Question Easy:
A 55-year-old woman presents with fatigue, pallor, and a craving to chew ice. Her blood tests reveal a microcytic hypochromic anemia. What is the most likely underlying cause of her anemia? 🩸
A) Vitamin B12 deficiency
B) Iron deficiency
C) Thalassemia
D) Folate deficiency
E) Sickle cell disease
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: Iron deficiency anemia is the most common cause of microcytic hypochromic anemia, especially in middle-aged women. Pica, such as craving to chew ice (pagophagia), is often associated with iron deficiency anemia. This condition should be investigated considering NICE guidelines, exploring potential causes like blood loss or dietary insufficiency.
Question Medium:
A 68-year-old man with a history of chronic venous insufficiency presents with a painful, swollen left lower leg, and red, warm, taught skin. Duplex ultrasound confirms a deep vein thrombosis (DVT) in the popliteal vein. Which of the following is the most appropriate immediate treatment option? 💉
A) Warfarin
B) Apixaban
C) Compression stockings
D) Heparin
E) Rivaroxaban
Question Medium Answer: E
Question Medium Explanation: The immediate use of a direct oral anticoagulant (DOAC) such as rivaroxaban is recommended by NICE guidelines for the treatment of DVT in many cases. These agents are preferred due to ease of use (fixed dosing, no monitoring) compared to heparin or warfarin. Rivaroxaban can be initiated immediately and is effective in reducing clot propagation and risk of embolization.
Question Hard:
A 40-year-old woman discovers a persistent, irregular, non-tender lymph node in her neck. Biopsy reveals Reed-Sternberg cells. What additional symptom is commonly associated with this condition? 🕵️♂️
A) Weight gain
B) Profuse sweating
C) Weight loss
D) Hypercalcemia
E) Skin rash
Question Hard Answer: C
Question Hard Explanation: The presence of Reed-Sternberg cells is indicative of Hodgkin’s lymphoma. This condition is commonly associated with B symptoms, which include unexplained weight loss of more than 10% of body weight over 6 months, fever, and drenching night sweats. Node biopsy and clinical assessment as per NHS guidelines ensure accurate diagnosis and staging.
Medical fact of the day: Did you know that the spleen can swell to hold up to 10 times its normal volume of blood during certain haematological conditions? This can significantly impact haematopoiesis and the body’s immune response.
Quote of the day: “In the depths of uncertainty, seek the light of discovery; every patient is a teacher, and every encounter a lesson.” 🌟