Question Easy:
A 35-year-old woman presents with weight gain, cold intolerance, and dry skin. On examination, her thyroid gland is not enlarged, and laboratory tests reveal increased TSH and decreased free T4 levels. What is the most likely diagnosis? 🌡️
A) Hyperthyroidism
B) Hypothyroidism
C) Subacute thyroiditis
D) Euthyroid sick syndrome
E) Thyroid cancer
Question Easy Answer:
B)
Question Easy Explanation:
The patient’s presentation and the lab results of increased TSH and decreased free T4 are indicative of primary hypothyroidism. According to NICE guidelines, common symptoms include weight gain, cold intolerance, and dry skin. The absence of thyroid enlargement suggests other causes rather than Hashimoto’s thyroiditis which often presents with a goiter.
Question Medium:
A 55-year-old man comes with complaints of frequent headaches, bitemporal hemianopia, and abnormal growth in his extremities. On examination, he has a prominent jaw and enlarged hands and feet. What is the most likely diagnosis? 🤔
A) Prolactinoma
B) Cushing’s disease
C) Acromegaly
D) Hypopituitarism
E) Meningioma
Question Medium Answer:
C)
Question Medium Explanation:
The patient exhibits classic symptoms of acromegaly, which include bitemporal hemianopia due to optic chiasm compression and abnormal growth of hands, feet, and facial features. According to NHS guidelines, acromegaly is caused by excessive production of growth hormone, typically from a pituitary adenoma.
Question Hard:
A 42-year-old woman is brought to the emergency department with a severe headache, nausea, vomiting, and left-sided weakness for 2 hours. Her BP is 180/110 mmHg. CT scan shows a subarachnoid hemorrhage. Which of the following is the initial most appropriate management step? ⚕️
A) Administer nimodipine
B) Perform a lumbar puncture
C) Start anticoagulation therapy
D) Perform urgent neurosurgery
E) Initiate blood pressure control with IV labetalol
Question Hard Answer:
A)
Question Hard Explanation:
The initial management of subarachnoid hemorrhage includes administering nimodipine to reduce the risk of cerebral vasospasm, as per BNF guidelines. While blood pressure control is important, immediate management with nimodipine is crucial to improve outcomes. Performing neurosurgery might be necessary, but stabilization with nimodipine comes first.
Medical fact of the day: The most common cause of hypercalcemia is primary hyperparathyroidism, especially in postmenopausal women, due to autonomously functioning parathyroid adenomas or hyperplasia.
Quote of the day: “In the journey of healing, every step you take brings you closer to your purpose and the ones you help. Keep moving forward.”