Question Easy: 🤔 A 25-year-old woman comes to the GP complaining of fatigue, weight gain, and feeling cold most of the time. On examination, she has dry skin and brittle hair. What is the most likely diagnosis?
A) Hyperthyroidism
B) Cushing’s syndrome
C) Hypothyroidism
D) Addison’s disease
E) Polycystic ovary syndrome (PCOS)
Question Medium: 🧠 A 52-year-old man presents with a sudden onset of right-sided weakness and slurred speech. He has a history of hypertension and smokes 20 cigarettes per day. On examination, he has right-sided lower facial droop and decreased power in the right upper and lower limbs. Which artery is most likely occluded?
A) Anterior cerebral artery
B) Middle cerebral artery
C) Posterior cerebral artery
D) Basilar artery
E) Vertebral artery
Question Hard: 🔍 A 35-year-old woman presents with episodic symptoms of severe headache, palpitations, and sweating. Her routine blood pressure measurements show consistent hypertension. Which of the following would be most useful in confirming the diagnosis of pheochromocytoma?
A) Serum cortisol levels
B) Plasma free metanephrines
C) 24-hour urine aldosterone
D) Serum TSH levels
E) CT scan of the abdomen
Explanations & Answers:
Question Easy Answer: C) Hypothyroidism
Question Easy Explanation: The symptoms described in the question are classic for hypothyroidism, where the body’s metabolism slows down due to decreased levels of thyroid hormones. According to NICE guidelines, symptoms include fatigue, weight gain, cold intolerance, dry skin, and brittle hair.
Question Medium Answer: B) Middle cerebral artery
Question Medium Explanation: The sudden onset of weakness and facial droop suggests a stroke, most likely ischemic. The pattern of symptoms, including facial involvement and limb weakness, suggests an occlusion in the middle cerebral artery, which supplies parts of the frontal, parietal, and temporal lobes, and the basal ganglia according to NHS stroke guidelines.
Question Hard Answer: B) Plasma free metanephrines
Question Hard Explanation: Pheochromocytoma is a catecholamine-secreting tumor that causes episodic symptoms of headache, palpitations, and sweating. NICE guidelines recommend measuring plasma free metanephrines as it is a sensitive test for diagnosing this condition, more so than urine catecholamines or other hormonal assays.
Medical fact of the day: The pituitary gland, although only the size of a pea, is often referred to as the “master gland” because it regulates critical body functions and plays a role in controlling the activity of other endocrine glands.
Quote of the day: “In the tapestry of healing, every small act of compassion weaves a thread of hope.”