Question Easy:
A 65-year-old man with a history of chronic obstructive pulmonary disease (COPD) presents with increasing breathlessness, a cough, and production of purulent sputum. His temperature is 38°C, and respiratory rate is 24/min. Considering his condition, which is the most appropriate initial antibiotic therapy?
A) Amoxicillin
B) Metronidazole
C) Ciprofloxacin
D) Erythromycin
E) Co-amoxiclav
Explanations & Answers:
Question Easy Answer: A) Amoxicillin
Question Easy Explanation: In the UK, the NICE guidelines recommend amoxicillin as a first-line treatment for an exacerbation of COPD with suspected bacterial infection. This choice aligns with common pathogens involved and considers antibiotic resistance patterns.
Question Medium:
A 58-year-old woman presents with palpitations and shortness of breath that started suddenly. On examination, her heart rate is 160 bpm, and ECG shows narrow complex tachycardia. What is the first-line management to revert her to sinus rhythm?
A) Amiodarone
B) Adenosine
C) Carotid sinus massage
D) Verapamil
E) Digoxin
Question Medium Answer: B) Adenosine
Question Medium Explanation: According to NICE guidelines, adenosine is the first-line treatment for stable patients with narrow complex tachycardia (SVT). It’s preferred for its rapid action and effectiveness in reverting to sinus rhythm. In cases where adenosine is contraindicated or unsuitable, a carotid sinus massage can also be attempted.
Question Hard:
A 45-year-old male presents with chest pain radiating to his back, described as tearing in nature. His blood pressure shows a disparity between the left and right arm. Which of the following diagnoses is most likely?
A) Myocardial infarction
B) Pneumothorax
C) Aortic dissection
D) Pulmonary embolism
E) Acute pericarditis
Question Hard Answer: C) Aortic dissection
Question Hard Explanation: The tearing chest pain radiating to the back, combined with a blood pressure differential between arms, is classic for aortic dissection. Immediate imaging, such as a CT angiogram, is crucial for diagnosis. It is a medical emergency requiring urgent intervention.
Medical fact of the day: Did you know? The human lungs, if unfolded and spread out, could cover a tennis court. The incredible surface area facilitates efficient gas exchange, vital for breathing and oxygenating blood. 🌬️
Quote of the day: “In the tapestry of life, every small action we take as healthcare providers weaves a thread of hope and healing. Be proud of your contributions to this great mosaic.”