Question Easy:
A 30-year-old woman presents to her GP with fatigue, weight gain, and feeling cold all the time 🥶. Blood tests reveal elevated TSH and low T4 levels. What is the most likely diagnosis?
A) Hyperthyroidism
B) Hashimoto’s thyroiditis
C) Graves’ disease
D) Subclinical hypothyroidism
E) Primary hypothyroidism
Question Medium:
An 18-year-old male presents with recurrent headaches 🤕, palpitations, and sweating. His blood pressure is consistently elevated at 160/100 mmHg. Urinary catecholamines are markedly elevated. What is the most likely diagnosis?
A) Essential hypertension
B) Phaeochromocytoma
C) Cushing’s syndrome
D) Panic disorder
E) Hyperthyroidism
Question Hard:
A 45-year-old male is experiencing progressive weakness and weight loss. Serum calcium is low, phosphate is high, and PTH levels are mildly elevated. He also presents with a pruritic skin rash. Which condition is most likely causing these symptoms?
A) Hypoparathyroidism
B) Primary hyperparathyroidism
C) Vitamin D deficiency
D) Renal osteodystrophy
E) Magnesium deficiency
Explanations & Answers:
Question Easy Answer: E) Primary hypothyroidism
Question Easy Explanation:
Primary hypothyroidism is characterised by elevated TSH (as the pituitary gland is working harder to stimulate the thyroid) and low levels of T4. Common symptoms include fatigue, weight gain, and feeling cold. NICE guidelines recommend levothyroxine as the treatment of choice.
Question Medium Answer: B) Phaeochromocytoma
Question Medium Explanation:
Phaeochromocytoma arises from the adrenal medulla and results in excessive catecholamine release, causing symptoms like headaches, palpitations, sweating, and hypertension. Elevated urinary catecholamines confirm the diagnosis. According to NHS guidelines, surgical removal of the tumour is often required.
Question Hard Answer: D) Renal osteodystrophy
Question Hard Explanation:
Renal osteodystrophy occurs in chronic kidney disease and leads to secondary hyperparathyroidism. This is due to phosphate retention and decreased activation of vitamin D, resulting in low calcium and high phosphate levels. The pruritic rash may be due to associated conditions like calciphylaxis. NICE guidelines highlight the importance of managing phosphate levels in such cases.
Medical fact of the day: The human brain generates approximately 20 watts of power while awake, enough to power a dim light bulb! 🧠💡
Quote of the day: “In the chaos of the ward or a classroom, find the quiet rhythm in your pulse and let it remind you why you chose this path.” 🌟