Question Easy:
During a routine check-up of your elderly patient, you notice a firm abdominal mass pulsating in the midline. What is the most likely diagnosis?
A) Renal artery stenosis
B) Abdominal aortic aneurysm
C) Pancreatic tumor
D) Hepatomegaly
E) Gallbladder disease
Explanations & Answers:
Question Easy Answer:
B) Abdominal aortic aneurysm
Question Easy Explanation:
An abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. It is often asymptomatic but can present as a pulsatile abdominal mass. Routine screening for AAA is recommended in the UK for men aged 65 and over due to the potential risk of rupture.
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Question Medium:
A 35-year-old woman comes to the clinic with complaints of fatigue, pallor, and shortness of breath on exertion. On examination, there is pallor of the conjunctiva and koilonychia. Her blood work shows microcytic hypochromic anemia. What is the likely cause of her condition?
A) Iron deficiency anemia
B) Vitamin B12 deficiency
C) Sickle cell anemia
D) Thalassemia
E) Megaloblastic anemia
Explanations & Answers:
Question Medium Answer:
A) Iron deficiency anemia
Question Medium Explanation:
Iron deficiency anemia is characterized by microcytic, hypochromic red blood cells. It is the most common type of anemia, especially in women of childbearing age due to menstrual blood loss, or in those with poor dietary intake. Symptoms include fatigue, pallor, and sometimes koilonychia (spoon-shaped nails). NICE guidelines recommend checking for dietary insufficiency and menorrhagia as potential causes.
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Question Hard:
A 55-year-old male with a history of smoking and hypertension presents with leg pain while walking which is relieved by rest. On physical examination, his left leg pulse is noticeably diminished compared to the right. What is the first-line pharmacotherapy recommended for his condition?
A) Aspirin
B) Warfarin
C) Clopidogrel
D) Atorvastatin
E) Cilostazol
Explanations & Answers:
Question Hard Answer:
E) Cilostazol
Question Hard Explanation:
Intermittent claudication is a key symptom of peripheral arterial disease (PAD), often due to atherosclerosis. Following NICE guidelines, the first-line treatment for intermittent claudication is the phosphodiesterase inhibitor cilostazol, which works to improve blood flow and reduce symptoms. Lifestyle modifications, such as smoking cessation and exercise, along with statin therapy and antithrombotic therapy like aspirin or clopidogrel, are also important components of managing PAD.
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Medical fact of the day:
Did you know that the UK’s NHS offers an abdominal aortic aneurysm screening program specifically for men aged 65 and over? This initiative helps to detect potential life-threatening aneurysms early and significantly reduce the risk of rupture.
Quote of the day:
“In every heartbeat and every breath, lies the resilience and dedication of those who heal. Keep striving, for even the simplest care makes the largest impact.”