Question Easy: 😃
A 65-year-old man with a history of hypertension presents to the GP surgery with complaints of ankle oedema. His current medication includes ramipril. Which drug is most likely contributing to his ankle swelling?
A) Lisinopril
B) Amlodipine
C) Bisoprolol
D) Spironolactone
E) Furosemide
Explanations & Answers:
Question Easy Answer: B) Amlodipine
Question Easy Explanation: Amlodipine, a calcium channel blocker, is known to cause peripheral oedema, particularly ankle swelling, due to vasodilation. It is a common side effect and a key consideration when prescribing.
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Question Medium: 🤔
A 55-year-old woman with chronic obstructive pulmonary disease (COPD) is admitted to the hospital with an acute exacerbation. She is on her maximum dose of inhaled long-acting beta-agonists and long-acting muscarinic antagonists. What is the next step in pharmacological management according to NICE guidelines?
A) Add oral corticosteroids
B) Add oral theophylline
C) Add nebulised salbutamol
D) Initiate continuous oxygen therapy
E) Start intravenous antibiotics
Explanations & Answers:
Question Medium Answer: A) Add oral corticosteroids
Question Medium Explanation: According to NICE guidelines, during an acute exacerbation of COPD, oral corticosteroids like prednisolone are often added to manage inflammation. They are typically given for 5 to 7 days to improve recovery time and lung function.
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Question Hard: 😤
A 45-year-old woman with a known history of pulmonary embolism is currently on warfarin therapy. She is admitted with a new episode of deep vein thrombosis (DVT). Her INR is subtherapeutic. What is the most appropriate immediate management?
A) Increase the dose of warfarin
B) Start intravenous heparin
C) Start rivaroxaban instead of warfarin
D) Administer fresh frozen plasma
E) Continue warfarin and re-check INR in 24 hours
Explanations & Answers:
Question Hard Answer: B) Start intravenous heparin
Question Hard Explanation: If a patient on warfarin develops a new thrombotic event and the INR is subtherapeutic, immediate anticoagulation is necessary. Heparin, typically low-molecular-weight heparin (LMWH), provides rapid anticoagulation and is started until the INR reaches therapeutic levels.
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Medical fact of the day: Did you know? In the UK, cardiovascular disease accounts for nearly one in four deaths. However, prevention through lifestyle changes like a healthy diet and regular physical activity can significantly reduce this risk.
Quote of the day: “In every challenge faced and every life touched, health care workers find the strength to inspire a healthier tomorrow.”