Practice Paper MLA SBAs Flashcards
. A 25 year old man has had penile pain for two days. His most recent sexual
intercourse was one week ago.
There are multiple tender ulcers on his preputial skin. His penile and scrotal
skin does not have any other abnormality.
Which is the most likely diagnosis?
A. Genital warts
B. Gonorrhoea
C. Herpes simplex
D. Lymphogranuloma venereum
E. Syphilis
Correct Answer(s): C
Justification for correct answer(s): Based on the given information, the most likely
diagnosis is Herpes simplex. The presence of multiple tender ulcers on the
preputial skin following recent sexual intercourse is suggestive of herpes
simplex virus infection. Genital warts usually present as painless, raised, and
cauliflower-like growths on the genital skin. Ulcers in syphilis are typically
painless, whilst gonorrhoea presents with discharge. In lymphogranuloma
venerum discharge and lymphadenopathy is often present.
A 60 year old man has increasing left hip pain. It is worse after exercise and
occasionally wakes him at night. He has stiffness in the mornings that lasts for
about 10 minutes. He has hypertension treated with ramipril, but is otherwise
in good health.
He has reduced internal rotation on passive movement. This also elicits pain.
Which is the most appropriate initial treatment for his pain?
A. Celecoxib
B. Codeine phosphate
C. Naproxen
D. Paracetamol
E. Tramadol
Correct Answer(s): C
Justification for correct answer(s): Oral non-steroidal anti-inflammatory drugs are
recommended as initial pharmacotherapy for hip osteoarthritis. Paracetamol or
weak opioids should not be routinely offered unless they are only used
infrequently for short-term pain relief and all other pharmacological treatments
are contraindicated, not tolerated or ineffective.
An 18 year old woman is 19 weeks pregnant. An ultrasound scan shows her
baby has anencephaly. She wants to discuss her options with regards to
termination of pregnancy.
When will termination of this pregnancy be legally permitted?
A. After spontaneous fetal death
B. At any time during the pregnancy
C. Before 20 weeks’ gestation
D. Before 24 weeks’ gestation
E. Before 28 weeks’ gestation
Correct Answer(s): B
Justification for correct answer(s): The law is the UK is that the usual limit for
termination of pregnancy is 24 weeks’ gestation. However, anacephaly is a
fetal anomaly that inevitably results in the death of the fetus. This, or a risk of
serious harm to the woman, means that termination is legal at any time.
. A 65 year old man has had constant back and right knee pain for 6 months,
partially relieved by analgesia. He is an ex-smoker. He is otherwise well.
Investigations:
Haemoglobin 132 g/L (130-175)
Alkaline phosphatase 850 IU/L (25-115)
Calcium 2.3 mmol/L (2.2-2.6)
Phosphate 0.9 mmol/L (0.8-1.5)
Prostate specific antigen 5 μg/L (<4.0)
X-rays: sclerotic areas in lower right femur and lumbar spine L3
Isotope bone scan: areas of increased uptake in femur, lumbar spine and
skull
Which is the most likely diagnosis?
A. Hyperparathyroidism
B. Metastatic carcinoma of prostate
C. Metastatic small cell carcinoma of lung
D. Myeloma
E. Paget’s disease of bone
Correct Answer(s): E
Justification for correct answer(s): Based on the given information, the most likely
diagnosis is E. The patient’s history, investigations and imaging findings
suggest a diagnosis of Paget’s disease of bone. The elevated alkaline
phosphatase, with normal Calcium and Phosphate and bone scan results
support this diagnosis. Hyperparathyroidism can cause hypercalcemia and
bone resorption, but it is less likely in this case given the normal calcium and
phosphate levels. Metastatic small cell carcinoma of lung, prostate and
myeloma can also cause the imaging changes, but these are less likely given
the patient’s history, and laboratory findings.
A 14 year old girl has had crampy abdominal pain and poor appetite for 24
hours. She has also had a sore throat for 3 days.
Her temperature is 38.5°C. There is cervical lymphadenopathy and
tenderness in the right iliac fossa.
Which is the most likely diagnosis?
A. Acute appendicitis
B. Crohn’s ileitis
C. Meckel’s diverticulum
D. Mesenteric adenitis
E. Ovarian cyst
Correct Answer(s): D
The links between deprivation and health inequalities are well evidenced and
widely accepted, but there are a number of explanations for that association.
One explanation proposes that ill health determines people’s social class.
Which type of explanation of health inequality is this?
A. Artefact
B. Cultural/behavioural
C. Idealist
D. Materialist
E. Social selection/mobility
Correct Answer(s): E
