Question Easy:
A 25-year-old woman visits her GP with fatigue and pallor. Blood tests reveal a microcytic, hypochromic anaemia. What is the most likely cause of her anaemia? 🍏
A) Folate deficiency
B) Vitamin B12 deficiency
C) Iron deficiency
D) Sickle cell disease
E) Anaemia of chronic disease
Question Medium:
A 60-year-old man presents with a swollen, painful left leg after a long-haul flight. A D-dimer test is positive, and a Doppler ultrasound confirms the presence of a deep vein thrombosis (DVT). What is the initial anticoagulant treatment recommended in the UK? ✈️
A) Aspirin
B) Warfarin
C) Low-molecular-weight heparin (LMWH)
D) Rivaroxaban
E) Fondaparinux
Question Hard:
A 55-year-old woman is found to have a high platelet count on routine blood tests. She feels well and has no significant past medical history. Examination is unremarkable. Further tests reveal normal red cell mass and absence of the Philadelphia chromosome. What is the most likely diagnosis? 🩸
A) Essential thrombocythaemia
B) Polycythaemia vera
C) Chronic myeloid leukaemia
D) Myelodysplastic syndrome
E) Secondary thrombocytosis
Explanations & Answers:
Question Easy Answer: C) Iron deficiency
Question Easy Explanation: Iron deficiency anaemia is the most common type of anaemia worldwide and is typically characterised by microcytic, hypochromic red blood cells. In this age group and with these symptoms, iron deficiency, often due to menstrual blood loss, is most likely. NICE guidelines support testing for iron levels and considering dietary factors or blood loss as possible causes.
Question Medium Answer: C) Low-molecular-weight heparin (LMWH)
Question Medium Explanation: In the UK, NICE recommendations suggest the use of LMWH as the initial treatment for confirmed DVTs. LMWHs, such as enoxaparin, provide rapid anticoagulation and are generally preferred for initial management due to their predictable pharmacokinetics and ease of outpatient management.
Question Hard Answer: A) Essential thrombocythaemia
Question Hard Explanation: Essential thrombocythaemia is a myeloproliferative disorder characterised by an elevated platelet count and is not associated with an elevated red cell mass or the Philadelphia chromosome. It is often diagnosed in asymptomatic individuals when a high platelet count is found incidentally. NICE guidelines recommend considering causes like iron deficiency or inflammatory disease but in absence of these, essential thrombocythaemia is plausible.
Medical fact of the day: Did you know that chronic venous insufficiency is one of the most common vascular conditions affecting up to 40% of the UK population at some point in their lives? Early diagnosis and management can greatly improve patient quality of life. 🦵
Quote of the day: “In medicine, we are not just treating diseases, but human beings with lives full of hopes, dreams, and challenges. Let’s treat with compassion and serve with dedication.” 🌟