Question Easy: A 55-year-old man presents to the GP with increased shortness of breath, wheezing, and a productive cough. He is a long-term smoker. Which of the following is the most likely diagnosis? 🚬
A) Asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Pneumonia
D) Lung cancer
E) Bronchitis
Question Medium: A 70-year-old woman with a history of hypertension and diabetes presents with acute chest pain that radiates to her left arm. She is pale and sweating profusely. What is the most likely immediate investigation to confirm your diagnosis? 💓
A) Chest X-ray
B) Echocardiogram
C) Coronary angiography
D) 12-lead ECG
E) Cardiac MRI
Question Hard: A 62-year-old man with chronic heart failure (NYHA Class III) is on optimal medical therapy including an ACE inhibitor, beta-blocker, and diuretic. He continues to experience frequent exacerbations. Which additional therapy is recommended according to NICE guidelines? 🔍
A) Digoxin
B) Spironolactone
C) Calcium channel blocker
D) Warfarin
E) Statin
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: The patient’s symptoms of chronic cough, wheezing, and history of long-term smoking are most consistent with chronic obstructive pulmonary disease (COPD), according to NICE guidelines. COPD is a common condition, especially in smokers, and is characterized by airflow obstruction.
Question Medium Answer: D
Question Medium Explanation: The clinical presentation is suggestive of an acute myocardial infarction (heart attack). A 12-lead ECG is the quickest and most effective initial investigation to confirm this diagnosis, as per NHS guidelines. It helps identify ST-segment changes indicative of myocardial ischemia.
Question Hard Answer: B
Question Hard Explanation: According to NICE guidelines, for patients with heart failure who continue to have symptoms despite optimal medical therapy, an aldosterone antagonist such as spironolactone is recommended. It helps improve symptoms and reduce hospital admissions due to heart failure exacerbations.
Medical fact of the day: Did you know that COPD is the second most common lung disease in the UK after asthma, affecting around 1.2 million people? Early diagnosis and management are key to improving quality of life and reducing exacerbations.
Quote of the day: “Every heartbeat tells a story, and every breath carries hope. As healthcare workers, we are the authors of healing and the bearers of compassion.”