Cardio and Respiratory SBA Questions
Question Easy:
A 45-year-old woman presents with chest pain lasting 10 minutes, radiating to her left arm. This occurred while she was at rest. She is a smoker with a high-stress job. What is the most likely diagnosis?
A) Heartburn
B) Angina pectoris
C) Myocardial infarction
D) Panic attack
E) Pulmonary embolism
Question Easy Answer:
C) Myocardial infarction
Question Easy Explanation:
This woman presents with typical symptoms of a myocardial infarction (MI), including chest pain radiating to the arm and occurring at rest. According to NICE guidelines, the presence of these symptoms in a person with risk factors, such as smoking and high stress, should raise immediate suspicion for MI. Urgent medical evaluation and management are necessary.
Question Medium:
A 65-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea and productive cough with green sputum. His respiratory rate is elevated, and he has bilateral wheezing on auscultation. What is the best initial management for this patient?
A) Increase dose of inhaled corticosteroids
B) Start oral corticosteroids and antibiotics
C) Administer nebulized salbutamol
D) Initiate mechanical ventilation
E) Advise home oxygen therapy
Question Medium Answer:
B) Start oral corticosteroids and antibiotics
Question Medium Explanation:
In a patient with COPD presenting with acute exacerbation, NICE guidelines recommend a course of oral corticosteroids, typically prednisolone, and antibiotics if there is purulent sputum suggestive of a bacterial infection. These measures aim to reduce airway inflammation and treat underlying bacterial infection, thereby alleviating symptoms and preventing further deterioration.
Question Hard:
A 55-year-old man with hypertension, diabetes, and a history of smoking presents with sudden onset of chest pain and shortness of breath. His ECG shows S1Q3T3 pattern and he is tachycardic with a low oxygen saturation. What is the most likely diagnosis?
A) Acute myocardial infarction
B) Aortic dissection
C) Pericarditis
D) Pulmonary embolism
E) Pneumothorax
Question Hard Answer:
D) Pulmonary embolism
Question Hard Explanation:
The S1Q3T3 pattern on ECG, along with sudden onset of chest pain, dyspnea, and risk factors like smoking and hypertension, strongly suggests pulmonary embolism. NICE guidelines emphasize that this combination of symptoms and ECG findings points towards a high probability of PE, necessitating immediate diagnostic confirmation and treatment, such as anticoagulation.
Medical fact of the day: Did you know that around 80% of cases of chronic obstructive pulmonary disease (COPD) are caused by smoking? This makes smoking cessation the single most effective intervention in the prevention and management of COPD.
Quote of the day: “In the heart of every healthcare worker lies an undeniable commitment to the well-being of others. Remind yourself daily of your remarkable impact. 🌟”