Question Easy:
A 67-year-old man visits the GP with symptoms of breathlessness and swollen ankles. He has a history of coronary artery disease. What is the most likely diagnosis?
A) Asthma
B) Heart failure
C) Pulmonary embolism
D) Atrial fibrillation
E) Pneumonia
Question Medium:
A 55-year-old woman with a history of asthma is brought to the emergency department with severe shortness of breath, wheezing, and a persistent cough. Despite using her inhaler multiple times, she hasn’t improved. Which medication is most appropriate to administer first?
A) Oral prednisolone
B) Inhaled salbutamol
C) Intravenous aminophylline
D) Subcutaneous adrenaline
E) Intravenous hydrocortisone
Question Hard:
A 48-year-old male presents with progressive exertional dyspnoea, chronic cough, and a history of occupational exposure to asbestos. His chest X-ray shows pleural plaques. What is the most likely diagnosis?
A) Mesothelioma
B) Asbestosis
C) Silicosis
D) Chronic bronchitis
E) Bronchiectasis
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: The symptoms of breathlessness and swollen ankles in a patient with a history of coronary artery disease are classic signs of heart failure, as per NICE guidelines. Heart failure often presents with fluid retention, leading to peripheral oedema and dyspnea due to pulmonary congestion.
Question Medium Answer: B
Question Medium Explanation: In an acute asthma exacerbation, inhaled salbutamol, a short-acting beta-agonist, is the first-line treatment as recommended by the British Thoracic Society guidelines. It rapidly relieves bronchoconstriction, allowing for immediate relief from symptoms.
Question Hard Answer: B
Question Hard Explanation: The presence of pleural plaques and a history of asbestos exposure are indicative of asbestosis, an interstitial lung disease resulting from inhalation of asbestos fibers. Mesothelioma, while also related to asbestos exposure, is a malignant condition and would not present purely with pleural plaques without further malignant signs.
Medical fact of the day: Did you know that the UK has one of the highest rates of asthma worldwide? Approximately 5.4 million people are currently receiving treatment for asthma in the UK. Early diagnosis and proper management are key components in reducing hospital admissions and improving quality of life.
Quote of the day: “In the tapestry of healthcare, even a single thread of kindness can weave a masterpiece of hope and healing.” 🌟