Question Easy:
A 55-year-old man presents with chest pain that is central, crushing, and radiating to his left arm, with associated shortness of breath and sweating. He has a history of hypertension. What is the most likely diagnosis? 🚨
A) Gastroesophageal reflux disease
B) Acute coronary syndrome
C) Pulmonary embolism
D) Costochondritis
E) Panic attack
Explanations & Answers:
Question Easy Answer: B) Acute coronary syndrome
Question Easy Explanation: The symptoms described are characteristic of acute coronary syndrome (ACS), typically presenting as central chest pain, often radiating to the arm, and associated with autonomic symptoms such as sweating. It’s important to recognize these symptoms quickly to initiate appropriate treatment, aligning with NICE guidelines on chest pain management.
Question Medium:
A 62-year-old woman with a 40-pack-year smoking history presents with a chronic cough, sputum production, and dyspnoea. Spirometry reveals an FEV1/FVC ratio of 0.6. What is the most likely diagnosis? 🩺
A) Asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Bronchiectasis
D) Pulmonary fibrosis
E) Congestive heart failure
Explanations & Answers:
Question Medium Answer: B) Chronic obstructive pulmonary disease (COPD)
Question Medium Explanation: The patient’s history of smoking and symptoms such as chronic cough, sputum production, and reduced FEV1/FVC ratio align with the diagnosis of COPD. This is supported by NICE guidelines, which emphasize the role of smoking history and spirometry in diagnosing COPD.
Question Hard:
A 45-year-old female presents with sudden onset shortness of breath, pleuritic chest pain, and hemoptysis. She has a history of recent prolonged flight. Her vitals show tachycardia, tachypnoea, and oxygen saturation of 88% on room air. What is the most appropriate initial diagnostic test? ✈️
A) CT Pulmonary Angiography
B) D-dimer test
C) Chest X-ray
D) Ventilation-perfusion (V/Q) scan
E) Echocardiogram
Explanations & Answers:
Question Hard Answer: A) CT Pulmonary Angiography
Question Hard Explanation: The clinical presentation is highly suggestive of a pulmonary embolism (PE). CT Pulmonary Angiography is the gold standard for diagnosing PE in this scenario, according to NICE guidelines, especially with the history of risk factors such as long flights which can lead to deep vein thrombosis and subsequent PE.
Medical fact of the day: Did you know? In the UK, coronary heart disease is the most common cause of death, accounting for around 160,000 deaths annually. Early recognition and management of risk factors can significantly reduce morbidity and mortality.
Quote of the day: “In the midst of every challenge lies a healing heart; a testament to our unwavering spirit and the art of caring.”