Question Easy: 🚑 A 65-year-old man with a history of hypertension presents with sudden chest pain radiating to the left arm. He feels nauseous and clammy. What is the most appropriate first step in management?
A) Nitroglycerin
B) Aspirin
C) Morphine
D) Oxygen
E) Beta-blocker
Question Medium: 🌬️ A 23-year-old woman presents with episodic shortness of breath, wheezing, and a chronic non-productive cough. This typically occurs at night or in the early morning. Which of the following is the most appropriate initial test for diagnosis?
A) Chest X-ray
B) Peak flow measurement
C) Sputum culture
D) Spirometry
E) CT scan
Question Hard: 💔 A 56-year-old woman presents with fatigue, peripheral oedema, and nocturnal dyspnoea. Her ECG shows left bundle branch block, and echocardiography reveals a dilated left ventricle with an ejection fraction of 30%. What is the most appropriate next step in her management?
A) Digoxin
B) Loop diuretic
C) Beta-blocker
D) ACE inhibitor
E) Cardiac resynchronisation therapy
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: In the case of suspected myocardial infarction (MI), the priority is to administer aspirin to reduce platelet aggregation, thus lowering the risk of further clot expansion. According to NICE guidelines, immediate aspirin administration is crucial while awaiting further assessment and management.
Question Medium Answer: B
Question Medium Explanation: Peak flow measurement is a simple yet effective initial test for diagnosing asthma, especially when symptoms are episodic and associated with triggers. It provides an easy way to assess airflow obstruction, common in asthma, aligning with NHS recommendations for initial asthma evaluation.
Question Hard Answer: D
Question Hard Explanation: For heart failure with reduced ejection fraction (HFrEF), an ACE inhibitor is recommended as part of the standard treatment regime. NICE guidelines suggest starting an ACE inhibitor alongside a beta-blocker to improve survival and symptoms in patients with a reduced ejection fraction, particularly with evidence of heart failure symptoms.
Medical fact of the day: Did you know that the UK has one of the highest incidences of asthma in the world, with approximately 5.4 million people currently receiving treatment? This emphasizes the importance of understanding and managing respiratory conditions effectively in UK medical practice.
Quote of the day: “In every heart beating with purpose, lies a healthcare hero ready to inspire change. Keep believing in the power of healing.”