Question Easy:
A 68-year-old man presents to the GP with fatigue, shortness of breath, and palpitations. Blood tests reveal a haemoglobin level of 10 g/dL, mean corpuscular volume (MCV) of 72 fL, and serum ferritin level of 8 ng/mL. What is the most likely underlying cause of his anaemia? 🌡️
A) Vitamin B12 deficiency
B) Folate deficiency
C) Iron deficiency
D) Chronic kidney disease
E) Thalassemia trait
Explanations & Answers:
Question Easy Answer: C) Iron deficiency
Question Easy Explanation: The patient’s symptoms and laboratory findings are consistent with iron deficiency anaemia. A low haemoglobin level with a low MCV indicates microcytic anaemia, and the low ferritin confirms iron deficiency as the cause.
Question Medium:
A 55-year-old woman is admitted with deep vein thrombosis (DVT) and starts on anticoagulation. She has a past medical history of gastric ulcers. What is the most appropriate anticoagulant to administer given her background? 💉
A) Unfractionated heparin
B) Low molecular weight heparin (LMWH)
C) Warfarin
D) Fondaparinux
E) Direct oral anticoagulants (DOACs)
Explanations & Answers:
Question Medium Answer: B) Low molecular weight heparin (LMWH)
Question Medium Explanation: In patients with DVT and a history of gastrointestinal bleeding, LMWH is often preferred due to a lower risk of bleeding and the fact that it’s easily reversible if necessary. Warfarin and DOACs can increase the risk due to gastrointestinal irritation.
Question Hard:
A 33-year-old woman presented to the emergency department with an 8-hour history of severe abdominal pain. A CT angiogram shows a superior mesenteric artery occlusion. What is the most likely underlying cause in this patient? 🚨
A) Atrial fibrillation
B) Vasculitis
C) Hypercoagulable state
D) Atherosclerosis
E) Smoking
Explanations & Answers:
Question Hard Answer: C) Hypercoagulable state
Question Hard Explanation: In a young patient with mesenteric ischaemia, common causes such as atherosclerosis are less likely. A hypercoagulable state should be considered, particularly if there is no history of atrial fibrillation or smoking, making conditions like antiphospholipid syndrome or factor V Leiden mutation possible.
Medical fact of the day: Did you know? Polycythemia vera can lead to the thickening of blood, increasing the risk of blood clots and conditions like stroke and heart attack. It’s managed with phlebotomy and sometimes medications to reduce blood cell production.
Quote of the day: “In the heartbeat of every caregiver beats the rhythm of compassion and perseverance. Every life touched is a victory.” 🌟