobin level of 8 g/dL, reticulocytosis, and schistocytes on the blood film. What is the most likely type of anaemia? 💓🔬
A) Iron deficiency anaemia
B) Anaemia of chronic disease
C) Thrombotic thrombocytopenic purpura
D) Autoimmune haemolytic anaemia
E) Mechanical haemolytic anaemia
Explanations & Answers:
Question Hard Answer:
E) Mechanical haemolytic anaemia
Question Hard Explanation:
The presence of schistocytes and reticulocytosis in a patient with a prosthetic heart valve suggests mechanical haemolytic anaemia. Schistocytes are fragmented red blood cells caused by mechanical damage, common in artificial heart valves, leading to haemolysis. The reticulocytosis indicates the bone marrow’s response to anaemia by increasing red blood cell production.
Medical fact of the day: Did you know that the UK was the first country to screen newborns for sickle cell disease as part of its routine neonatal screening programme? This helps in early identification and management, reducing complications.
Quote of the day: “In the world of healing, the true heroes are those who find hope in the humblest moments and spark light where it’s needed most.” 🌟