Sample/practice exam 2017 Questions and Answers Medicine 100 % A+ Guide

Which is the most useful diagnostic investigation? A. 24-h urinary cortisol test B. Glucose tolerance test C. Serum corrected calcium D. Short Synacthen test E. Water deprivation test Answers available at https://b ...

Which is the most useful diagnostic investigation? A. 24-h urinary cortisol test B. Glucose tolerance test C. Serum corrected calcium D. Short Synacthen test E. Water deprivation test Answers available at https://bit.ly/2Y9KNSz Which is the most appropriate long-term plan for secondary stroke prevention? A. Apixaban B. Aspirin C. Aspirin and dipyridamole D. Clopidogrel E. Ticagrelor Answers available at https://bit.ly/2Y9KNSz 5. A 65 year old woman had a stroke 2 weeks ago causing right arm weakness and dysphasia. CT scan of head showed a left parietal lobe infarct. Her medication since the stroke includes aspirin and simvastatin. Her pulse rate is 82 bpm and irregular. Investigations: ECG: atrial fibrillation, rate 68 bpm. lOMoAR cPSD|784381 Answers available at https://bit.ly/2Y9KNSz 6. A 49 year old man has 3 days of cough and fever. He undergoes haemodialysis three times per week. His temperature is 38.6°C, pulse rate 90 bpm, BP 122/80 mmHg, respiratory rate 30 breaths per minute and oxygen saturation 95% breathing 15 L/min oxygen via a non-rebreather mask. His JVP is 4 cm above the sternal angle. He has inspiratory crackles in the right mid and lower zone and left upper zone. His blood capillary glucose is 12 mmol/L. Investigations: Sodium 131 mmol/L (135–146) Potassium 5.7 mmol/L (3.5–5.3) Urea 16.7 mmol/L (2.5–7.8) Creatinine 327 μmol/L (60–120) Chext X-ray: see image lOMoAR cPSD|784381 Answers available at https://bit.ly/2Y9KNSz Answers available at https://bit.ly/2Y9KNSz Answers available at https://bit.ly/2Y9KNSz Answers available at https://bit.ly/2Y9KNSz Answers available at https://bit.ly/2Y9KNSz Page 7 of 51 lOMoAR cPSD|784381 Which is the most appropriate initial treatment? A. Haemodialysis B. Intravenous 10 mL 10% calcium gluconate C. Intravenous 1000 mL 0.9% sodium chloride over 1 h D. Intravenous co-amoxiclav and clarithromycin E. Intravenous furosemide Which is the most appropriate treatment to give before the scan? A. Intravenous 0.9% sodium chloride infusion B. Intravenous acetylcysteine C. Intravenous furosemide infusion D. Intravenous hydrocortisone E. Intravenous mannitol Answers available at https://bit.ly/2Y9KNSz eGFR 39 mL/min/1.73 m2 (>60) (2.5–7.8) Creatinine 165 µmol/L (60–120) 7. A 67 year old man is due to have a CT scan of chest, abdomen and pelvis with intravenous contrast as assessment for possible lymphoma. He had a renal transplant 5 years ago. His medication includes prednisolone, tacrolimus and lisninopril. His BP is 131/86 mmHg. Investigations: Urea 12.9 mmol/L lOMoAR cPSD|784381 Which is the most likely cause for her acute kidney injury? A. Glomerulonephritis B. Hypovolaemia C. Renal arterial emboli D. Rhabdomyolysis E. Ureteric obstruction 9. A 76 year old woman has become increasingly confused over the past 2 weeks. She has a history of hypertension and cardiac failure. She is taking bendroflumethiazide, doxazosin, amlodipine, ramipril and atenolol. Her BP is 108/71 mmHg. Investigations: Sodium 121 mmol/L (135–146) Potassium 3.5 mmol/L (3.5–5.3) Urea 10.0 mmol/L (2.5–7.8) Creatinine 105 µmol/L (60–120) Which medication is most likely to be responsible for her presentation? A. Amlodipine B. Atenolol C. Bendroflumethiazide D. Doxazosin E. Ramipril Urinalysis: glucose negative, ketones negative, blood 2+, protein 1+, leucocytes positive (catheter sample). She has passed 60 mL of urine over the past 2 hours. (135–146) (3.5–5.3) (2.5–7.8) (60–120) Creatine kinase 870 U/L (25–175) 8. A 78 year old woman is admitted after been found collapsed at home. She has been lying on the floor overnight. She has a history of hypertension and takes amlodipine. Her temperature is 35.8°C, pulse rate 88 bpm and irregular, and BP 102/60 mmHg. Investigations: Sodium 136 mmol/L Potassium 5.8 mmol/L Urea 20.9 mm