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Question Easy:
A 40-year-old woman presents with weight gain, fatigue, and cold intolerance. On examination, she has dry skin and bradycardia. What is the most likely diagnosis? 🩺
A) Hyperthyroidism
B) Addison’s disease
C) Hypothyroidism
D) Cushing’s syndrome
E) Pheochromocytoma
Question Medium:
A 65-year-old man comes to the clinic with complaints of loss of peripheral vision over several months. Visual field testing confirms bitemporal hemianopia. What is the most likely cause of his symptoms? 👀
A) Retinal detachment
B) Pituitary adenoma
C) Multiple sclerosis
D) Glaucoma
E) Optic neuritis
Question Hard:
A 28-year-old woman presents with episodes of severe headaches, nausea, vomiting, and visual disturbances. Her MRI shows white matter lesions scattered throughout the brain. What is the most likely diagnosis? 🧠
A) Migraine
B) Multiple sclerosis
C) Cluster headache
D) Bell’s palsy
E) Tension headache
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The patient’s symptoms of weight gain, fatigue, cold intolerance, dry skin, and bradycardia are classic signs of hypothyroidism. According to NICE guidelines, primary hypothyroidism is commonly diagnosed by elevated TSH and low free T4 levels.
Question Medium Answer: B
Question Medium Explanation: The bitemporal hemianopia (loss of peripheral vision on both sides) suggests a lesion at the optic chiasm. A common cause for this is a pituitary adenoma, which can compress the optic chiasm and lead to visual field defects.
Question Hard Answer: B
Question Hard Explanation: The presence of white matter lesions scattered throughout the brain on an MRI, along with episodes of neurological symptoms, is highly suggestive of multiple sclerosis (MS). MS is an autoimmune condition that affects the central nervous system, leading to demyelination and varying symptom patterns as per NHS guidelines.
Medical fact of the day: In the UK, approximately 100,000 people are living with Multiple Sclerosis, a condition of the central nervous system that can cause a wide range of symptoms, including problems with vision, arm or leg movement, sensation, and balance.
Quote of the day: “In the quiet battlefield of the mind and body, healthcare workers are the unsung heroes, leading the charge with compassion and resilience.” 🌟