Question Easy: A 35-year-old woman presents with fatigue, weight loss, and heat intolerance. On examination, she has a diffusely enlarged thyroid and exophthalmos. Which of the following is the most likely diagnosis?
A) Hashimoto’s thyroiditis
B) Graves’ disease
C) Subacute thyroiditis
D) Thyroid cancer
E) Plummer’s disease
Question Medium: A 40-year-old man experiences sudden onset severe headache, nausea, and vomiting. He recently stopped taking antihypertensive medication. His blood pressure is now 200/120 mmHg. CT brain shows a small bleed in the right basal ganglia. Which of the following is the most likely cause of this condition?
A) Subarachnoid haemorrhage
B) Ischaemic stroke
C) Tension headache
D) Intracerebral haemorrhage
E) Migraine
Question Hard: A 28-year-old woman with recurrent bladder dysfunction, optic neuritis, and sensory impairment in her limbs presents for review. Her MRI shows multiple demyelinating lesions in the brain and spinal cord. Which of the following is the most likely diagnosis?
A) Multiple sclerosis
B) Guillain-Barre syndrome
C) Amyotrophic lateral sclerosis
D) Myasthenia gravis
E) Transverse myelitis
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: This clinical presentation, particularly the symptoms of hyperthyroidism (fatigue, weight loss, heat intolerance) along with the diffuse goitre and exophthalmos, is characteristic of Graves’ disease. According to NICE guidelines, Graves’ disease is the most common cause of hyperthyroidism and is associated with thyroid eye disease (exophthalmos). Treatment often involves anti-thyroid drugs, radioactive iodine, or surgery.
Question Medium Answer: D
Question Medium Explanation: The presentation suggests a case of hypertensive intracerebral haemorrhage, with the basal ganglia being a common site. NICE guidelines recommend urgent blood pressure management and supportive care in such cases. The sudden onset of symptoms following uncontrolled hypertension is typical of an intracerebral bleed.
Question Hard Answer: A
Question Hard Explanation: The combination of symptoms and MRI findings is highly suggestive of Multiple Sclerosis (MS). MS is a demyelinating disease prevalent in younger adults and is characterised by episodes of neurological dysfunction. The multiple demyelinating lesions observed on the MRI are typical of relapsing-remitting MS, as per NHS guidelines.
Medical fact of the day: Did you know that the UK has one of the highest rates of Multiple Sclerosis in the world? Research suggests this could be linked to genetic factors and environmental triggers, including low sunlight exposure and vitamin D levels.
Quote of the day: “In the vast world of medicine, every small act of care 🎗️ is a giant step towards healing. Keep inspiring and changing lives, one patient at a time.”