Basic MSRA Practice

Question 1

A 40 year-old woman exhibits symptoms of heat intolerance, weight loss, sweating, and loose stools. Upon examination, three thyroid nodules were found, and the following measurements were made: T = 36.8, HR = 92, and BP = 129/83. Provide the most plausible diagnosis.

Accepted Answer

Multinodular Goitre

Answer

The patient presents with classic symptoms of hyperthyroidism, including heat intolerance, weight loss, sweating, and an elevated heart rate. The key finding is the presence of three thyroid nodules. While Graves' disease also causes hyperthyroidism, the specific finding of multiple nodules strongly suggests a toxic multinodular goitre, where autonomous nodules produce excess thyroid hormone, leading to the hyperthyroid state.

Question 2

A 50-year-old man with chest pain experienced flu-like symptoms for three days after finishing a half-marathon a week prior. He is currently speaking in complete sentences and has a 110 pulse. From the list of diagnoses below, select the most likely one.

Accepted Answer

Myocarditis

Answer

Myocarditis is an inflammation of the heart muscle, often triggered by a viral infection, which aligns with the patient's recent flu-like symptoms. Strenuous physical activity, such as a half-marathon, can exacerbate or unmask myocarditis. The combination of chest pain, recent viral illness, and an elevated pulse (tachycardia) makes myocarditis the most plausible diagnosis in this context.

Question 3

Which class of medications is used to treat female urge incontinence?

Accepted Answer

Antimuscarinics

Answer

Urge incontinence is characterized by involuntary contractions of the bladder muscle (detrusor), leading to a sudden and strong need to urinate. Antimuscarinic medications work by blocking muscarinic receptors in the bladder, which helps to relax the detrusor muscle and reduce these involuntary contractions. This mechanism directly addresses the underlying physiological cause of urge incontinence, making them a primary treatment option.

Question 4

Which class of medications is used to treat male patients primarily for voiding symptoms in the first line of care?

Accepted Answer

Alpha Blocker

Answer

Voiding symptoms in male patients, often associated with benign prostatic hyperplasia (BPH), are caused by the enlargement of the prostate gland obstructing the urethra. Alpha-blockers work by relaxing the smooth muscles in the prostate and bladder neck, which reduces the resistance to urine flow. This action improves urinary symptoms like hesitancy, weak stream, and incomplete emptying, making them a first-line treatment.

Question 5

A 75-year-old man who has been diagnosed with AF appears with bilateral fine crepitations and a cough. He has not raised his JVP. HR: 72 Regular, Temperature: 36.8 C, Oxygen Saturations: 95%, and Respiratory Rate: 18. Which diagnosis seems most likely?

Accepted Answer

Pulmonary Fibrosis

Answer

The patient's presentation of bilateral fine crepitations and a cough in an elderly man with a history of AF, but without a raised JVP or signs of acute heart failure (normal HR, O2 sats, RR), is highly suggestive of pulmonary fibrosis. Pulmonary fibrosis is a chronic interstitial lung disease characterized by progressive scarring of the lungs, typically presenting with persistent cough and characteristic 'Velcro' crackles on auscultation. Pulmonary oedema would typically involve a raised JVP and more acute respiratory distress.

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

Basic MSRA Practice