Adult Health Flashcards
A 22 year old female with no background medical history, except smoking, and use of the oral contraceptive pill, presents with sharp left-sided sub-mammary pain. It started 3 days before, is not worse with exertion, and lasts up to 30 seconds at a time. It does not radiate, and is not worse with exertion. Examination reveals all pulses present, P64 reg, BP 110/74, JVP not elevated, heart sounds normal, chest clear with respiratory rate 14/min, but localised tenderness under her left breast
Please select the correct diagnosis from the list below.
A. Pleuritic Pain B. Pneumothorax C. Pulmonary Embolism D. Reflux Oesophagitis E. Acute Coronary Syndrome F. Dissecting Aortic Aneurysm G. Pericarditis H. Costochondritis
H?
Costochondritis
A 56 year old man, who is a diabetic on oral agents and hypertensive, presents with sweating, nausea and mild parasthesia in his left hand which started 4 hours before. Clinically there are no significant findings except a regular pulse rate of 40/min, BP 90/50, JVP 8cm above sternal angle, and bibasal crackles.
Please select the correct diagnosis from the list below. A. Pleuritic Pain B. Pneumothorax C. Pulmonary Embolism D. Reflux Oesophagitis E. Acute Coronary Syndrome F. Dissecting Aortic Aneurysm G. Pericarditis H. Costochondritis
E
Acute Coronary Syndrome
A 74 year old man with a history of hypertension and intermittent claudication presents with severe central chest pain, radiating to his back. Examination reveals absent left arm pulses and weak femoral and absent foot pulses bilaterally. BP 102/46, JVP elevated 6cm above sternal angle, and an early diastolic murmur along the left sternal border.
Please select the correct diagnosis from the list below. A. Pleuritic Pain B. Pneumothorax C. Pulmonary Embolism D. Reflux Oesophagitis E. Acute Coronary Syndrome F. Dissecting Aortic Aneurysm G. Pericarditis H. Costochondritis
F?
Dissecting Aortic Aneurysm
A 47 year old asthmatic presents with sharp right sided chest pain for one day. She was well until 3 days before when she returned from a trip to the United Kingdom. Just before returning, she started developing a wheeze, and she needed to increase the use of her B-agonist inhaler. She also complains of blood stained sputum. The pain is worse on inspiration. Examination reveals pulse 104 reg, all present, BP 98/50, JVP not elevated, respiratory rate 30/min and chest equal air entry but with mild prolonged expiration.
Please select the correct diagnosis from the list below. A. Pleuritic Pain B. Pneumothorax C. Pulmonary Embolism D. Reflux Oesophagitis E. Acute Coronary Syndrome F. Dissecting Aortic Aneurysm G. Pericarditis H. Costochondritis
C
Pulmonary Embolism
What of the following features on ECG is usually first to appear during an Acute Myocardial Infarction: A. ST depression B. ST elevation C. T wave inversion D. Q waves
B
ST elevation
Which of the following is NOT an AIDS defining illness: A. Cryptococcal Meningitis B. Kaposi’s Sarcoma C. Pulmonary Tuberculosis D. Pneumocystis Pneumonia
C
Pulmonary Tuberculosis
Which one of the following is NOT associated with a flapping tremor (asterixis)? A. Respiratory Failure B. Renal Failure C. Liver Failure D. Cardiac Failure
D
Cardiac Failure
Which of the following is one of the most common causes of chronic renal failure?
A. SLE
B. Amyloidosis
C. Diabetes Mellitus
D. Post-Streptococcal Glomerulonephritis
C
Diabetes Mellitus
Which one of the follow is the most worrying symptom in an Asthmatic presenting with a “tight chest” ie. sign of acute severe asthma? A. Silent Chest B. Pulse Rate 92/min C. Diffuse Wheezing D. Respiratory Rate 26/min
A
Silent Chest
Which of the following clinical signs would most usefully differentiate cardiac failure from pneumonia in a patient presenting with dyspnoea? A. Raised JVP B. Productive cough C. Cyanosis D. Basal Crackles
A
Raised JVP
A homeless man was brought to Groote Schuur Hospital casualty with reduced level of consciousness (coma). Which of the following conditions may explain his clinical presentation? A. Epileptic seizure B. Hypoglycaemia C. Head injury D. All are possible
D
All are possible
Which of the following agent(s)/condition(s) are NOT recognized causes of diarrhoea?
