Question Easy: A 28-year-old woman presents to the GP with symptoms of fatigue, weight gain, and hair loss. On examination, she is noted to have dry skin and mild bradycardia. Which of the following is the most likely diagnosis? 🩺
A) Hyperthyroidism
B) Addison’s disease
C) Hypothyroidism
D) Cushing’s syndrome
E) Type 2 diabetes mellitus
Question Medium: A 65-year-old man presents with tremor, rigidity, and bradykinesia. His GP suspects Parkinson’s disease. Which of the following is the most appropriate initial treatment according to NICE guidelines? 🤔
A) Levodopa
B) Gabapentin
C) Amantadine
D) Entacapone
E) Piribedil
Question Hard: A 56-year-old woman with a history of type 2 diabetes presents with sudden onset of a headache, nausea, and visual disturbances. On examination, she has a right pupil that is larger than the left and reacts poorly to light. CT scan shows a pituitary mass with evidence of acute hemorrhage. What is the most likely diagnosis? 🏥
A) Meningioma
B) Pituitary adenoma
C) Craniopharyngioma
D) Pituitary apoplexy
E) Glioblastoma
Explanations & Answers:
Question Easy Answer: C) Hypothyroidism
Question Easy Explanation: The woman’s symptoms of fatigue, weight gain, hair loss, dry skin, and bradycardia are classic signs of hypothyroidism. According to NICE guidelines, these clinical features suggest an underactive thyroid, which is confirmed through elevated TSH and low free T4 on blood tests.
Question Medium Answer: A) Levodopa
Question Medium Explanation: According to NICE guidelines, Levodopa is generally recommended as the initial treatment for motor symptoms in Parkinson’s disease, particularly when these symptoms are impacting quality of life. It is often combined with a dopa decarboxylase inhibitor like carbidopa to enhance its effect.
Question Hard Answer: D) Pituitary apoplexy
Question Hard Explanation: Pituitary apoplexy is characterized by sudden hemorrhage or infarction of the pituitary gland, often in the context of a pre-existing adenoma. Symptoms include severe headache, visual disturbances, and ophthalmoplegia due to cranial nerve compression. The CT findings and clinical picture support this diagnosis.
Medical fact of the day: Did you know? Around 6% of adults in the UK have undiagnosed diabetes, with many potentially experiencing “silent” neuropathies as a complication. Early diagnosis and management are key to preventing serious outcomes.
Quote of the day: “In the practice of medicine, dedication is not measured by time spent, but by the heart we put into caring for each patient. Keep inspiring, keep healing. 🌟”