Question Easy:
A 65-year-old man with a history of hypertension presents with sudden onset chest pain radiating to his left arm. Which investigation would you perform first to assess his condition? 🩺
A) Echocardiogram
B) Chest X-ray
C) ECG
D) Blood test for troponin
E) Coronary angiography
Question Medium:
A 55-year-old woman presents with a persistent cough, shortness of breath, and wheezing. Her peak expiratory flow rate is 60% of the predicted value. What is the most likely diagnosis? 🩻
A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Pulmonary embolism
D) Pneumonia
E) Pleural effusion
Question Hard:
A 45-year-old man with a known ventricular septal defect (VSD) is experiencing increased fatigue and shortness of breath. Which of the following complications is he most at risk for? 🚑
A) Endocarditis
B) Aortic dissection
C) Mitral valve prolapse
D) Pulmonary hypertension
E) Left ventricular hypertrophy
Explanations & Answers:
Question Easy Answer:
C) ECG
Question Easy Explanation:
An ECG should be performed first in a patient with sudden onset chest pain to quickly assess for any signs of myocardial infarction or other cardiac abnormalities. According to NICE guidelines, an ECG is the standard initial investigation for evaluating chest pain in primary and emergency care settings.
Question Medium Answer:
B) Asthma
Question Medium Explanation:
The combination of symptoms such as persistent cough, shortness of breath, and wheezing, along with a peak expiratory flow rate of 60% of the predicted value, is indicative of asthma. According to NICE guidelines, these symptoms are characteristic of asthma, and spirometry or peak flow measurements help confirm the diagnosis.
Question Hard Answer:
D) Pulmonary hypertension
Question Hard Explanation:
Patients with a ventricular septal defect (VSD) are at risk of developing pulmonary hypertension due to increased blood flow to the pulmonary circulation. This condition can lead to Eisenmenger’s syndrome if left untreated. Pulmonary hypertension is a severe and common complication of VSD, aligning with NHS guidelines on the management of congenital heart disease in adults.
Medical fact of the day:
Did you know that in the UK, chronic obstructive pulmonary disease (COPD) is one of the most common respiratory diseases, affecting approximately 1.2 million people? Early diagnosis and management are crucial in improving patient outcomes.
Quote of the day:
“Compassion and knowledge are the two vital instruments in the hands of a healthcare professional. Together, they can heal beyond measures.”