A 65-year-old man presents for follow-up at the hypertension clinic. He is currently on a regimen of amlodipine and ramipril and has no significant medical history. He regularly checks his blood pressure at home and brings in a printed spreadsheet of his readings. What is the recommended target blood pressure for these home measurements?
A 58-year-old woman who has just been diagnosed with hypertension wants to know your opinion on salt consumption. What would be the most suitable answer based on the latest available evidence?
You assess a 63-year-old man who has recently been released from a hospital in Hungary after experiencing a heart attack. He presents a copy of an echocardiogram report indicating that his left ventricular ejection fraction is 38%. During the examination, you note that his pulse is regular at 78 beats per minute, his blood pressure is 124/72 mmHg, and his chest is clear. He is currently taking aspirin, simvastatin, and lisinopril. What would be the most appropriate course of action regarding his medication?
A 26-year-old female comes to her GP complaining of feeling tired and experiencing episodes of dizziness. During the examination, the GP observes an absent pulse in the patient’s left radial artery. The following blood test results are obtained:
– Sodium (Na+): 136 mmol/l
– Potassium (K+): 4.1 mmol/l
– Urea: 2.3 mmol/l
– Creatinine: 77 µmol/l
– Erythrocyte sedimentation rate (ESR): 66 mm/hr
Based on these findings, what is the most likely diagnosis?
You are conducting a medication review for a 65-year-old man who has a history of cerebrovascular disease (having suffered a stroke 2 years ago), depression, and knee osteoarthritis. He is currently taking the following medications:
– Clopidogrel 75 mg once daily
– Simvastatin 20 mg once daily
– Amlodipine 5mg once daily
– Ramipril 10 mg once daily
– Diclofenac 50 mg as needed
– Sertraline 50 mg once daily
What changes would you recommend to his medication regimen?
You assess a patient who has been hospitalized with a non-ST elevation myocardial infarction in the ED. They have been administered aspirin 300 mg stat and glyceryl trinitrate spray (2 puffs). As per the latest NICE recommendations, which patients should be given ticagrelor?
A 67-year-old woman presents to the emergency department with a 3-day history of pain and swelling in her left lower leg. She denies any recent injury.
Upon examination, you observe that her left calf is swollen and red, measuring 3 cm larger in diameter than the right side. She experiences localised tenderness along the deep venous system.
Based on your clinical assessment, you suspect a deep vein thrombosis (DVT) and order blood tests, which reveal a D-Dimer level of 900 ng/mL (< 400). You initiate treatment with therapeutic doses of apixaban and schedule a proximal leg ultrasound for the next day. However, the ultrasound doesn’t detect any evidence of a proximal leg DVT. What is the most appropriate course of action?
Which one of the following would not be considered a normal variant on the ECG of an athletic 29-year-old man?
A 68-year-old man presents for follow-up of his atrial fibrillation. He recently underwent catheter ablation for atrial fibrillation and it was successful.
The patient has a medical history of hypertension and type 2 diabetes. His most recent blood pressure reading was 150/92 mmHg.
What is the optimal approach for managing his anticoagulation?
A 75-year-old man visits his GP for a follow-up appointment 6 weeks after undergoing catheter ablation due to unresponsive atrial fibrillation despite antiarrhythmic treatment. He has a medical history of asthma, which he manages with a salbutamol reliever and beclomethasone preventer inhaler, and type II diabetes, which he controls through his diet. The patient is currently receiving anticoagulation therapy in accordance with guidelines. There are no other significant medical histories.
What should be the next course of action in his management?