Question Easy: A 30-year-old woman presents to the GP with a feeling of tiredness, weight gain, and cold intolerance. She mentions her periods have become irregular. On examination, she has dry skin and a puffy face. 🐢 What is the most likely diagnosis?
A) Hyperthyroidism
B) Hypothyroidism
C) Cushing’s syndrome
D) Polycystic ovarian syndrome
E) Addison’s disease
Question Medium: A 65-year-old man is brought to A&E with sudden onset of right-sided weakness and slurred speech. He has a history of hypertension and irregularly takes his medication. On examination, he has a facial droop and is unable to raise his right arm. What is the most appropriate initial investigation? 🚨
A) ECG
B) CT scan of the head
C) Carotid Doppler ultrasound
D) MRI of the brain
E) Blood glucose level
Question Hard: A 45-year-old woman attends the endocrinology clinic with complaints of severe headaches, visual disturbances, and galactorrhea. MRI of the brain reveals a pituitary tumour. Blood tests show elevated prolactin levels. What is the first-line treatment for her condition? 💊
A) Radiotherapy
B) Surgical removal of the tumour
C) Bromocriptine
D) Cabergoline
E) Transsphenoidal surgery
Explanations & Answers:
Question Easy Answer: B) Hypothyroidism
Question Easy Explanation: This woman’s symptoms of tiredness, weight gain, cold intolerance, and menstrual irregularities, along with dry skin and a puffy face, align well with hypothyroidism. According to NICE guidelines, these are classic indications of an underactive thyroid, which is often confirmed with thyroid function tests.
Question Medium Answer: B) CT scan of the head
Question Medium Explanation: The man exhibits symptoms of an acute stroke, which demands immediate imaging to identify any haemorrhage or infarction. NICE recommends a non-contrast CT of the head to be performed as soon as possible to guide further management.
Question Hard Answer: D) Cabergoline
Question Hard Explanation: This woman’s presentations and her MRI results suggest a prolactinoma. According to NHS guidelines, the first-line treatment for prolactinomas is dopamine agonists like cabergoline, which is preferred due to its efficacy and lower side effect profile compared to bromocriptine.
Medical fact of the day: The hypothalamus controls the pituitary gland with releasing and inhibiting hormones, linking the nervous and endocrine systems by way of the pituitary gland for hormonal secretions!
Quote of the day: “In every task that must be done, there is an opportunity for compassion, learning, and growth. Shine your light — it just might brighten someone else’s day.” 🌟