Question Easy:
🏥 A 64-year-old man presents to his GP complaining of breathlessness and a persistent cough. He is a current smoker with a 40 pack-year history. Auscultation reveals a wheeze and decreased breath sounds bilaterally. What is the most likely diagnosis?
A) Asthma
B) Chronic Obstructive Pulmonary Disease (COPD)
C) Pulmonary Embolism
D) Congestive Heart Failure
E) Lung Cancer
Question Medium:
🔍 A 55-year-old woman is admitted to A&E with acute chest pain. The pain radiates to her left arm and jaw. Her ECG shows ST elevation in the anterior leads. Which coronary artery is most likely to be occluded?
A) Left Circumflex Artery
B) Right Coronary Artery
C) Left Anterior Descending Artery
D) Right Marginal Artery
E) Posterior Descending Artery
Question Hard:
📉 A 70-year-old patient with a history of heart failure presents with worsening exertional dyspnoea and orthopnoea. Physical examination reveals elevated jugular venous pressure and bilateral pitting oedema. An echocardiogram shows a left ventricular ejection fraction of 35%. According to NICE guidelines, which medication should be added to optimize his treatment plan?
A) Digoxin
B) Spironolactone
C) Verapamil
D) Atorvastatin
E) Amoxicillin
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: The patient’s symptoms and smoking history are characteristic of Chronic Obstructive Pulmonary Disease (COPD). Smoking is the leading cause of COPD, and the presence of wheeze and decreased breath sounds supports this diagnosis.
Question Medium Answer: C
Question Medium Explanation: ST elevation in the anterior leads typically indicates an occlusion in the Left Anterior Descending (LAD) artery, which supplies the anterior wall of the heart. This type of myocardial infarction is often referred to as an anterior STEMI.
Question Hard Answer: B
Question Hard Explanation: According to NICE guidelines for heart failure management, the addition of a mineralocorticoid receptor antagonist like Spironolactone is recommended for patients with heart failure with reduced ejection fraction, as it can help alleviate symptoms and reduce mortality.
Medical fact of the day: The UK has one of the highest incidences of asthma in the world, affecting approximately 1 in 11 children and 1 in 12 adults. Effective management can significantly improve quality of life and reduce hospitalization rates.
Quote of the day: “The true measure of success in medicine is not in the cure alone, but in the compassion and care we provide each patient along their journey.” 😊