Question Easy:
A 56-year-old man presents to the GP with exertional chest pain and shortness of breath. He has a past medical history of hypertension and hyperlipidaemia. What is the most likely initial investigation to perform? 📈
A) Blood tests
B) Chest X-ray
C) Transthoracic echocardiogram
D) Exercise ECG
E) Coronary angiography
Question Medium:
A 65-year-old woman is admitted to A&E with sudden onset breathlessness, pleuritic chest pain, and haemoptysis. Her heart rate is 110 bpm and oxygen saturation is 91% on room air. What is the most appropriate initial management for this patient? 🏥
A) CT Pulmonary Angiography
B) Administer Oxygen
C) Start on IV Fluids
D) Immediate thrombolysis
E) Low molecular weight heparin
Question Hard:
A 28-year-old woman with a history of asthma comes to the clinic complaining of increased shortness of breath and wheezing, occurring mainly at night. Her peak expiratory flow rate is 75% of her personal best. Despite using a salbutamol inhaler, symptoms persist. What is the next step in management according to UK guidelines? 🌬️
A) Oral corticosteroids
B) Sputum culture
C) Increase inhaled corticosteroid dose
D) Montelukast
E) Long-acting beta-agonist
Explanations & Answers:
Question Easy Answer: D) Exercise ECG
Question Easy Explanation: The initial investigation for exertional chest pain suggestive of angina is typically an Exercise ECG. NICE guidelines recommend it to assess for ischemic changes under stress, helping guide further management.
Question Medium Answer: B) Administer Oxygen
Question Medium Explanation: The patient presents with symptoms suggestive of a pulmonary embolism. The first step in management is to support oxygenation and stabilize the patient as per NHS guidelines, which often involves administering supplemental oxygen.
Question Hard Answer: C) Increase inhaled corticosteroid dose
Question Hard Explanation: According to NICE guidelines, for asthma patients whose symptoms are not well-controlled on a short-acting beta-agonist, the dose of inhaled corticosteroids should be stepped up before other treatments like long-acting beta-agonists or leukotriene receptor antagonists are considered.
Medical fact of the day: The human heart beats about 100,000 times a day, which equates to over 36 million beats in a year. Despite this impressive workload, the heart can function with remarkable efficiency and resilience. ❤️
Quote of the day: “Healing is an art, medicine is a science, and the mind is the key. Keep learning, keep caring, for every patient is a return on your investment in empathy.”