Question Easy:
A 25-year-old woman presents to the GP with a persistent nosebleed 🤧. She has no significant past medical history, takes no medications, and her vital signs are stable. On examination, you notice petechiae on her arms and legs. What’s the most likely cause of her symptoms?
A) Iron deficiency anemia
B) Vitamin K deficiency
C) Immune thrombocytopenic purpura (ITP)
D) Hemophilia A
E) von Willebrand disease
Question Medium:
A 67-year-old man presents with a swollen, painful left leg. On examination, there’s redness and warmth. A Doppler ultrasound confirms a deep vein thrombosis (DVT). Which factor does NOT contribute to Virchow’s triad of DVT formation? 🔍
A) Reduced blood flow
B) Endothelial injury
C) Hypercoagulable state
D) Hypovolemia
E) Stasis
Question Hard:
A 55-year-old woman with a history of hyperlipidemia and hypertension presents with sudden onset chest pain and dyspnea. ECG and troponins are indicative of a myocardial infarction. You consider starting dual antiplatelet therapy. Which is the most appropriate combination according to NICE guidelines?
A) Aspirin and warfarin
B) Aspirin and clopidogrel
C) Clopidogrel and ticagrelor
D) Aspirin and ticagrelor
E) Rivaroxaban and aspirin
Explanations & Answers:
Question Easy Answer:
C) Immune thrombocytopenic purpura (ITP)
Question Easy Explanation:
The symptoms suggest a bleeding disorder. The presence of petechiae (small red or purple spots caused by bleeding into the skin) and frequent nosebleeds are classic signs of thrombocytopenia, which in a young adult female, is most likely due to ITP. ITP is an autoimmune condition where platelets are destroyed, leading to bleeding tendencies.
Question Medium Answer:
D) Hypovolemia
Question Medium Explanation:
Virchow’s triad consists of three factors that contribute to the formation of thrombi: stasis of blood flow, endothelial injury, and a hypercoagulable state. Hypovolemia is not part of Virchow’s triad.
Question Hard Answer:
B) Aspirin and clopidogrel
Question Hard Explanation:
According to NICE guidelines for the management of myocardial infarction, dual antiplatelet therapy involving aspirin in combination with clopidogrel is standard. Newer agents like ticagrelor can be used, but clopidogrel remains a widely recommended agent in the combination.
Medical fact of the day:
Did you know that the UK has one of the highest rates of blood donation in Europe? Donating just one pint of blood can save up to three lives, making it a vital part of healthcare provision.
Quote of the day:
“Every small action in healthcare is a ripple that touches countless lives. Be the best pebble you can be.” 🌊