MSCAA Practice Paper 2 November 2018 Flashcards
1
Q
- 73, M
- Collapses on surgical ward 24hrs after having a sigmoid volvulus reduced by sigmoidoscopy
- No pulse, ECG shows asystole
- Chest compressions and ventilation started
- Cardiac arrest team are with patient
Most appropriate next step in management?
A
IV adrenaline/epinephrine
2
Q
- 78, F
- Pain in both shoulders, hips and thighs
- Very stiff on waking
- Takes 2-3hrs to loosen up
- Getting dressed difficult
ESR 67mm/hr (<20)
CRP 87 mg/L (<5)
Most appropriate intial Tx?
A
Prednisolone
3
Q
- 36, M
- Rescued from house fire
- Alert, talking but dull headache
- PR 98bpm, BP 139/86 mm Hg
- RR 22 breaths/min
- Oxygen Sat 100% breathing 15 L/min oxygen via a non-rebreather mask
Most appropiate parameter to measure?
A
Carboxyhaemoglobin
- Carbon monoxide inhalation likely
4
Q
- 65, F
- Mechanical aortic valve replacement and coronary revascularisation 3days agi
- Being treated with dalteparin sodium
- Taking aspirin long term
Most approriate long-term patient management?
A
Warfarin sodium
5
Q
- 18, F
- Chronic skin condn for several years
- Well-defined areas of scale formation at sites of minor sin injuries (scratches)
- Scaling can persist for several weeks or months
Underlying skin condition?
A
Psoriasis
- Typical of Koebnerisation (appearance of new skin lesions secondary to trauma, psoriasis common underlying cause)
6
Q
- 23, M
- Admitted to acute surgical ward with appendicitis and prepared for theatre
- Not eaten for 24 hrs but vomiting on and off all day
Which airway device protects lungs from regurgitated stomach contents / aspiration?
A
Tracheal tube
7
Q
- 33, F
- 4 mths joint pain, stiff
- Worst in morning, improves gradualy throughout day
- Tired all time but no other health problems
Which investigation would confirm most likely diagnosis?
A
Anti-cylic citrillinated peptide antibody (anti-CCP)
- For rheum arthritis
8
Q
- 18 y/o man born in UK
- Visits g-parents in Malawi
- 2 days after return, drowsy, confused
- Over past week recurrent eps of high fever
Investigations:Haemoglobin 92 g/L (130–175)
White cell count 3.2 × 109/L (3.8–10.0)
Platelets 184 × 109/L (150–400)
Blood film parasites visible
Causative organism?
A
Plasmodium falciparum
