Question Easy:
A 45-year-old woman presents to her GP with complaints of fatigue, weight gain, and cold intolerance. On examination, she has dry skin and a modestly enlarged thyroid. Which of the following is the most likely diagnosis?
A) Hyperthyroidism
B) Hypothyroidism
C) Addison’s disease
D) Cushing’s syndrome
E) Pheochromocytoma
Question Medium:
A 32-year-old man is brought to the emergency department after experiencing a seizure. His partner reports he has been excessively thirsty and urinating frequently. His blood tests reveal a sodium level of 150 mmol/L. What is the most likely diagnosis?
A) Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH)
B) Diabetes Mellitus
C) Diabetes Insipidus
D) Hyperthyroidism
E) Hypoparathyroidism
Question Hard:
A 58-year-old male presents with bitemporal hemianopia and severe headaches. Further investigation reveals increased levels of prolactin. An MRI shows a pituitary mass. What is the most appropriate initial treatment?
A) Surgery
B) Radiation therapy
C) Cabergoline
D) Bromocriptine
E) Corticosteroids
Explanations & Answers:
Question Easy Answer: B) Hypothyroidism
Question Easy Explanation: The symptoms of fatigue, weight gain, cold intolerance, dry skin, and an enlarged thyroid are classic for hypothyroidism. According to the NHS, these symptoms correspond with decreased thyroid hormone production, as seen in hypothyroidism.
Question Medium Answer: C) Diabetes Insipidus
Question Medium Explanation: Diabetes insipidus is characterised by polyuria and thirst due to a deficiency in antidiuretic hormone or a kidney response issue, leading to high sodium levels. NICE guidelines advise considering causes of hypernatraemia and excessive urination patterns typical of diabetes insipidus.
Question Hard Answer: C) Cabergoline
Question Hard Explanation: A prolactinoma, a type of pituitary adenoma, can cause symptoms including bitemporal hemianopia due to optic chiasm compression. Cabergoline, a dopamine agonist, is the first-line treatment to reduce tumour size and prolactin levels, as per UK management guidelines.
Medical fact of the day: The pineal gland is a small endocrine structure in the brain responsible for producing melatonin, which regulates sleep patterns. Recent studies have noted its role in seasonal affective disorder (SAD), particularly in regions like the UK with less daylight during winter.
Quote of the day: “In the tapestry of healthcare, every thread of kindness you weave can transform a patient’s journey into a blanket of comfort and hope.”