Question Easy:
A 28-year-old woman presents with significant bruising and prolonged bleeding after minor cuts. A full blood count reveals a low platelet count. What is the most likely diagnosis?
A) Iron deficiency anaemia
B) Immune thrombocytopenic purpura (ITP)
C) Polycythaemia vera
D) Hodgkin’s lymphoma
E) Chronic myeloid leukaemia
Explanations & Answers:
Question Easy Answer:
B) Immune thrombocytopenic purpura (ITP)
Question Easy Explanation:
Immune thrombocytopenic purpura (ITP) is a condition where the immune system destroys platelets, leading to low platelet count. This results in symptoms such as bruising and prolonged bleeding after minor injuries. According to NICE guidelines, ITP is diagnosed through exclusion of other causes of thrombocytopenia and characteristic lab findings.
Question Medium:
A 45-year-old man with a history of smoking presents with a painless, pulsatile abdominal mass. What is the most appropriate next step in management?
A) Immediate surgery
B) Abdominal ultrasound
C) MRI scan
D) Chest X-ray
E) Watchful waiting
Question Medium Answer:
B) Abdominal ultrasound
Question Medium Explanation:
An abdominal ultrasound is the first-line imaging modality recommended by NICE for the assessment of an abdominal aortic aneurysm (AAA). A painless, pulsatile abdominal mass in a patient with a history of smoking is highly suggestive of AAA. An ultrasound can confirm the diagnosis and help in planning appropriate management measures.
Question Hard:
A 35-year-old female presents with episodes of venous thrombosis and a prolonged APTT. Her lupus anticoagulant is positive. What is the most likely diagnosis?
A) Factor V Leiden mutation
B) Antiphospholipid syndrome
C) Heparin-induced thrombocytopenia
D) von Willebrand disease
E) Protein C deficiency
Question Hard Answer:
B) Antiphospholipid syndrome
Question Hard Explanation:
Antiphospholipid syndrome (APS) is characterized by recurrent venous or arterial thrombosis and presence of antiphospholipid antibodies, such as lupus anticoagulant. Patients typically present with prolonged APTT despite a prothrombotic state. NICE guidelines recommend considering APS when these clinical and laboratory features are present, and confirmatory tests for antiphospholipid antibodies are essential for diagnosis.
Medical fact of the day: 🩸 Did you know that the incidence of abdominal aortic aneurysms in men over 65 in the UK is around 4-8%? The NHS Abdominal Aortic Aneurysm Screening Programme aims to reduce the mortality from ruptured AAAs through early detection.
Quote of the day: “The human spirit is stronger than anything that can happen to it. When you think you can’t go on, remember the reason why you began.” 🌟