Question Easy:
A 65-year-old man visits his GP with a complaint of breathlessness and a persistent cough. He smokes 20 cigarettes a day and has done so for the last 40 years. Which of the following is the most likely diagnosis?
A) Asthma
B) Chronic Obstructive Pulmonary Disease (COPD)
C) Pneumonia
D) Lung cancer
E) Congestive heart failure
Question Medium:
A 52-year-old woman presents to the emergency department with sudden onset chest pain and dyspnoea. Her ECG shows ST-elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
A) Left anterior descending artery
B) Right coronary artery
C) Circumflex artery
D) Left main coronary artery
E) Posterior descending artery
Question Hard:
A 40-year-old man comes to the clinic with palpitations. His ECG shows a regular narrow complex tachycardia with a rate of 200 bpm. He has no significant past medical history. What is the most appropriate initial management in this case?
A) Start IV amiodarone
B) Administer IV adenosine
C) Perform Valsalva maneuver
D) Perform carotid sinus massage
E) Start IV digoxin
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: COPD is most likely given the patient’s significant smoking history and symptoms of persistent cough and breathlessness, aligning with NICE guidelines on COPD diagnosis which emphasize smoking as a major risk factor.
Question Medium Answer: B
Question Medium Explanation: ST-elevation in leads II, III, and aVF suggest an inferior myocardial infarction due to occlusion of the right coronary artery, in accordance with NICE guidelines on managing acute coronary syndromes.
Question Hard Answer: C
Question Hard Explanation: For a regular narrow complex tachycardia, the Valsalva maneuver is an initial, non-invasive management option. It is recommended by NICE guidelines before proceeding to pharmacological interventions, such as adenosine.
Medical fact of the day: The UK has one of the highest rates of asthma in Europe, and it is estimated that approximately 5.4 million people in the UK are currently receiving treatment for asthma, emphasizing the need for effective management strategies.
Quote of the day: “In the tapestry of care, every thread you weave brings warmth and healing to those you touch.”