Question Easy:
A 58-year-old man with a history of hypertension presents with chest pain that radiates to his left arm and jaw. He describes the pain as a heavy, crushing sensation that started while he was watching television. Which of the following is the most likely diagnosis?
A) Stable angina
B) Myocardial infarction
C) Aortic dissection
D) Pulmonary embolism
E) Pericarditis
Question Medium:
A 67-year-old woman with a history of chronic obstructive pulmonary disease (COPD) is brought to the emergency department with increased shortness of breath, wheezing, and productive cough. She reports increased sputum production over the past three days. Which of the following is the most appropriate initial treatment?
A) Oral steroids
B) Antibiotics
C) Beta-blockers
D) Inhaled beta-agonists
E) Oxygen therapy
Question Hard:
A 45-year-old male with dilated cardiomyopathy presents with dizziness, palpitations, and syncope. His ECG shows a wide QRS complex tachycardia at a rate of 180 beats per minute. Which of the following is the most appropriate next step in management?
A) Adenosine IV
B) Amiodarone IV
C) Digoxin PO
D) Cardioversion
E) Verapamil IV
Explanations & Answers:
Question Easy Answer: B) Myocardial infarction
Question Easy Explanation: The patient’s symptoms of chest pain radiating to the left arm and jaw, described as a heavy, crushing sensation, are classic signs of a myocardial infarction (heart attack) according to NICE guidelines. Immediate medical attention is crucial.
Question Medium Answer: D) Inhaled beta-agonists
Question Medium Explanation: In a COPD exacerbation, NICE guidelines highlight the importance of bronchodilators like inhaled beta-agonists as an initial treatment to relieve bronchospasm and improve airflow. Antibiotics may be considered if a bacterial infection is suspected.
Question Hard Answer: D) Cardioversion
Question Hard Explanation: In a patient with dilated cardiomyopathy experiencing a wide QRS complex tachycardia with hemodynamic instability (dizziness, palpitations, syncope), electrical cardioversion is recommended as per NHS guidelines to restore normal rhythm.
Medical fact of the day: Did you know that over 7 million people in the UK live with cardiovascular disease, which is one of the leading causes of death, accounting for nearly 25% of all deaths?
Quote of the day: “In every heart that cares beats the pulse of a better tomorrow. Keep that rhythm strong and steady.” 🌟