Question Easy:
A 50-year-old woman presents with chest pain that radiates to her left arm. She is anxious and sweating. Her ECG shows ST elevation in leads V2-V4. What is the most likely diagnosis? 😟❤️
A) Stable angina
B) Unstable angina
C) Atrial fibrillation
D) Acute myocardial infarction
E) Acute pericarditis
Question Medium:
A 65-year-old man with a history of COPD presents with increasing breathlessness and a productive cough. On examination, he has a respiratory rate of 28/min, wheezing, and reduced breath sounds on auscultation. What is the most appropriate initial treatment in this acute setting? 🌬️🫁
A) Salbutamol inhaler
B) Ipratropium bromide nebuliser
C) Oral prednisolone
D) Amoxicillin
E) Oxygen therapy
Question Hard:
A 28-year-old woman presents with recurrent episodes of breathlessness and palpitations. She reports a family history of sudden cardiac death. Her ECG shows a shortened PR interval and a delta wave. What is the most likely diagnosis? ⚡
A) Long QT syndrome
B) Brugada syndrome
C) Wolff-Parkinson-White syndrome
D) AV nodal reentrant tachycardia
E) Lown-Ganong-Levine syndrome
Explanations & Answers:
Question Easy Answer: D
Question Easy Explanation: The clinical presentation and ECG findings are characteristic of an acute myocardial infarction (MI), specifically an anterior MI due to the ST elevation in leads V2-V4. Immediate management is crucial to reduce cardiac damage and improve outcomes.
Question Medium Answer: E
Question Medium Explanation: The man is likely experiencing an acute exacerbation of COPD. Oxygen therapy is crucial to correct hypoxaemia (if present) in these patients. However, oxygen should be administered cautiously to avoid CO2 retention. The other options may form part of the management plan but are not typically the immediate step recommended in acute settings. NICE guidelines emphasize controlled oxygen delivery in acute exacerbations of COPD.
Question Hard Answer: C
Question Hard Explanation: The presence of a shortened PR interval and a delta wave on an ECG is characteristic of Wolff-Parkinson-White (WPW) syndrome. This condition involves an accessory conduction pathway (the bundle of Kent) that can lead to tachyarrhythmias. Family history of sudden cardiac death adds further suspicion to this diagnosis due to potential for fatal arrhythmias. Managing WPW often includes ablation of the aberrant pathway.
Medical fact of the day: Did you know that patients with COPD in the UK are provided with annual flu vaccinations to help prevent exacerbations? Flu can severely impact respiratory health, especially in those with underlying conditions.
Quote of the day: “In the art of healing, every heart that cares is a beacon of hope. Together, we illuminate the path to wellness.” 🌟