SBAs and explanations 7 Flashcards
What is the inheritance pattern of polycystic kidney disease?
A Autosomal dominant B Autosomal recessive C X-linked dominant D X-linked recessive E Mitochondrial
Autosomal dominant.
Which of the following statements about inflammatory bowel disease is false?
A Crohn’s disease causes transmural inflammation, whereas UC causes inflammation of the mucosa or submucosa
B Crohn’s disease causes skip lesions, whereas UC is continuous
C Crohn’s disease is associated with abscesses, fistulae, adhesions and
strictures, whereas UC is associated with toxic megacolon
D Crohn’s disease favours the rectum, whereas UC favours the terminal ileum
E Barium follow-through will show rose-thorn ulcers and a cobblestone mucosa in Crohn’s disease, but a lead pipe mucosa in UC
Crohn’s disease favours the rectum, whereas UC favours the terminal ileum.
A 68-year-old care home resident is brought into A+E hyperventilating and complaining of a ‘ringing sound’ in her ears. She has a low-grade fever and appears to be confused. She has a past medical history of depression and a TIA (2 months ago). What is the most likely diagnosis?
A Aspirin overdose B Paracetamol overdose C TCA overdose D Cerebrovascular accident E Pneumonia
Aspirin overdose.
A 25-year-old male presents to his GP complaining of a lump in his armpit. He says it doesn’t usually hurt except for when he goes out binge drinking with his friends. In the past few months, he has noticed that his clothes have become quite loose-fitting and he has been getting very hot and sweaty more than usual. On examination, he has firm, rubbery axillary lymphadenopathy, splenomegaly and scratch marks on his arms.
A Multiple myeloma B Chronic lymphocytic leukaemia C Chronic myeloid leukaemia D Non-Hodgkin’s lymphoma E Hodgkin’s lymphoma
Hodgkin’s lymphoma.
A 68-year-old man presents to his GP complaining of a cough that has been bothering him for 3 months. He says that he has coughed up large volumes of ‘rusty- coloured’ sputum. According to his hospital notes, he has been admitted 4 times in the past 12 months due to pneumonia. On examination, his fingers are clubbed and coarse crepitations are heard at the lung bases. What is the most likely underlying diagnosis?
A COPD B Bronchiectasis C Pneumonia D Interstitial lung disease E TB
Bronchiectasis.
A 55-year-old woman is receiving treatment for chronic myeloid leukaemia. The consultant is concerned that this patient may have developed tumour lysis syndrome and requests some blood tests. What would you expect to see in the blood results of a patient with tumour lysis syndrome?
A Low K+, High PO43-, High Ca2+ and High Uric Acid
B High K+, High PO43-, Low Ca2+ and High Uric Acid
C High K+, Low Na+, Low Ca2+ and High Mg2+
D Low K+, High Na+, Low Mg2+ and High Uric Acid
E High Ca2+, Low PO43- and High Uric Acid
High K+, High PO43-, Low Ca2+ and High Uric Acid.
Which of the following is a cardiac cause of finger clubbing?
A Congenital cyanotic heart disease B Viral pericarditis C Dilated cardiomyopathy D Rheumatic fever E Wolff-Parkinson-White syndrome
Congenital cyanotic heart disease.
A 39-year-old homeless man is brought into A+E having been found lying in a pool of blood on the street. He is known to the A+E department having frequently been admitted for alcohol-related issues. There are no obvious signs of trauma and blood is seen in and around his mouth. Vital Signs: HR = 110 bpm; BP = 87/61 mm Hg. On examination, splenomegaly, shifting dullness and dilated veins on the anterior abdomen are identified. The registrar suspects a variceal bleed secondary to portal hypertension. What is the first step in this patient’s management?
A TIPS procedure
B Band ligation
C Terlipressin and prophylactic antibiotics
D Beta-blockers
E Terlipressin and beta-blockers
Terlipressin and prophylactic antibiotics.
A 23-year-old woman comes to see her GP about some breast lumps that she has noticed over the past 6 months. She mentions that her breasts become quite painful and feel ‘lumpy’, especially in the few days before her period. The pain is relieved when she has her period. What is the most likely diagnosis?
A Fibrocystic disease B Fibroadenoma C Breast cancer D Breast abscess E Duct ectasia
Fibrocystic disease.
