Question Easy: A 55-year-old man presents to the GP with chest pain that occurs during physical exertion and is relieved by rest. He has a history of hypertension and hyperlipidaemia. What is the most likely diagnosis? 💔
A) Acute coronary syndrome
B) Stable angina
C) Pulmonary embolism
D) Aortic dissection
E) Costochondritis
Explanations & Answers:
Question Easy Answer: B) Stable angina
Question Easy Explanation: The patient’s chest pain description is characteristic of stable angina – a type of chest pain triggered by physical exertion and alleviated by rest. This condition is associated with underlying coronary artery disease and risk factors such as hypertension and hyperlipidaemia. NICE guidelines recommend management with lifestyle changes and medications such as nitrates or beta-blockers.
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Question Medium: A 70-year-old woman with a history of chronic obstructive pulmonary disease (COPD) comes into the clinic with increased breathlessness, productive cough, and wheezing. What is the most appropriate initial management? 🫁
A) High-dose long-term oxygen therapy
B) Oral corticosteroids
C) Inhaled short-acting beta-agonists
D) Antibiotics
E) Smoking cessation support
Explanations & Answers:
Question Medium Answer: C) Inhaled short-acting beta-agonists
Question Medium Explanation: In the acute exacerbation of COPD, the most immediate relief for breathlessness is provided by inhaled short-acting beta-agonists such as salbutamol. According to NICE guidelines, these medications help to open the airways and improve symptoms quickly. Other treatments, including oral corticosteroids and antibiotics, may be used depending on the specific clinical scenario and presence of respiratory infection.
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Question Hard: A 35-year-old man collapses in the park. On examination, he is found to have a tense, distended neck veins, hypotension, and muffled heart sounds. Which of the following is the most likely diagnosis? ⚕️
A) Acute myocardial infarction
B) Tension pneumothorax
C) Cardiac tamponade
D) Aortic regurgitation
E) Pulmonary hypertension
Explanations & Answers:
Question Hard Answer: C) Cardiac tamponade
Question Hard Explanation: The clinical findings suggest Beck’s triad: distended neck veins, hypotension, and muffled heart sounds, which is characteristic of cardiac tamponade. This condition occurs as a result of fluid accumulation in the pericardial space, impeding cardiac filling. This is a medical emergency requiring prompt diagnostic and therapeutic measures, such as pericardiocentesis, as advised by NHS guidelines.
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Medical fact of the day: Did you know that heart disease remains the leading cause of death in the UK, but early interventions and lifestyle modifications have significantly enhanced survival rates and quality of life in recent years?
Quote of the day: “In the heart of healing, every small act of kindness and care creates a ripple of hope and recovery.” 🌟