Question Easy: A 55-year-old man presents to the GP with chest pain after shovelling snow. The pain is relieved by rest and sublingual glyceryl trinitrate. What is the most likely diagnosis? 🚶♂️❤️
A) Acute myocardial infarction
B) Aortic dissection
C) Angina pectoris
D) Pericarditis
E) Pulmonary embolism
Question Medium: A 67-year-old woman is admitted with a productive cough, fever, and pleuritic chest pain. Her chest X-ray shows right lower lobe consolidation. What is the most appropriate first-line antibiotic for this condition in the UK? 🤒📸
A) Amoxicillin
B) Clarithromycin
C) Doxycycline
D) Ciprofloxacin
E) Co-amoxiclav
Question Hard: A 45-year-old patient with a history of chronic heart failure is admitted with worsening dyspnea and peripheral oedema. Despite optimal medical treatment including ACE inhibitors and beta-blockers, his symptoms persist. According to NICE guidelines, what is the next line of treatment to consider? 🚑💊
A) Digoxin
B) Ivabradine
C) Spironolactone
D) Sacubitril/valsartan
E) Hydralazine and isosorbide dinitrate
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The patient’s chest pain, which is triggered by exertion (shovelling snow) and relieved by rest and nitroglycerin, is characteristic of angina pectoris. This occurs due to a mismatch between myocardial oxygen supply and demand, often due to coronary artery disease. NICE guidelines recommend lifestyle modifications and medication to manage angina.
Question Medium Answer: A
Question Medium Explanation: Community-acquired pneumonia in a typical presentation, such as this case, can be treated with amoxicillin as the first choice according to NICE guidelines, unless there is a history of beta-lactam allergy or if atypical pathogens are suspected, where clarithromycin or doxycycline might be considered.
Question Hard Answer: D
Question Hard Explanation: For patients with chronic heart failure who remain symptomatic despite optimal treatment, NICE guidelines recommend considering sacubitril/valsartan as a next step. This combination provides an alternative mechanism of heart failure management and may improve patient outcomes by enhancing natriuretic peptide effects and inhibiting the renin-angiotensin system.
Medical fact of the day: In the UK, cardiovascular diseases remain the leading cause of death, accounting for nearly a quarter of all fatalities. However, with timely intervention and lifestyle changes, many cardiovascular events are preventable.
Quote of the day: “In the midst of challenges, your compassion is the heart of healing and the bridge to hope. Keep inspiring, for every small act of care lights up a patient’s path.” 🌟💉