A 92-year-old female, with a history of osteoporosis, is brought into A+E by her grandson. He says that she has been drifting in and out of consciousness for the past 2 weeks and has been complaining of a headache that has been keeping her up at night and getting progressively more severe. On examination, her left pupil is dilated and displaced downwards and outwards. What investigation should be performed first?
A Lumbar puncture B Carotid artery Doppler C CT head D EEG E Transthoracic echocardiogram
CT head.
A 29-year-old man presents with a 4-day history of high fever. On inspection, you notice some needle track marks on his arms and a pansystolic murmur is heard on auscultation, which had not previously been documented in his hospital notes. What is the most likely diagnosis?
A Mitral regurgitation B Pericarditis C Infective endocarditis D Aortic stenosis E Mitral valve prolapse
Infective endocarditis.
Which of the following is not part of the criteria for diagnosing SLE?
A Pleurisy B Thrombocytopaenia C Anti-dsDNA antibodies D Oral ulcers E Heliotrope rash
Heliotrope rash.
A 43-year-old woman presents with a 2-month history of diarrhoea and weight loss. She has also been feeling anxious about her appearance, as many people have commented that she always looks like she is staring. On examination, her eyes appear slightly protruded and lid lag is demonstrated. She has a fine tremor in both her hands and a lumpy skin lesion is noticed on her shins. What is the most likely
diagnosis?
A Toxic multinodular goitre B Graves’ disease C De Quervain’s thyroiditis D Hashimoto’s thyroiditis E Riedel’s thyroiditis
Graves’ disease.
A 76-year-old man is admitted to hospital with a cough productive of green sputum. He has also experienced some shortness of breath and a fever. A week before his admission, his carers noted that he had a high fever, malaise and myalgia for a few days. A chest X-ray shows a cavitating lesion with an air fluid level. What is the most likely causative organism?
A Staphylococcus aureus B Streptococcus pneumoniae C Legionella pneumophila D Mycoplasma pneumonia E Haemophilus influenzae
Staphylococcus aureus.
The urine output of a 78-year-old inpatient on the surgical ward has decreased gradually over the past 24 hours despite maintaining an adequate fluid intake. The nurses add that he has recently become rather confused and complains of nausea. U+Es are requested:
Creatinine : 231 micromol/L (baseline : 97) Urea : 12.5 mmol/L (2.5-6.7)
Na+ : 139 mmol/L (135-145)
K+ : 6.1 mmol/L (3.5-5)
An AKI is diagnosed. He is currently on ramipril (for his hypertension), bisoprolol (for his paroxysmal AF) and ibuprofen.
Which of the following steps is inappropriate in this patient’s management?
A Assess and optimise fluid status B 10 mL of 10% calcium gluconate IV C Stop Ramipril D Stop bisoprolol E Stop ibuprofen
Stop bisoprolol.
A 57-year-old man is complaining of numbness and weakness in his arms. It began in his hands, 2 weeks ago, but for the last 3 days his forearms have also felt numb. On examination, there is no sensation below his elbows, tone is reduced bilaterally and the biceps and brachioradialis reflexes cannot be elicited. He adds that he recently recovered from a bout of diarrhoea and vomiting. What is the most likely diagnosis?
A Multiple sclerosis B Motor neuron disease C Parkinson’s disease D Guillain-Barré syndrome E Huntington’s disease
Guillain-Barre syndrome.
A 77-year-old patient with cirrhosis presents to A+E with diffuse abdominal pain, abdominal heaviness and fever. Associated symptoms include nausea and vomiting. On examination shifting dullness is demonstrated and a fluid thrill is observed. What investigation should form part of the initial diagnostic work-up?
A Abdominal X-ray B Abdominal ultrasound C Abdominal CT D Diagnostic paracentesis E Stool sample for MC+S
Diagnostic paracentesis.
Which of the following is the correct chronological sequence of retinal changes that occur in hypertensive retinopathy?
