Question Easy:
A 70-year-old gentleman presents to the GP with fatigue, pallor, and shortness of breath. Blood tests reveal a haemoglobin level of 9 g/dL and a mean corpuscular volume (MCV) of 70 fL. What is the most likely diagnosis?
A) Iron deficiency anaemia
B) Vitamin B12 deficiency
C) Sickle cell anaemia
D) Aplastic anaemia
E) Thalassaemia
Question Medium:
A 56-year-old woman is consulting her GP about a recurring pain in her right calf that occurs after walking for 10 minutes and resolves with rest. She has a history of hypertension and hypercholesterolemia. What is the most likely diagnosis?
A) Deep vein thrombosis
B) Peripheral arterial disease
C) Raynaud’s disease
D) Chronic venous insufficiency
E) Intermittent claudication
Question Hard:
A 25-year-old woman presents with a painful, swollen left leg. She was recently on a long-haul flight. Her D-dimer test is elevated, and a Doppler ultrasound of her left lower limb confirms a deep vein thrombosis (DVT). Which anticoagulant would be the most appropriate first-line treatment?
A) Warfarin
B) Heparin
C) Apixaban
D) Fondaparinux
E) Aspirin
Explanations & Answers:
Question Easy Answer: A) Iron deficiency anaemia
Question Easy Explanation: The combination of low haemoglobin, microcytic anaemia (MCV <80 fL), and symptoms such as fatigue and pallor are classic indicators of iron deficiency anaemia. According to NICE guidelines, it’s the most common type of anaemia, especially in this age group, often caused by chronic blood loss or dietary deficiency.
Question Medium Answer: B) Peripheral arterial disease
Question Medium Explanation: The symptoms described are characteristic of intermittent claudication, which is a symptom of peripheral arterial disease (PAD). It’s caused by atherosclerosis, leading to reduced blood flow to the limbs. NICE guidelines note that PAD is common in patients with risk factors like hypertension and high cholesterol.
Question Hard Answer: C) Apixaban
Question Hard Explanation: Direct oral anticoagulants (DOACs) such as apixaban are recommended by NICE for the treatment of DVT as they don’t require monitoring like warfarin and have a lower risk of bleeding compared to heparin. Apixaban is effective and convenient for patients following a diagnosis of DVT, especially in young adults.
Medical fact of the day: Did you know that the radial artery is often preferred for coronary artery bypass grafting in the UK due to its superior long-term patency rates compared to the saphenous vein?
Quote of the day: “In every moment of caring, you hold the potential to change a life. Keep the light of compassion shining bright 🌟.”