Question Easy:
A 55-year-old woman attends your clinic with fatigue and weight gain over the past six months. Her blood tests show low free T4 and elevated TSH levels. What is the most likely diagnosis? 🚑
A) Hyperthyroidism
B) Hypothyroidism
C) Diabetes Mellitus
D) Addison’s Disease
E) Cushing’s Syndrome
Question Medium:
A 32-year-old man presents with episodes of excessive sweating, palpitations, and headaches. A CT scan reveals a tumour in the adrenal gland. What is the most likely diagnosis?
A) Adrenal adenoma
B) Pheochromocytoma
C) Cushing syndrome
D) Conn’s syndrome
E) Addison’s disease
Question Hard:
A 68-year-old woman presents with sudden onset ocular pain, headache, and impaired vision in her right eye. Examination shows a fixed mid-dilated pupil and a steamy cornea. What is the most appropriate initial treatment? 👁️
A) Pilocarpine eye drops
B) Acetazolamide
C) Betamethasone eye drops
D) Atropine eye drops
E) Glycerin
Explanations & Answers:
Question Easy Answer:
B) Hypothyroidism
Question Easy Explanation:
The symptoms of fatigue and weight gain, alongside low free T4 and elevated TSH levels, indicate primary hypothyroidism. NICE guidance recommends levothyroxine as the treatment of choice. 🌟
Question Medium Answer:
B) Pheochromocytoma
Question Medium Explanation:
The triad of symptoms—sweating, palpitations, and headache—coupled with an adrenal gland tumour, suggests pheochromocytoma. This condition involves catecholamine-secreting tumours. Diagnosis is supported by elevated urinary metanephrines. Management usually includes surgical resection after alpha-blockade.
Question Hard Answer:
B) Acetazolamide
Question Hard Explanation:
The presentation is suggestive of acute angle-closure glaucoma. Acetazolamide reduces intraocular pressure quickly, making it the best initial treatment in this scenario according to NICE guidelines. The fixed mid-dilated pupil and steamy cornea are classical features.
Medical fact of the day:
In the UK, approximately 1 in 10 people over the age of 40 is living with a thyroid disorder, highlighting the significance of understanding thyroid pathologies for timely diagnosis and management.
Quote of the day:
“Every patient you encounter is a story waiting to be understood; listen intently, for through understanding, we heal beyond the physical.” 🌼