Question Easy:
A 25-year-old woman presents with excessive thirst, frequent urination, and weight loss. Her fasting blood glucose is 13 mmol/L. What is the most likely diagnosis? 😊
A) Type 1 Diabetes Mellitus
B) Type 2 Diabetes Mellitus
C) Diabetes Insipidus
D) Hyperthyroidism
E) Cushing’s Syndrome
Question Medium:
A 56-year-old man presents with progressive muscle weakness, difficulty swallowing, and appears to have slurred speech. He also has fasciculations in his arms. Which condition is most consistent with his symptoms?
A) Myasthenia Gravis
B) Motor Neurone Disease
C) Multiple Sclerosis
D) Parkinson’s Disease
E) Peripheral Neuropathy
Question Hard:
A 40-year-old woman presents with episodes of headaches, palpitations, sweats, and hypertension. A 24-hour urinary collection reveals increased catecholamines. Which of the following is the most appropriate next step in confirming the diagnosis?
A) MRI of the brain
B) Renal ultrasound
C) Serum cortisol levels
D) MIBG scan
E) CT of the abdomen
Explanations & Answers:
Question Easy Answer:
A) Type 1 Diabetes Mellitus
Question Easy Explanation:
The symptoms of excessive thirst, frequent urination, and weight loss, along with a high fasting blood glucose level, are classic presentations of Type 1 Diabetes Mellitus. According to NICE guidelines, a raised blood glucose level, especially in conjunction with symptoms of hyperglycaemia, strongly suggests diabetes.
Question Medium Answer:
B) Motor Neurone Disease
Question Medium Explanation:
The presenting symptoms of muscle weakness, difficulty swallowing, slurred speech, and fasciculations are characteristic of Motor Neurone Disease (MND), also known as Amyotrophic Lateral Sclerosis (ALS). This aligns with NHS insights into the clinical manifestations of MND.
Question Hard Answer:
E) CT of the abdomen
Question Hard Explanation:
The patient’s symptoms and findings suggest a pheochromocytoma, which is a catecholamine-secreting tumour. According to BNF guidelines, a CT or MRI of the abdomen is typically performed to confirm the presence of adrenal tumours after biochemical confirmation.
Medical fact of the day:
Did you know that pheochromocytomas, although rare, can be detected using urine or plasma metanephrines due to their high sensitivity? They usually present with a classic triad of headache, sweating, and palpitations. 🩺
Quote of the day:
“In the realm of healing, every small act of kindness ripples to infinity, crafting the tapestry of care and compassion.”