Question Easy: A 45-year-old man presents to his GP with fatigue, weight gain, and feeling cold all the time. On examination, his skin is dry, and his pulse is 55 beats per minute. Which of the following is the most likely diagnosis? 😊
A) Diabetes mellitus
B) Addison’s disease
C) Hypothyroidism
D) Hyperthyroidism
E) Cushing’s syndrome
Question Medium: A 30-year-old woman presents with episodic headaches, palpitations, and sweating. These episodes often occur several times a day. During these episodes, her blood pressure is significantly elevated. What is the most likely diagnosis?
A) Panic disorder
B) Pheochromocytoma
C) Hyperthyroidism
D) Carcinoid syndrome
E) Essential hypertension
Question Hard: A patient presents with difficulty in concentration, polyuria, and polydipsia. His plasma osmolality is elevated, but urine osmolality is low. After administration of desmopressin, there is a significant increase in urine osmolality. What condition does this test suggest?
A) Diabetes mellitus type 1
B) Nephrogenic diabetes insipidus
C) Central diabetes insipidus
D) Psychogenic polydipsia
E) Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The symptoms and signs described, such as fatigue, weight gain, feeling cold, dry skin, and bradycardia, are consistent with hypothyroidism. The NICE guidelines emphasize managing hypothyroidism with levothyroxine to normalize thyroid function.
Question Medium Answer: B
Question Medium Explanation: The triad of episodic headaches, palpitations, and sweating, along with paroxysmal hypertension, is characteristic of pheochromocytoma. This condition involves catecholamine-secreting tumours of the adrenal medulla, requiring surgical intervention as per NHS treatment pathways.
Question Hard Answer: C
Question Hard Explanation: The response to desmopressin, with an increase in urine osmolality, indicates central diabetes insipidus. Central diabetes insipidus is caused by insufficient production of antidiuretic hormone (ADH), and treatment involves desmopressin, as outlined in BNF guidelines.
Medical fact of the day: Did you know that the adrenal glands can secrete excess adrenaline due to a pheochromocytoma, a rare tumour? This leads to symptoms such as severe hypertension and anxiety, crucial for differential diagnoses in hypertensive crises.
Quote of the day: “In the quiet moments between the chaos, remember that your care and compassion transform lives beyond numbers. Keep shining, healthcare hero!” 🌟