Question Easy: A 65-year-old man presents to the GP with a history of exertional dyspnoea and a chronic cough. He has smoked 20 cigarettes a day for 40 years. On examination, you note decreased breath sounds and hyper-resonance on percussion of the chest. What is the most likely diagnosis? 🚬
A) Bronchial asthma
B) Chronic bronchitis
C) Emphysema
D) Pneumonia
E) Pulmonary embolism
Explanations & Answers:
Question Easy Answer: C) Emphysema
Question Easy Explanation: The clinical features described, including the patient’s smoking history, exertional dyspnoea, chronic cough, decreased breath sounds, and hyper-resonance on percussion, are characteristic of emphysema. Emphysema is part of chronic obstructive pulmonary disease (COPD) and is commonly caused by long-term smoking.
Question Medium: A 50-year-old woman presents to the emergency department with acute central chest pain radiating to the left arm and is sweating profusely. Her ECG shows ST elevation in leads II, III, and aVF. What is the most likely coronary artery affected? ❤️
A) Left anterior descending artery
B) Right coronary artery
C) Left circumflex artery
D) Left main coronary artery
E) Posterior descending artery
Question Medium Answer: B) Right coronary artery
Question Medium Explanation: ST elevation in leads II, III, and aVF is indicative of an inferior myocardial infarction, which is most commonly caused by an occlusion of the right coronary artery. Prompt recognition and treatment are essential to prevent further cardiac damage.
Question Hard: A 42-year-old man with a history of hypertension is found unconscious at home with laboured breathing. In the hospital, he is diagnosed with acute cardiogenic pulmonary oedema. Which of the following medications should be administered first?
A) Digoxin
B) Furosemide
C) Glyceryl trinitrate
D) Spironolactone
E) Enalapril
Question Hard Answer: C) Glyceryl trinitrate
Question Hard Explanation: In the acute management of cardiogenic pulmonary oedema, immediate attention is required to reduce preload and afterload. Glyceryl trinitrate (GTN) is effective in rapidly dilating veins and coronary arteries, reducing preload and improving symptoms. According to NICE guidelines, nitrates such as GTN are recommended as first-line treatment in the management of acute pulmonary oedema.
Medical fact of the day: Did you know that cardiovascular disease (CVD) is the leading cause of death in the UK, but almost 80% of premature heart attacks and strokes are preventable through lifestyle changes and early management?
Quote of the day: “Every heartbeat is a reminder of life’s fragility and resilience. It is our duty to protect, heal, and cherish each one.”