SBAs and explanations 10 Flashcards
An 18-year-old student is brought to see his GP by his mother. Since returning from university 2 days ago, he has become drowsy and has developed a fever. He has also vomited 3 times. On examination, the patient complains of pain when the GP flexes his hip and extends his knee, and a non-blanching rash is seen on his trunk. What should the GP do next?
A Reassure and discharge
B Administer IV or IM benzylpenicillin and call an ambulance
C Administer IV dexamethasone and call an ambulance
D Prescribe oral benzylpenicillin and arrange a follow up appointment
E Prescribe oral dexamethasone and arrange a follow up appointment
Administer IV or IM benzylpenicillin and call an ambulance.
A 24-year-old man presents to the outpatient clinic with a 3-month history of lower abdominal pain and bloody diarrhoea. He often defecates more than 4 times per day and sometimes does not feel completely empty afterwards. On examination, his fingers are clubbed and a large irregular ulcer is found on his left shin. What is the most likely diagnosis?
A Irritable bowel syndrome B Gastroenteritis C Crohn’s disease D Ulcerative colitis E Coeliac disease
Ulcerative colitis.
Which joint is most commonly affected in gout?
A 1st Metacarpophalangeal joint B 1st Metatarsophalangeal joint C 1st Tarsometatarsal joint D 1st Interphalangeal joint E Talonavicular joint
1st Metatarsophalangeal joint.
A 10-year-old boy is brought to the respiratory clinic by his mother. Since he was very young, he has suffered from recurrent infections and has been hospitalized many times. As he has frequently moved country, a formal diagnosis has never been made. In the past 6 months, he has become increasingly breathless and has experienced a chronic cough, productive of large volumes of purulent sputum. A chest X-ray is performed revealing widespread bronchiectasis, and situs inversus. What is the most likely diagnosis?
A Cystic fibrosis B Young’s syndrome C Kartagener’s syndrome D Caplan’s syndrome E alpha 1 antitrypsin deficiency
Kartagener’s syndrome.
Which system is used to stage Hodgkin’s lymphoma?
A Ann Arbor B Gleason C Dukes’ D Rai and Binet E Breslow
Ann Arbor.
A 63-year-old woman presents with a moist, shallow ulcer just superior to the medial malleolus of her left foot. It is diagnosed as a venous ulcer. Which of the following features is not associated with venous ulcers?
A Varicose veins B Calloused edges C Stasis eczema D Haemosiderin deposition E Lipodermatosclerosis
Calloused edges.
Which of these conditions does not typically cause eye signs?
A Ulcerative colitis B Crohn’s disease C Ankylosing spondylitis D Reactive arthritis E Cervical spondylosis
Cervical spondylosis.
Whilst enjoying a drink in a bar with some friends, a 36-year-old woman feels a sudden sensation of tingling in her ring finger which spreads to the rest of her hand over a couple of seconds. She only feels the sensation in her right hand and she maintains awareness throughout the episode, which lasts less than a minute. What type of seizure is this describing? A Absence B Simple partial C Complex partial D Myoclonic E Atonic
Simple partial.
An 82-year-old lady has been in hospital for 4 weeks due to a hip fracture that she sustained after falling at home. Due to her immobility, a pressure sore has developed on the heel of her right foot. There is an intact fluid-filled blister measuring 3 inches in diameter. The ulcer is superficial and there is no subcutaneous tissue visible. According to the EPUAP, what grade of severity is this pressure ulcer?
A Grade 1 B Grade 2 C Grade 3 D Grade 4 E Ungradable
Grade 2.
What is the most common cause of encephalitis in the UK?
A Herpes simplex virus B Syphilis C EBV D Varicella zoster virus E Coxsackie virus
Herpes simplex virus.
A 49-year-old bird keeper has become more and more breathless over the last 6 months. She used to be able to easily complete her daily dog walk, however, recently, she has found that she is having to taking more breaks to catch her breath. She has also had a dry cough. Examination reveals fine inspiratory crackles and a chest X-ray shows reticulo-nodular shadowing. What is the most likely diagnosis?
A Extrinsic allergic alveolitis B COPD C Pneumoconiosis D Aspergillosis E Asbestosis
Extrinsic allergic alveolitis.
A 64-year-old man has been referred for an outpatient appointment with the urology department. Over the past 5 months, he has been urinating around 10-12 times per day. He often takes several minutes to start urinating and his stream is much weaker than it used to be. Once he has finished, he does not feel ‘completely empty’ and finds that he ‘leaks a little bit’ as well. Digital rectal examination reveals a smoothly enlarged prostate gland with a palpable midline sulcus. A diagnosis of benign prostatic hyperplasia is made. He is eager to avoid surgery if possible. Which treatment would be best for him?
A Oxybutynin B Solifenacin C Tamsulosin D Nitrofurantoin E Co-trimoxazole
Tamsulosin.
