Essential MSRA MCQ

Question 1

The 54-year-old Ramesh is requesting a PSA test at your next appointment because he is concerned after learning that a colleague has been diagnosed with prostate cancer. After discussing the fact that a PSA test is not diagnostic, you schedule one.
Of the following, which one wouldn't have an impact on a PSA reading?

Accepted Answer

Ejaculation 72 hours ago

Answer

PSA levels can be temporarily elevated by various factors that irritate or inflame the prostate, including recent prostate biopsy, active urinary tract infections, and vigorous exercise. While ejaculation can also cause a transient rise in PSA, this effect is typically short-lived and usually resolves within 24-48 hours. Therefore, ejaculation 72 hours prior would generally not have a significant impact on a PSA reading, unlike the other options which can cause more prolonged or significant elevations.

Question 2

Jenny arrives to discuss her baby's potential for hip developmental dysplasia—she is twelve weeks along and her friend's child just underwent surgery for the condition.
Which of the following is not a risk factor for a person's developmentally dysplastic hip dysplasia (DDH)?

Accepted Answer

Polyhydramnios

Answer

Developmental Dysplasia of the Hip (DDH) has several known risk factors, including female sex, first-born status, and breech presentation, all of which can influence fetal positioning and hip development. Polyhydramnios, which is an excessive amount of amniotic fluid, typically provides more space for fetal movement, making it less likely to restrict hip development. In contrast, oligohydramnios (too little amniotic fluid) would be a risk factor due to restricted movement.

Question 3

Seven-year-old Tom started going to school with his mother when he noticed a lump on his right leg. Tom is typically in good health, and neither of them can recall any past trauma. With the exception of slight exhaustion, he denies experiencing any pain or changed sensations.
Upon examination, there is no skin alterations overlying the bony swelling at the distal end of his right femur. Firm and anchored to the underlying structures is the swelling. There isn't any discernible localized lymphadenopathy.
What would be the best course of action to take next?

Accepted Answer

Extremely urgent 48-hour direct access X-ray

Answer

A new, firm, bony swelling in a child, especially without a clear history of trauma and with associated mild systemic symptoms like exhaustion, raises significant concern for a possible bone tumour, such as osteosarcoma. Current guidelines recommend extremely urgent imaging, specifically an X-ray within 48 hours, for unexplained bone pain or swelling in children. This prompt action is crucial for early diagnosis and management of potential malignancies.

Question 4

Jane, a sixteen-year-old competitive cyclist and gymnast, trains multiple times a week. Her mother, who is worried about her right knee, accompanies her to the GP office. For the past six months, they have experienced intermittent pain, but despite the mild discomfort, they are worried about how long the symptoms will last. Subsequent investigation revealed that there is no knee swelling or other affected joints, but that kneeling and jumping exacerbate the pain. Jane is in good health overall and has no additional medical history.
Examining the area revealed tibial tuberosity tenderness, which grew worse when the knee was extended against resistance. She has a normal gait, no swelling in her knee joints, and complete range of motion in both knees.

Accepted Answer

Osgood-Schlatter disease

Answer

Osgood-Schlatter disease is a common cause of knee pain in active adolescents, particularly those involved in sports like cycling and gymnastics that involve repetitive quadriceps contractions. The classic presentation includes pain and tenderness at the tibial tuberosity (just below the kneecap), which is exacerbated by activities such as kneeling, jumping, and resisted knee extension. It is an overuse injury involving inflammation of the patellar tendon insertion.

Question 5

Terry, 52, was recently diagnosed with hypertension, but despite taking his medication as directed, his condition is regrettably still out of control. Upon closer inspection, his potassium level is consistently low, and his sodium level is on the verge of being high. He is otherwise fine; neither his weight nor appearance have changed.
Of the following conditions, which one is most likely to be present in him?

Accepted Answer

Conn’s syndrome

Answer

Conn's syndrome, or primary hyperaldosteronism, is characterized by resistant hypertension, consistently low potassium (hypokalemia), and often mild elevation of sodium (hypernatremia). The excess aldosterone production leads to increased sodium reabsorption and potassium excretion in the kidneys, causing these specific electrolyte imbalances and contributing to difficult-to-control high blood pressure. This clinical picture makes Conn's syndrome the most likely diagnosis for secondary hypertension.

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

Essential MSRA MCQ