Question Easy:
A 65-year-old man presents to the GP with chest discomfort, especially after meals or physical exertion. He describes it as a pressure-like sensation. He also experiences occasional breathlessness but has no history of smoking. What is the most likely diagnosis? 🤔
A) Pulmonary embolism
B) Gastroesophageal reflux disease (GERD)
C) Stable angina
D) Aortic stenosis
E) Pericarditis
Explanations & Answers:
Question Easy Answer: C) Stable angina
Question Easy Explanation: Angina presents as a pressure-like discomfort usually brought on by physical exertion or heavy meals due to reduced blood flow to the heart. Unlike GERD, which often causes burning sensations, angina’s pain is typically more gripping and is relieved by rest or nitroglycerin. NICE guidelines recommend considering the typical symptoms and triggers in these cases.
Question Medium:
A 40-year-old female presents with a cough productive of green sputum, wheezing, and shortness of breath on exertion. She mentions having had similar episodes in the past, especially during the winter months. What is the most likely diagnosis? 🤔
A) Chronic obstructive pulmonary disease (COPD)
B) Asthma
C) Acute bronchitis
D) Bronchiectasis
E) Pneumonia
Explanations & Answers:
Question Medium Answer: B) Asthma
Question Medium Explanation: Asthma is characterized by episodes of wheezing, breathlessness, and cough, often with sputum production. This is typically exacerbated by triggers such as infections, cold weather, and exercise. NHS guidelines highlight these patterns, and compared to COPD, asthma often begins earlier in life with episodic symptoms.
Question Hard:
A 58-year-old woman with a history of long-standing hypertension and hypercholesterolemia presents with sudden onset chest pain radiating to her back. Her blood pressure is 220/110 mmHg, and she is diaphoretic. Which diagnostic imaging is most appropriate to confirm the suspected diagnosis? 🚨
A) CT Pulmonary Angiogram
B) Transthoracic Echocardiogram
C) CT Chest without contrast
D) MRI Chest
E) CT Angiogram of the Aorta
Explanations & Answers:
Question Hard Answer: E) CT Angiogram of the Aorta
Question Hard Explanation: The presentation suggests the possibility of an aortic dissection, particularly with the sudden onset of chest pain radiating to the back and severe hypertension. NICE guidelines recommend a CT Angiogram of the Aorta as the gold standard for diagnosing aortic dissection due to its rapid acquisition and high sensitivity.
Medical fact of the day: The average human lung is home to more than 300 million alveoli, which would cover the size of a tennis court if spread out flat! This intricate structure is pivotal for effective gas exchange.
Quote of the day: “In the art of healing, the heart beats louder than the hands, for it is compassion that weaves the fabric of care.”