A Papilloedema –> Silver Wiring –> Flame Haemorrhages –> AV Nipping
B Silver Wiring –> AV Nipping –> Flame Haemorrhages –> Papilloedema
C Silver Wiring –> Flame Haemorrhages –> AV Nipping –> Papilloedema
D AV Nipping –> Papilloedema –> Silver Wiring –> Flame Haemorrhages
E AV Nipping –> Silver wiring –> Papilloedema –> Flame Haemorrhages
Silver Wiring –> AV Nipping –> Flame Haemorrhages –> Papilloedema.
A 44-year-old woman is complaining of pain and a tingling feeling in the lateral half of her right hand. She often finds that she wakes up in the middle of the night because of the pain, which is then relieved by shaking her hand vigorously. Which nerve has been affected?
A Ulnar nerve B Radial nerve C Musculocutaneous nerve D Median nerve E Posterior interosseous nerve
Median nerve.
Which of the following full blood count and clotting screen results is consistent with a diagnosis of disseminated intravascular coagulation?
A High platelets, High Hb, High APTT/PT, High fibrinogen
B High platelets, High Hb, Low APTT/PT, High fibrinogen
C Low platelets, High Hb, Low APTT/PT, Low fibrinogen
D Low platelets, Low Hb, High APTT/PT, Low fibrinogen
E Low platelets, Low Hb, Low APTT/PT, Low fibrinogen
Low platelets, Low Hb, High APTT/PT, Low fibrinogen.
A 40-year-old woman is admitted to A+E with shortness of breath that began suddenly a day after she returned from a holiday to the Maldives. What is the first step in her management?
A D-dimer B High flow oxygen and low molecular weight heparin C IV heparin D CTPA E Venous ultrasound of the lower limbs
High flow oxygen and low molecular weight heparin.
What is the gold standard diagnostic test for acromegaly?
A Insulin suppression test B Oral glucose tolerance test C Short synacthen test D IGF-1 levels E Thyroid function test
Oral glucose tolerance test.
Which of the following sets of results would be consistent with alcoholic hepatitis?
A Elevated MCV, ALT:AST > 2 and elevated GGT
B Elevated MCV, AST:ALT > 2 and elevated GGT
C Reduced MCV, AST:ALT >2 and elevated GGT
D Elevated MCV, ALT:AST > 2 and reduced GGT
E Reduced MCV, AST:ALT > 2 and reduced GGT
Elevated MCV, AST:ALT > 2 and elevated GGT.
An inpatient on the orthopaedic surgery ward has recently developed a cough, high fevers and chills. Blood cultures are taken which identify MRSA. Which of the following antibiotics is often used in the treatment of MRSA infections?
A Vancomycin B Flucloxacillin C Tazocin D Metronidazole E Cefuroxime
Vancomycin.
A 77-year-old man is referred to the outpatient clinic by his GP having presented with chest pain and worsening shortness of breath. He has a history of COPD, diagnosed 12 years ago. On examination, his JVP is elevated, a parasternal heave is palpated and auscultation reveals an early diastolic murmur. An ECG is performed which shows right-axis deviation, a tall R wave in V1 and peaked P waves in lead ll. What is the most likely diagnosis?
A Aortic regurgitation B Mitral stenosis C Pulmonary hypertension D Right heart failure E Exacerbation of COPD
Pulmonary hypertension.
Which of the following is not a histopathological type of malignant melanoma?
A Superficial spreading B Acral lentiginous C Bowen’s disease D Nodular E Lentigo maligna
Bowen’s disease.
An 82-year-old man has recently suffered from a right-sided stroke and is undergoing physiotherapy. He is referred for an upper limb neurological examination. The power in his right arm is normal. He can abduct his left arm by himself, but fails to maintain that position as soon as any resistance is applied. What is the MRC grading of his left shoulder abduction?
A Grade 1 B Grade 2 C Grade 3 D Grade 4 E Grade 5
Grade 3.
A 54-year-old female, with a BMI of 28, presents with a 2-year history of epigastric pain that radiates to the neck. It gets worse when lying down, and she also complains of painless regurgitation of food. What is the most appropriate investigation to confirm the diagnosis?
A Chest X-ray B Barium swallow C ECG D OGD E Manometry
Barium swallow.
Which of the following is not an indication for dialysis in the context of acute kidney injury?
A Refractory hyperkalaemia B Refractory pulmonary oedema C Uraemic pericarditis D Severe metabolic acidosis E Macroscopic haematuria
Macroscopic haematuria.
