MSRA Clinical Reasoning Flashcards
6 cards from real MSRA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 MSRA Clinical Reasoning flashcards as text
A 4-year-old child presents with fever, stridor, and a 'barking cough' that is worse at night. What is the most likely diagnosis?
Answer: Croup (laryngotracheobronchitis)
A barking cough with stridor that worsens at night in a young child is the hallmark presentation of croup, typically caused by parainfluenza virus.
A 25-year-old male presents with acute onset monoarthritis of the right knee, urethral discharge, and conjunctivitis following a gastrointestinal infection. What is the likely diagnosis?
Answer: Reactive arthritis
The triad of arthritis, urethritis, and conjunctivitis following an enteric or urogenital infection is diagnostic of reactive arthritis (formerly Reiter's syndrome).
A 68-year-old woman with known atrial fibrillation presents with sudden left-sided weakness and facial droop lasting 45 minutes before fully resolving. What is the most appropriate next step?
Answer: Admit urgently using the ABCD2 score and fast-track TIA pathway
A TIA in a patient with AF carries high early stroke risk; same-day neurovascular assessment and urgent investigation are mandatory under the fast-track TIA pathway.
A 50-year-old male presents with central crushing chest pain radiating to the left arm, diaphoresis, and nausea. ECG shows ST elevation in V1–V4. What is the immediate priority?
Answer: Primary PCI within 90–120 minutes
Anterior STEMI requires primary percutaneous coronary intervention (PCI) as the first-line reperfusion strategy, targeting a door-to-balloon time within 90–120 minutes.
A neonate at 24 hours of life develops jaundice. Total bilirubin is markedly elevated. What is the most important cause to exclude first?
Answer: Haemolytic disease of the newborn
Jaundice in the first 24 hours is always pathological; haemolytic disease of the newborn due to Rh or ABO incompatibility must be excluded urgently to prevent kernicterus.
A 72-year-old woman presents with confusion, polyuria, and severe hypercalcaemia (Ca²⁺ 3.8 mmol/L). She has a history of non-small cell lung cancer. What is the mechanism?
Answer: PTHrP secretion by tumor
Hypercalcaemia of malignancy in lung cancer is most commonly mediated by parathyroid hormone-related peptide (PTHrP) secreted by the tumor cells.
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