Question Easy:
A 25-year-old woman presents to the GP with a 3-month history of easy bruising and frequent nosebleeds. Her blood tests reveal a low platelet count. Which of the following is the most likely diagnosis?
A) Iron deficiency anaemia
B) Immune thrombocytopenic purpura (ITP)
C) Von Willebrand disease
D) Haemophilia A
E) Chronic myeloid leukaemia
Question Medium:
A 60-year-old man with a history of hypertension presents with sudden onset chest pain radiating to the back and a blood pressure discrepancy between his arms. What is the most likely diagnosis?
A) Myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pneumothorax
E) Pericarditis
Question Hard:
A 45-year-old man comes to the emergency department with sudden onset of left leg pain, swelling, and a bluish discoloration. He works as a long-haul truck driver. Which of the following is the most likely diagnosis?
A) Peripheral arterial disease
B) Varicose veins
C) Deep vein thrombosis (DVT)
D) Cellulitis
E) Lymphoedema
Explanations & Answers:
Question Easy Answer: B) Immune thrombocytopenic purpura (ITP)
Question Easy Explanation: ITP is a condition characterized by low platelet counts causing easy bruising and bleeding. It is the most likely diagnosis in this young woman with blood test results indicating thrombocytopenia. NICE guidelines highlight ITP as a common cause of isolated low platelet counts in young adults.
Question Medium Answer: C) Aortic dissection
Question Medium Explanation: Aortic dissection presents with sudden, severe chest or back pain and can result in unequal blood pressures in the arms. Hypertension is a major risk factor. This clinical presentation aligns with NHS guidelines on identifying acute aortic dissections.
Question Hard Answer: C) Deep vein thrombosis (DVT)
Question Hard Explanation: The patient’s profession as a long-haul driver increases his risk of venous thromboembolism. Sudden leg pain, swelling, and discoloration suggest a DVT, consistent with NICE guidelines for venous thromboembolic disease risk assessment and presentation.
Medical fact of the day: The UK has implemented a national screening programme for abdominal aortic aneurysms in men aged 65 and over, reducing mortality from aortic aneurysm rupture by allowing for early detection and elective intervention.
Quote of the day: “In the silent courage of healing hands, every heartbeat is a reminder of the impact you can make on the world.”