Question Easy:
A 45-year-old man presents to the GP with a 3-day history of a sore throat, fever, and a new-onset rash. On examination, he has erythematous tonsils with exudate and a sandpaper-like rash on his trunk. What is the most likely causative organism? 🤒
A) Epstein-Barr virus
B) Streptococcus pneumoniae
C) Group A Streptococcus
D) Haemophilus influenzae
E) Adenovirus
Question Medium:
A 70-year-old female patient comes to the emergency department with increasing shortness of breath, ankle swelling, and fatigue over the last few weeks. On examination, her JVP is elevated, and there are fine basal crackles in her lungs. Her past medical history includes hypertension and a previous myocardial infarction. What is the most likely diagnosis? 🫁
A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Heart failure
D) Pulmonary embolism
E) Pneumonia
Question Hard:
A 28-year-old male runner presents with episodes of palpitations and dizziness, especially after exertion. An ECG shows a short PR interval and a delta wave. What is the probable diagnosis, and what is the main risk associated with this condition? 🏃♂️
A) Atrial flutter; thromboembolism
B) Wolff-Parkinson-White syndrome; sudden cardiac death
C) Long QT syndrome; syncope
D) Brugada syndrome; ventricular arrhythmias
E) Atrial fibrillation; heart failure
Explanations & Answers:
Question Easy Answer: C) Group A Streptococcus
Question Easy Explanation: The presentation of a sore throat, fever, and a characteristic sandpaper rash suggests scarlet fever, caused by Group A Streptococcus (Streptococcus pyogenes). NICE guidelines recommend considering GAS in children or adults presenting with such symptoms.
Question Medium Answer: C) Heart failure
Question Medium Explanation: The symptoms of breathlessness, ankle swelling, elevated JVP, and fine crackles are classic for heart failure, particularly considering her history of myocardial infarction and hypertension. NICE guidelines suggest managing heart failure with diuretics and ACE inhibitors.
Question Hard Answer: B) Wolff-Parkinson-White syndrome; sudden cardiac death
Question Hard Explanation: The presence of a short PR interval and delta wave on ECG is characteristic of Wolff-Parkinson-White syndrome, an accessory pathway disorder. The main risk is the development of serious arrhythmias, which can lead to sudden cardiac death, especially during physical exertion. Treatment options, per NHS guidelines, can include catheter ablation.
Medical fact of the day: Did you know? The smallest blood vessels in the body, capillaries, are so tiny that red blood cells have to travel through them single file. This allows for optimal gas exchange, vital for efficient respiratory function. 🌬️
Quote of the day: “In the gentle flow of care, endless resilience grows. Every heartbeat, every breath, fortifies the journey of healing and hope.” 🌟