Question Easy:
A 56-year-old man presents with exertional chest pain that resolves with rest. He has a history of hypertension and is a smoker. What is the most likely diagnosis? 🚶♂️💔
A) Myocardial infarction
B) Angina pectoris
C) Gastroesophageal reflux disease
D) Pulmonary embolism
E) Costochondritis
Question Medium:
A 70-year-old woman presents with shortness of breath and is found to have a pulmonary embolism. She has a history of atrial fibrillation. Which anticoagulant is the most appropriate for her initial management in the hospital? 🏥🔄
A) Aspirin
B) Warfarin
C) Rivaroxaban
D) Low molecular weight heparin
E) Fondaparinux
Question Hard:
A 45-year-old woman with systemic lupus erythematosus presents with acute dyspnea, pleuritic chest pain, and hypoxemia. A CT scan shows bilateral pulmonary infiltrates and pleural effusion. What is the most likely underlying pulmonary pathology? 🌬️💡
A) Pulmonary fibrosis
B) Pulmonary embolism
C) Lupus pneumonitis
D) Tuberculosis
E) Asthma
Explanations & Answers:
Question Easy Answer: B) Angina pectoris
Question Easy Explanation: The symptoms of exertional chest pain that resolves with rest are classic for stable angina pectoris. According to NICE guidelines, angina is usually triggered by physical exertion or emotional stress and relieved by rest or nitroglycerin.
Question Medium Answer: D) Low molecular weight heparin
Question Medium Explanation: For the initial management of a pulmonary embolism, NICE guidelines recommend low molecular weight heparin. These are preferred due to their ease of use and predictable pharmacokinetic profile compared to warfarin and other anticoagulants.
Question Hard Answer: C) Lupus pneumonitis
Question Hard Explanation: In patients with systemic lupus erythematosus presenting with acute respiratory symptoms and bilateral infiltrates, lupus pneumonitis is a likely cause. The NICE guidelines indicate that lupus can lead to inflammation of the lung tissue, causing such symptoms.
Medical fact of the day: Did you know? In the UK, cardiovascular disease is the leading cause of death, responsible for 27% of all deaths in 2019. Prevention strategies focus significantly on lifestyle modifications and early intervention.
Quote of the day: “In the heart of medicine lies compassion, where each patient is a chapter in the book of healing.” 🌟