A. Inflammatory bowel disease (Crohn’s disease and Ulcerative colitis)
B. Bacterial infections like Salmonella and Shigella
C. Reflux oesophagitis
D. Antibiotics
C
Reflux oesophagitis
A 48 year old man from Gugulethu (Cape Town Township) was referred from the day hospital with a 2 month history of progressive shortness of breath, fever, productive cough, and 15 Kg weight loss. A chest X-ray shows right upper lobe infiltrates with cavitation. The most likely diagnosis is, A. Pneumococcal pneumonia B. Pulmonary tuberculosis C. Pulmonary oedema D. Malignant pleural effusion
B
Pulmonary tuberculosis
An elderly woman was seen at the Cardiac clinic with recent onset angina and reduced effort tolerance for 3 weeks. She was found to be pale with an ejection systolic murmur (flow murmur), but was otherwise stable. Her blood investigations were as follows; Hb 6.8 MCV 58 WBC 7.5 Platelets 590. What is the likely cause of her anaemia?
A. Folate deficiency
B. Anaemia of chronic disorders
C. Iron deficiency from chronic blood loss.
D. Vitamin B12 deficiency
B
Anaemia of chronic disorders
A fifth year medical student presented at student health with a history of abdominal pain, haematemesis and melaena for 24 hours. She is not on any medication, other than ibuprofen (NSAIDs) for her monthly periods. On examination she was stable with a normal BP and pulse. Which is the most likely cause of her bleed? A. Rectal cancer B. Duodenal ulcer C. Sigmoid colon polyp D. Diverticular disease
B
Duodenal ulcer
A fifth year medical student presented at student health with a history of abdominal pain, haematemesis and melaena for 24 hours. She is not on any medication, other than ibuprofen (NSAIDs) for her monthly periods. On examination she was stable with a normal BP and pulse. Which is the best investigation to determine the cause of gastrointestinal bleeding in this patient? A. Barium enema B. Gastroscopy C. Colonoscopy D. Colonoscopy and barium enema
B
Gastroscopy
An elderly man (78 years) has recent onset constipation, fresh rectal bleeding and 20 kg weight loss. A chest X-ray shows evidence of metastasis. Which of the following is the likely cause of his symptoms? A. Pancreatic cancer B. Colorectal carcinoma C. Gastric carcinoma D. Prostate cancer
B
Colorectal carcinoma
A 14 year old boy from the Cape flats is referred by his General Practitioner with blood in his urine and a high blood pressure. On examination he was found to have pitting oedema, infected scabies rash and BP 170/100 mmHg. Urinalysis showed 3+ proteins and 4+ blood. What is the likely cause of his elevated BP? A. Acute Glomerulonephritis B. Acute pyelonephritis C. Acute Rheumatic Fever D. Acute cystitis
A
Acute Glomerulonephritis
A 14 year old boy from the Cape flats is referred by his General Practitioner with blood in his urine and a high blood pressure. On examination he was found to have pitting oedema, infected scabies rash and BP 170/100 mmHg. Urinalysis showed 3+ proteins and 4+ blood.
Concerning the patient above, which of the following management options are indicated?
A. Treat his BP
B. Give antibiotics for the infection
C. Blood tests to monitor his electrolytes
D. All of these options are indicated
D
All of these options are indicated
A local priest was rushed to hospital with a history of sudden collapse while preaching last Sunday. Which of the following is an unlikely cause of his symptoms? A. Stroke B. Heartburn C. Pulmonary embolus D. Acute Myocardial Infarction
B
Heartburn
