Question Easy:
A 55-year-old man presents with chest pain that came on while walking his dog. The pain is relieved by rest and a sublingual tablet he was given. What is the most likely diagnosis? 🚶♂️❤️
A) Myocardial infarction
B) Pulmonary embolism
C) Angina pectoris
D) Gastroesophageal reflux disease
E) Pneumothorax
Question Medium:
A 70-year-old woman with a history of long-standing hypertension and diabetes presents with progressively worsening shortness of breath, orthopnea, and paroxysmal nocturnal dyspnea. She has bilateral basal crackles on auscultation. 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 34-year-old female presents with an acute onset of breathlessness and pleuritic chest pain. She has a history of taking oral contraceptive pills. On examination, she is tachycardic and has a slightly elevated respiratory rate. Her chest X-ray is normal. What is the most likely diagnosis? 🏃♀️❗
A) Spontaneous pneumothorax
B) Acute pericarditis
C) Pulmonary embolism
D) Myocarditis
E) Anxiety attack
Explanations & Answers:
Question Easy Answer:
C) Angina pectoris
Question Easy Explanation:
The presentation of chest pain induced by exertion and relieved by rest and nitroglycerin (sublingual tablets) is classic for angina pectoris. This is due to myocardial ischemia caused by an imbalance between cardiac oxygen supply and demand, typically due to coronary artery disease.
Question Medium Answer:
C) Heart failure
Question Medium Explanation:
The symptoms of worsening shortness of breath, orthopnea, and paroxysmal nocturnal dyspnea, along with bilateral basal crackles, are indicative of heart failure, likely due to left ventricular dysfunction. This aligns with NICE guidelines assessing symptomatic heart failure.
Question Hard Answer:
C) Pulmonary embolism
Question Hard Explanation:
The acute onset of breathlessness and pleuritic chest pain in a young woman on oral contraceptives, combined with a normal chest X-ray, is suggestive of a pulmonary embolism. The hypercoagulable state induced by contraceptive pills places her at risk. This is consistent with NHS guidelines on thromboembolic disease.
Medical fact of the day:
Did you know that in the UK, heart failure affects about 920,000 people, making it a significant public health challenge? It often has a greater impact on quality of life than many other chronic conditions and is a major cause of hospital admissions.
Quote of the day:
“Every heartbeat counts, and with each breath, we have the power to heal. Let compassion be the rhythm of your practice and courage the pace of your learning.”