Question Easy:
A 55-year-old man visits his GP with leg swelling and easy bruising. He is found to have a low platelet count on routine blood tests. Which of the following is the most likely cause of his thrombocytopenia? 😕
A) Iron deficiency anemia
B) Vitamin B12 deficiency
C) Immune thrombocytopenic purpura (ITP)
D) Deep vein thrombosis (DVT)
E) Polycythaemia vera
Explanations & Answers:
Question Easy Answer:
C) Immune thrombocytopenic purpura (ITP)
Question Easy Explanation:
ITP is a common cause of low platelet count (thrombocytopenia) and is frequently characterised by easy bruising and petechiae. Treatments typically focus on preventing bleeding and may include corticosteroids, intravenous immunoglobulins, or thrombopoietin receptor agonists, as guided by NICE.
Question Medium:
A 45-year-old woman presents with shortness of breath and a swollen left calf. A Doppler ultrasound confirms a deep vein thrombosis (DVT). What is the recommended initial anticoagulant treatment for DVT according to NICE guidelines? 🚑
A) Aspirin
B) Warfarin
C) Dabigatran
D) Low molecular weight heparin (LMWH)
E) Rivaroxaban
Explanations & Answers:
Question Medium Answer:
D) Low molecular weight heparin (LMWH)
Question Medium Explanation:
According to NICE guidelines, LMWH is typically recommended as first-line treatment for a new DVT, especially in initial management, due to its rapid onset and ease of use. Rivaroxaban or other direct oral anticoagulants may be considered subsequently or in specific situations.
Question Hard:
A 60-year-old man is undergoing pre-operative assessment and is found to have a high red blood cell count and a haematocrit of 58%. He is asymptomatic. After further investigation, JAK2 mutation is positive. What is the most appropriate management for this patient? 🚨
A) Low-dose aspirin only
B) Phlebotomy
C) Hydroxycarbamide
D) Interferon-alpha
E) Observation only
Explanations & Answers:
Question Hard Answer:
B) Phlebotomy
Question Hard Explanation:
This patient’s presentation suggests polycythaemia vera (PV), a myeloproliferative disorder often associated with a JAK2 mutation. First-line treatment is typically phlebotomy to reduce haematocrit levels and decrease the risk of thrombotic events. Low-dose aspirin is also recommended to reduce thrombotic risk, but phlebotomy is prioritised for immediate management.
Medical fact of the day: 🤔
Did you know that around 1 in 100 people over the age of 60 are diagnosed with polycythaemia vera in the UK? Regular monitoring and appropriate management can help reduce the risk of complications like thrombosis.
Quote of the day:
“Caring for others provides us with the chance to heal, not just those we tend to, but ourselves too. Every patient, every challenge, is a reflection of our resilience and compassion.”