Question Easy:
A 75-year-old man presents with fatigue and shortness of breath. His blood test shows haemoglobin of 9 g/dL, MCV of 70 fL, and low ferritin levels. What is the most likely diagnosis? 🤔
A) Vitamin B12 deficiency
B) Iron deficiency anaemia
C) Sickle cell disease
D) Thalassaemia
E) Anaemia of chronic disease
Question Medium:
A 52-year-old woman with a history of hypertension is brought to A&E with sudden onset of severe chest pain radiating to the back. Her blood pressure is noted to be 180/110 mmHg in the right arm and 150/90 mmHg in the left arm. What is the most likely diagnosis? 🚑
A) Myocardial infarction
B) Pericarditis
C) Pulmonary embolism
D) Aortic dissection
E) Pneumothorax
Question Hard:
A 32-year-old female presents with episodic leg swelling and a family history of varicose veins. On examination, she has obvious varicosities and a positive Trendelenburg test. Which vein is most commonly involved in primary varicose veins?
A) Short saphenous vein
B) Inferior vena cava
C) Femoral vein
D) Great saphenous vein
E) Popliteal vein
Explanations & Answers:
Question Easy Answer: B)
Question Easy Explanation: This patient presents with microcytic anaemia (low MCV) and low ferritin levels, indicative of iron deficiency anaemia. According to NICE guidelines, iron deficiency should be suspected with these clinical features. 🚑
Question Medium Answer: D)
Question Medium Explanation: The sudden onset of chest pain radiating to the back, coupled with differential blood pressures in the arms, strongly points to an aortic dissection. NHS guidance emphasizes these classic signs, making it vital to treat this condition urgently.
Question Hard Answer: D)
Question Hard Explanation: Primary varicose veins most often involve the great saphenous vein. This is supported by NHS guidelines, which describe venous reflux as frequently starting in this superficial vein, hence the positive Trendelenburg test.
Medical fact of the day: The abdominal aorta supplies blood to roughly 7cm of the lower gastrointestinal tract at the level of the renal arteries, a critical supply point noted particularly during surgeries or when determining causes of abdominal pain in UK medical practice.
Quote of the day: “In the silent acts of care, the healing begins. 🌟”