Question Easy:
A 45-year-old woman presents to the GP with weight gain, fatigue, and constipation. On examination, she has dry skin and thinning hair. Which of the following is the most likely diagnosis? 🧐
A) Hyperthyroidism
B) Hypothyroidism
C) Cushing’s syndrome
D) Addison’s disease
E) Polycystic ovary syndrome
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: The symptoms described—weight gain, fatigue, constipation, dry skin, and thinning hair—are classic signs of hypothyroidism. According to NICE guidelines, these manifestations are typically associated with low levels of thyroid hormone.
Question Medium:
A 35-year-old man visits the emergency department with a severe headache, photophobia, and neck stiffness. A CT scan of the head is normal. What is the next best step in management to confirm the diagnosis?
A) MRI of the brain
B) Lumbar puncture
C) EEG
D) Urgent admission for observation
E) Start empirical antibiotics
Question Medium Answer: B
Question Medium Explanation: The symptoms suggest meningitis or subarachnoid haemorrhage. While the CT scan can initially rule out significant bleeding, a lumbar puncture is needed to definitively identify or exclude subarachnoid haemorrhage as it would show xanthochromia. NICE guidelines recommend this as the next step following a normal CT in the presence of such symptoms.
Question Hard:
A 65-year-old man with a history of type 2 diabetes presents with sudden loss of vision in his left eye. Fundoscopy reveals a “cherry-red spot” on the retina. What is the most likely cause of his vision loss?
A) Diabetic retinopathy
B) Retinal detachment
C) Central retinal artery occlusion
D) Acute glaucoma
E) Vitreous hemorrhage
Question Hard Answer: C
Question Hard Explanation: The “cherry-red spot” is a classic sign of central retinal artery occlusion, which can cause sudden and painless loss of vision. According to NHS guidelines, immediate assessment and potential intervention are critical to prevent permanent vision loss. Diabetes, although a risk factor for other eye conditions, directly increases the risk of vascular occlusions.
Medical fact of the day: Did you know that the pituitary gland, often called the “master gland,” can control hormone secretion in other glands? Disorders of the pituitary can have widespread effects on the endocrine system, impacting everything from growth to metabolism.
Quote of the day: “Care for each patient with the same heart that ignited your passion to join this noble profession. In every moment of doubt, remember that healing is a journey, both for you and those you care for.”