Question Easy:
🧠 A 45-year-old man presents with increased thirst, frequent urination, and weight loss. Blood tests show hyperglycemia. Which hormone is most likely insufficient in this condition?
A) Cortisol
B) Insulin
C) Thyroxine
D) Growth hormone
E) Adrenaline
Question Medium:
🌡️ A 30-year-old woman is diagnosed with primary hypothyroidism. Her initial TSH level is high, and free T4 is low. According to NICE guidelines, what is the most appropriate initial treatment?
A) Propylthiouracil
B) Carbimazole
C) Levothyroxine
D) Radioactive iodine
E) Beta-blockers
Question Hard:
🧠 A 62-year-old man presents with progressive muscle weakness, difficulty swallowing, and slurred speech. On examination, there is evidence of both upper and lower motor neuron lesions. What is the most likely diagnosis?
A) Multiple Sclerosis
B) Myasthenia Gravis
C) Motor Neurone Disease
D) Guillain-Barré Syndrome
E) Parkinson’s Disease
Explanations & Answers:
Question Easy Answer: B) Insulin
Question Easy Explanation: The symptoms described are classic for diabetes mellitus, which is characterized by insufficient insulin production or function, leading to hyperglycemia.
Question Medium Answer: C) Levothyroxine
Question Medium Explanation: According to NICE guidelines, levothyroxine is the recommended treatment for primary hypothyroidism. It helps to normalize thyroid hormone levels and reduce symptoms.
Question Hard Answer: C) Motor Neurone Disease
Question Hard Explanation: The combination of upper and lower motor neuron signs in the context of the symptoms provided is indicative of Motor Neurone Disease, specifically Amyotrophic Lateral Sclerosis (ALS), a progressive neurodegenerative disease.
Medical fact of the day: The “rule of 10s” in pheochromocytoma suggests that 10% are malignant, 10% are bilateral, and 10% occur outside the adrenal medulla. This tumour can cause secondary hypertension due to excess catecholamine secretion.
Quote of the day: “In the care of others, we find the strength to heal both the body and the soul. Keep nurturing, keep believing, and know that your work can light up the world.”