Question Easy: A 45-year-old man presents to the GP with excessive thirst, frequent urination, and nocturia. Blood tests reveal hypercalcemia. What is the most likely diagnosis? 🩺
A) Diabetes mellitus
B) Diabetes insipidus
C) Primary hyperparathyroidism
D) Addison’s disease
E) Cushing’s syndrome
Question Medium: A 55-year-old woman presents with fatigue, weight gain, and cold intolerance. She also reports dry skin and constipation. Blood tests reveal elevated thyroid-stimulating hormone (TSH) levels. Which of the following is the most appropriate initial management for her condition?
A) Radioactive iodine therapy
B) Levothyroxine therapy
C) Thyroidectomy
D) Propylthiouracil
E) Observation
Question Hard: A 30-year-old woman presents with episodes of palpitations, headaches, and sweating. During these episodes, her blood pressure is significantly elevated. Urinary catecholamines are markedly increased. Which of the following is the most likely underlying cause of these symptoms?
A) Conn’s syndrome
B) Pheochromocytoma
C) Graves’ disease
D) Cushing’s disease
E) Acromegaly
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The symptoms described, particularly the hypercalcemia, are consistent with primary hyperparathyroidism. This condition is most commonly caused by a parathyroid gland adenoma leading to increased parathyroid hormone (PTH) secretion and elevated calcium levels. According to NICE guidelines, hypercalcemia in the context of these symptoms is typically due to primary hyperparathyroidism.
Question Medium Answer: B
Question Medium Explanation: The elevated TSH level along with her symptoms suggests hypothyroidism. The first-line treatment is levothyroxine therapy, as per NICE guidelines. Levothyroxine is a synthetic form of thyroxine (T4) used to restore normal hormone levels and relieve symptoms.
Question Hard Answer: B
Question Hard Explanation: The triad of palpitations, headaches, and sweating, coupled with elevated blood pressure and increased urinary catecholamines, is indicative of a pheochromocytoma. This is a rare catecholamine-secreting tumour that arises from the adrenal medulla, leading to the described episodes. According to BNF guidelines, biochemical testing for catecholamines is crucial in diagnosing this condition.
Medical fact of the day: Did you know that the pineal gland, located in the brain, is responsible for the production of melatonin, a hormone that regulates sleep-wake cycles? This tiny gland plays a significant role in maintaining circadian rhythms.
Quote of the day: “In the tapestry of healthcare, every thread is vital. Whether you are saving a life or providing comfort, your role is woven into the fabric of healing.” 🌟