Question Easy:
A 60-year-old man presents to his GP with complaints of chest pain on exertion that resolves with rest. He has a history of smoking and high cholesterol. What is the most likely diagnosis?
A) Gastroesophageal reflux disease (GERD)
B) Stable angina
C) Myocardial infarction
D) Peptic ulcer disease
E) Costochondritis
Question Medium:
A 45-year-old woman with a BMI of 32 and a history of hypertension presents with increased breathlessness over the past 6 months. On examination, you hear diffuse wheeze and reduced breath sounds bilaterally. Her peak expiratory flow rate is consistently low. What is the most likely diagnosis?
A) Asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Pulmonary embolism
D) Heart failure
E) Pneumonia
Question Hard:
A 70-year-old man is admitted to the hospital with worsening shortness of breath and peripheral edema. He has a past medical history of heart failure with reduced ejection fraction, type 2 diabetes, and chronic kidney disease stage 3. Examining his medication list, which of the following is most likely contributing to his symptom exacerbation?
A) Furosemide
B) Bisoprolol
C) Lisinopril
D) Metformin
E) Diltiazem
Explanations & Answers:
Question Easy Answer: B) Stable angina
Question Easy Explanation: Stable angina is chest pain that occurs predictably with exertion and resolves with rest, often associated with coronary artery disease. This is supported by the patient’s history of smoking and hypercholesterolemia, common risk factors according to NICE guidelines. 🚶♂️💓
Question Medium Answer: B) Chronic obstructive pulmonary disease (COPD)
Question Medium Explanation: COPD is likely given the patient’s risk factors, including obesity and hypertension, coupled with the chronic symptom of breathlessness and reduced breath sounds on examination. Persistent, low peak expiratory flow readings also align with COPD, differentiating it from asthma which often displays variability. 🫁🌬️
Question Hard Answer: E) Diltiazem
Question Hard Explanation: Diltiazem, a calcium channel blocker, may contribute to worsening heart failure symptoms, particularly fluid retention and exacerbation of heart failure, as it can reduce cardiac contractility and exacerbate heart failure symptoms, especially in the context of heart failure with reduced ejection fraction per BNF guidelines. 💊⚠️
Medical fact of the day: Did you know that the UK has one of the highest rates of asthma in Europe? Asthma affects over 5.4 million people in the UK, underscoring the importance of proper management and education. 🌍🇬🇧
Quote of the day: “In every heartbeat lies a rhythm of hope; each breath fuels the journey of healing. Keep the faith, for your work changes lives.” ❤️✨