Question Easy:
A 55-year-old man presents with crushing chest pain radiating to his left arm. He feels nauseous and sweaty. What is the most immediate step in management?
A) Perform an ECG
B) Administer aspirin
C) Administer sublingual GTN
D) Administer oxygen
E) Reassure the patient
Question Medium:
A 70-year-old woman with COPD is admitted with increasing breathlessness and productive cough, suggesting an infective exacerbation. Chest X-ray shows hyperinflation but no focal consolidation. She is hypoxic with an oxygen saturation of 86% on air. What is the most appropriate initial oxygen therapy?
A) Non-rebreather mask at 15 L/min
B) Nasal cannula at 2 L/min
C) Venturi mask at 28%
D) Simple face mask at 5 L/min
E) Bag-valve mask ventilation
Question Hard:
A 52-year-old patient with known atrial fibrillation presents with palpitations. Their ECG shows an irregularly irregular rhythm with no discernible P waves and a ventricular rate of 160 bpm. What is the most appropriate long-term treatment to reduce the risk of stroke for this patient?
A) Warfarin
B) Aspirin
C) Beta-blocker
D) Digoxin
E) Diltiazem
Explanations & Answers:
Question Easy Answer: B
Question Easy Explanation: In the case of suspected myocardial infarction, the immediate administration of aspirin (300 mg) is crucial as it works to inhibit platelet aggregation, reducing further thrombus formation. This aligns with NICE guidelines for initial NSTEMI/STEMI management. 🚑
Question Medium Answer: C
Question Medium Explanation: For COPD patients experiencing an exacerbation, controlled oxygen therapy via a Venturi mask at 28% is recommended initially, aiming for target saturations of 88-92% according to BTS and NICE guidelines. This prevents carbon dioxide retention and potential respiratory acidosis. 🌬️
Question Hard Answer: A
Question Hard Explanation: Warfarin is the most appropriate long-term treatment for stroke prevention in patients with atrial fibrillation, especially if they have high CHA2DS2-VASc scores. NICE guidelines recommend anticoagulation for stroke risk reduction in such patients, prioritizing newer oral anticoagulants (NOACs) unless contraindicated or unavailable. 🔄
Medical fact of the day: Did you know? Chronic obstructive pulmonary disease (COPD) is one of the leading causes of hospital admissions and readmissions in the UK, emphasizing the critical need for early diagnosis and proper management strategies. 🏥
Quote of the day: “In the realm of medicine, every moment of caring breathes life into hope and healing.” 🌟