Free APEA On-Demand Lectures Questions and Answers 1 — Questions and Answers
Question 1: A 45-year-old female with a history of type 2 diabetes presents with persistent cough and shortness of breath. An X-ray shows an opacity in the right upper lobe. Which of the following is the most likely diagnosis?
- Bronchitis
- Pneumonia
- Lung cancer (Correct answer)
- Pulmonary embolism
Correct answer: Lung cancer
A 45-year-old female with a history of type 2 diabetes presenting with persistent cough, shortness of breath, and an opacity in the right upper lobe on X-ray, raises significant concern for lung cancer. While pneumonia or bronchitis could cause similar symptoms and X-ray findings, the persistence of symptoms and the patient's age, along with the potential for diabetes to be a comorbidity, make lung cancer a critical consideration that requires further investigation.
Question 2: A patient presents with a painful, swollen knee and reports fever and chills. The knee is red, warm to the touch, and has decreased range of motion. What is the most likely diagnosis?
- Osteoarthritis
- Septic arthritis (Correct answer)
- Gout
- Rheumatoid arthritis
Correct answer: Septic arthritis
A painful, swollen, red, and warm knee with decreased range of motion, accompanied by systemic symptoms like fever and chills, is highly indicative of septic arthritis. This is a medical emergency caused by a bacterial infection within the joint space. Prompt diagnosis and treatment are crucial to prevent irreversible joint damage and systemic spread of the infection.
Question 3: A 30-year-old female presents with palpitations, weight loss, and heat intolerance. On examination, she has a diffusely enlarged thyroid. What is the most likely diagnosis?
- Hashimoto's thyroiditis
- Graves' disease (Correct answer)
- Thyroid nodule
- Subacute thyroiditis
Correct answer: Graves' disease
The constellation of symptoms including palpitations, weight loss, heat intolerance, and a diffusely enlarged thyroid (goiter) in a 30-year-old female is classic for Graves' disease. Graves' disease is an autoimmune disorder that causes hyperthyroidism, where the thyroid gland produces excessive amounts of thyroid hormones. These hormones accelerate the body's metabolism, leading to the observed symptoms.
Question 4: A 65-year-old male with a history of hypertension and smoking presents with sudden vision loss in the left eye. What is the most likely diagnosis?
- Retinal detachment
- Central retinal artery occlusion (Correct answer)
- Age-related macular degeneration
- Cataracts
Correct answer: Central retinal artery occlusion
Sudden, painless vision loss in one eye in an older male with a history of hypertension and smoking is highly suggestive of a central retinal artery occlusion (CRAO). This condition is often referred to as a 'stroke of the eye' and occurs when the main artery supplying blood to the retina becomes blocked, typically by an embolus. The risk factors of hypertension and smoking contribute to the development of atherosclerosis, which can lead to such occlusions.
Question 5: Which of the following is the first-line treatment for newly diagnosed hypertension in an otherwise healthy adult?
- Beta-blockers
- ACE inhibitors (Correct answer)
- Calcium channel blockers
- Diuretics
Correct answer: ACE inhibitors
ACE inhibitors are often recommended as first-line therapy for newly diagnosed hypertension in otherwise healthy adults, especially those under 60, due to their efficacy in lowering blood pressure and favorable impact on cardiovascular outcomes. They are particularly beneficial in patients with comorbid conditions like diabetes or chronic kidney disease, but are also a strong initial choice for general hypertension management.
A 45-year-old female with a history of type 2 diabetes presents with persistent cough and shortness of breath.
An X-ray shows an opacity in the right upper lobe.
Which of the following is the most likely diagnosis?