Question Easy: A 72-year-old man presents to the GP with complaints of shortness of breath and wheezing. On examination, he has bilateral wheezes and reduced breath sounds. He has a significant smoking history of 40 pack-years. What is the most likely diagnosis? 🚬
A) Asthma
B) Chronic Obstructive Pulmonary Disease (COPD)
C) Pulmonary Embolism
D) Pneumonia
E) Congestive Heart Failure
Explanations & Answers:
Question Easy Answer: B) Chronic Obstructive Pulmonary Disease (COPD)
Question Easy Explanation: The patient’s smoking history and symptoms align with COPD, which is characterised by long-term breathing problems and poor airflow. NICE guidelines highlight smoking as a significant risk factor for COPD, which often presents with wheezing and reduced breath sounds in older adults.
Question Medium: A 58-year-old woman presents to the emergency department with acute chest pain and dyspnea at rest. Her ECG shows ST-segment elevation in leads II, III, and aVF. What is the most appropriate initial management? 🚑
A) Intravenous morphine
B) Aspirin
C) Sublingual glyceryl trinitrate
D) Percutaneous coronary intervention (PCI)
E) Oxygen therapy
Question Medium Answer: D) Percutaneous coronary intervention (PCI)
Question Medium Explanation: The patient is experiencing an ST-Elevation Myocardial Infarction (STEMI). According to NICE guidelines, PCI is the most appropriate initial management in this scenario as it directly addresses the occluded coronary artery, restoring blood flow. Immediate revascularization is crucial for improving outcomes in STEMI patients.
Question Hard: A 45-year-old man presents with a 3-month history of progressive dyspnea, dry cough, and weight loss. High-resolution CT of the chest shows a honeycombing pattern with reticular abnormalities. Which of the following conditions is most strongly associated with these findings? 🔍
A) Pulmonary Fibrosis
B) Sarcoidosis
C) Interstitial Lung Disease due to Connective Tissue Disease
D) Tuberculosis
E) Mesothelioma
Question Hard Answer: A) Pulmonary Fibrosis
Question Hard Explanation: The honeycombing pattern on high-resolution CT is indicative of pulmonary fibrosis, particularly usual interstitial pneumonia (UIP), which is a pattern commonly associated with idiopathic pulmonary fibrosis (IPF). According to NHS guidance, UIP is the most common form of pulmonary fibrosis and is associated with progressive worsening of lung function.
Medical fact of the day: The UK has one of the highest rates of asthma in the world, with around 5.4 million people currently receiving treatment for the condition according to Asthma UK. Proper management and treatment can significantly reduce asthma-related hospitalisations.
Quote of the day: “The strength of a healthcare professional lies not only in knowledge but in the compassion they extend to those in their care.”