Question Easy:
🩸 A 25-year-old woman presents with a sudden onset of sharp, unilateral chest pain and shortness of breath. Her heart rate is 110 beats per minute, and her respiratory rate is 24 breaths per minute. She has been on an oral contraceptive pill for the past 5 years. Which is the most likely diagnosis?
A) Myocardial infarction
B) Pulmonary embolism
C) Pneumonia
D) Asthma exacerbation
E) Costochondritis
Explanations & Answers:
Question Easy Answer:
B) Pulmonary embolism
Question Easy Explanation:
In a young woman on an oral contraceptive, who presents with sudden-onset chest pain and shortness of breath, pulmonary embolism is the most likely diagnosis. The history of contraceptive use is a significant risk factor for venous thromboembolism. NICE guidelines emphasize the importance of considering PE in patients with these risk factors and symptoms. 🚑
Question Medium:
💉 A 35-year-old man presents with a swollen, painful left calf. He returned from a long-haul flight from Australia two days ago. On examination, there is tenderness and swelling of the left calf. What is the first-line investigation to diagnose his condition?
A) MRI of the calf
B) CT angiography
C) Doppler ultrasound
D) D-dimer test
E) Venography
Explanations & Answers:
Question Medium Answer:
C) Doppler ultrasound
Question Medium Explanation:
The first-line investigation to diagnose deep vein thrombosis (DVT) is a Doppler ultrasound, as per NICE guidelines. This non-invasive imaging modality helps visualize thrombi in the deep veins. While a D-dimer test can support the diagnosis, it is non-specific and would not alone confirm the presence of a DVT in this high-risk scenario (recent long-haul flight, symptoms of calf swelling, and tenderness). 🌍✈️
Question Hard:
🫀 A 68-year-old man with a history of type 2 diabetes and chronic kidney disease presents with rest pain in his left leg. On examination, there is diminished dorsalis pedis pulse, and the left lower limb is cool to touch. Which is the first-line management option for his condition?
A) Peripheral angioplasty
B) Amputation
C) Oral anticoagulation
D) Intravenous antibiotics
E) Conservative management
Explanations & Answers:
Question Hard Answer:
A) Peripheral angioplasty
Question Hard Explanation:
For a patient presenting with critical limb ischemia (CLI) as evidenced by rest pain and diminished pulses, peripheral angioplasty is often the first-line management according to NICE and NHS guidelines. This endovascular procedure aims to restore blood flow and alleviate symptoms. Immediate intervention is crucial to prevent tissue loss and potential amputation. 🦵
Medical fact of the day:
Did you know that the UK has one of the highest rates of venous thromboembolism (VTE) in Europe, with an estimated 60,000 cases of fatal pulmonary embolism each year? Early recognition and treatment are paramount in reducing the morbidity and mortality associated with VTE.
Quote of the day:
“Every heartbeat is a reminder that our purpose as healthcare providers is to sustain, nurture, and cherish the gift of life.” ❤️🩹