A 53-year-old lady has been feeling increasingly short of breath over the past 6 months. She adds that she always feels very tired and has, more recently, experienced a tingling sensation in both hands. Neurological examination reveals a sensory neuropathy affecting only the hands and feet. What is the most likely cause of her symptoms?
A Iron deficiency anaemia B Anaemia of chronic disease C Folic acid deficiency D Vitamin B12 deficiency E Thalassemia trait
Vitamin B12 deficiency.
A 33-year-old female with SLE presents to the fertility clinic complaining of repeated miscarriages. She has been desperately trying to start a family but has
unfortunately suffered 3 miscarriages over the last 7 years. Her past medical history includes an appendicectomy (aged 12) and two DVTs. Given the likely diagnosis, which of the following antibodies is associated with this disease?
A Anti-CCP antibody B Anti-Jo-1 antibody C Anti-centromere antibody D Anti-cardiolipin antibody E Anti-smooth muscle antibody
Anti-cardiolipin antibody.
Which of the following is not associated with infective endocarditis?
A Clubbing B Janeway lesions C Rose spots D New pansystolic murmur E Splinter haemorrhages
Rose spots.
A 43-year-old woman presents with a ‘rather embarrassing’ problem. Since the birth of her fourth child, 3 months ago, she has wet herself several times. She has noticed that whenever she laughs or coughs, a little bit of urine leaks out without her control. What is the name of this type of incontinence?
A Functional incontinence B Stress incontinence C Urge incontinence D Overflow incontinence E Double incontinence
Stress incontinence.
A 44-year-old man has been suffering from constant, nagging headaches for the past 2 years. In this time, he has also noticed that his hands and feet appear to have grown as he has changed shoe size 3 times, and had to get his wedding ring cut off. He has been relatively healthy throughout his life except for undergoing surgery for carpal tunnel syndrome last year. What is the most likely diagnosis? A Cushing’s disease B Acromegaly C Hypothyroidism D Gigantism E Prolactinoma
Acromegaly.
Which of the following is used to predict the severity of acute pancreatitis?
A Alvarado score B Rockall score C Modified Glasgow score D Glasgow-Blatchford score E Child-Pugh score
Modified Glasgow score.
A 31-year-old scuba diving instructor, living in the Maldives, had a seizure three days ago. He has no history of epilepsy, however, he has had persistent headaches over the past 5 months. He adds that the headaches are particularly bad when he goes to bed. On examination, a dark, irregular skin lesion is found on the back of his neck. An MRI scan shows multiple lesions across both cerebral hemispheres. What is the most likely diagnosis?
A Glioblastoma multiforme B Metastases C Neurofibromatosis Type 1 D Acoustic neuroma E Meningioma
Metastases.
Which of the following examination findings is not associated with COPD?
A Use of accessory muscles B Breathing through pursed lips C Peripheral cyanosis D Clubbing E Bounding pulse
Clubbing.
A 56-year-old man comes to A+E with a very swollen glans. He went to the toilet to urinate last night, however, once he had finished, he was unable to replace his foreskin back over his glans. Since then, his glans has gradually become very painful and inflamed. What is the name of this condition?
A Phimosis B Paraphimosis C Balanitis D Priapism E Peyronie’s disease
Paraphimosis.
A 59-year-old man presents to A&E with fatigue and shortness of breath, that gets worse when lying down. He has also been coughing up pink, frothy sputum. An echocardiogram is performed, which shows aortic regurgitation. On closer inspection of the patient’s hands, his nail beds appear to be pulsating. What is the name of this sign?
A de Musset’s sign B Quincke’s sign C Traube’s sign D Corrigan’s sign E Becker’s sign
Quincke’s sign.
A 61-year-old man attends an outpatient clinic appointment complaining of epigastric pain that gets better soon after eating. A urease breath test confirms the presence of H. pylori. A duodenal ulcer is suspected. What is the most appropriate management option?
A 1 week of once daily omeprazole, amoxicillin and clarithromycin
B 1 week of twice daily omeprazole, amoxicillin and clarithromycin
C 1 week of once daily ranitidine, amoxicillin and clarithromycin
D 1 week of twice daily ranitidine, amoxicillin and clarithromycin
E 1 week of once daily omeprazole, ranitidine and amoxicillin
1 week of twice daily omeprazole, amoxicillin and clarithromycin.
Which of the following is a major consequence of folate deficiency in pregnancy?
A Incomplete limb development B Neural tube defects C Congenital cardiac abnormalities D High birth weight E Cleft palate
Neural tube defects.
Which of the following is true about the target population group and frequency of breast cancer screening in the UK?
A Women aged 35-65 every 3 years B Women aged 40-60 every 3 years C Women aged 40-70 every 5 years D Women aged 50-75 every 5 years E Women aged 50-70 every 3 years
Women aged 50-70 every 3 years.
