Clinical Medicine & Diagnosis Flashcards

A 55-year-old male presents with crushing central chest pain radiating to the left arm and jaw. What is the most likely diagnosis?

Answer: Acute myocardial infarction

Crushing central chest pain radiating to the left arm and jaw in a middle-aged male is a classic presentation of acute myocardial infarction requiring immediate assessment and treatment.

Which investigation is the gold standard for diagnosing pulmonary embolism?

Answer: CT pulmonary angiography (CTPA)

CT pulmonary angiography is the gold standard investigation for diagnosing pulmonary embolism, providing direct visualization of clots in the pulmonary arterial system.

A patient presents with polyuria, polydipsia, and unexplained weight loss. Which condition should be investigated first?

Answer: Diabetes mellitus

The classic triad of polyuria (frequent urination), polydipsia (excessive thirst), and unexplained weight loss strongly suggests diabetes mellitus, requiring blood glucose testing.

What is the first-line treatment for community-acquired pneumonia in an otherwise healthy adult in the United States?

Answer: Amoxicillin or azithromycin

For community-acquired pneumonia in healthy adults without comorbidities, amoxicillin or azithromycin (for penicillin-allergic patients) is recommended as first-line outpatient therapy.

A patient presents with sudden onset severe headache described as 'the worst headache of my life.' What is the most important diagnosis to exclude?

Answer: Subarachnoid hemorrhage

A sudden-onset severe 'thunderclap' headache described as the worst ever experienced requires urgent exclusion of subarachnoid hemorrhage, a potentially life-threatening condition.

What is the most appropriate initial investigation for suspected deep vein thrombosis?

Answer: D-dimer test combined with Wells score assessment

Initial investigation of suspected DVT involves calculating the Wells score to determine pre-test probability, combined with a D-dimer test. A positive D-dimer in a moderate/high probability patient warrants ultrasound.