Question Easy:
A 68-year-old man presents to the GP with shortness of breath and fatigue. He has a history of hypertension and his ECG shows atrial fibrillation. Which medication should be considered first for rate control in this patient? 😊
A) Digoxin
B) Beta-blocker
C) Amiodarone
D) Calcium channel blocker
E) Sotalol
Question Medium:
A 50-year-old woman with a history of asthma presents to the emergency department with increased wheezing and shortness of breath after initiating a new medication for her hypertension. Which of the following is the most likely culprit? 🤔
A) Lisinopril
B) Amlodipine
C) Bisoprolol
D) Losartan
E) Ramipril
Question Hard:
A 48-year-old man with a 20-year history of smoking presents with chronic cough and sputum production. Spirometry shows FEV1/FVC ratio of 60%. Which of the following is the most appropriate initial management step according to NICE guidelines? 🚭
A) Inhaled corticosteroids
B) Long-acting beta agonist (LABA)
C) Smoking cessation support
D) Long-acting muscarinic antagonist (LAMA)
E) Oral corticosteroids
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: Beta-blockers are recommended as the first-line treatment for rate control in patients with atrial fibrillation according to NICE guidelines, unless contraindicated. They help slow the heart rate, reducing symptoms without affecting rhythm. 😊
Question Medium Answer: C
Question Medium Explanation: Bisoprolol is a beta-blocker, which can exacerbate asthma symptoms due to bronchoconstriction. This patient likely experienced worsening asthma after starting bisoprolol for hypertension. NICE recommends caution with beta-blockers in asthmatic patients.
Question Hard Answer: C
Question Hard Explanation: Smoking cessation is the most effective initial step in managing chronic obstructive pulmonary disease (COPD) according to NICE guidelines, as it can slow disease progression and improve overall health outcomes. 🚭
Medical fact of the day: The UK has one of the highest rates of asthma in Europe, affecting approximately 5.4 million people. It’s crucial to be mindful of asthma triggers, including medications, which can aggravate respiratory symptoms.
Quote of the day: “In the healing journey, remember that kindness is the best prescription, and empathy is the most potent medicine.”