Angina — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

EasyPharmacology & TherapeuticsAnginaORE Part 1

A 55-year-old man with known angina develops central chest tightness during routine dental treatment. He has brought his prescribed glyceryl trinitrate (GTN) spray. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Stop treatment, seat him, and give 1–2 GTN sprays sublingually

Explanation lettering: D = shown as A · A = shown as B · B = shown as D

The correct answer is **A**. For chest tightness consistent with angina, stop treatment, allow the patient to rest in a seated position, and give their prescribed sublingual GTN. The UK SmPC specifies one or two sprays at the onset of an attack and states that the patient should rest, ideally sitting, during administration. Lying flat (B) is not the routine position and may be unsafe if GTN causes hypotension. High-flow oxygen (C) is not the primary treatment for uncomplicated angina and is reserved for hypoxaemia or other clinical indication. Intramuscular adrenaline (D) is for anaphylaxis and may increase myocardial oxygen demand. Aspirin (E) may be appropriate if myocardial infarction is suspected, but it does not replace immediate GTN-based management of a recognised angina episode.

Reference: electronic Medicines Compendium. Glyceryl Trinitrate Spray 400 micrograms/metered dose, sublingual spray: Summary of Product Characteristics, section 4.2, accessed July 2026. https://www.medicines.org.uk/emc/product/674/smpc