MSRA MSRA Data Interpretation

Question 1

A patient has Na⁺ 128 mmol/L, serum osmolality 258 mOsm/kg, urine osmolality 620 mOsm/kg, and urine Na⁺ 55 mmol/L. She takes an SSRI. What is the most likely cause?

Accepted Answer

SIADH

Answer

Psychogenic polydipsia

Answer

Hypothyroidism

Answer

Adrenal insufficiency

Question 2

ABG shows: pH 7.28, PaCO₂ 52 mmHg, HCO₃⁻ 24 mmol/L, PaO₂ 58 mmHg on air. What is the primary disorder?

Accepted Answer

Respiratory acidosis

Answer

Metabolic acidosis

Answer

Respiratory alkalosis

Answer

Mixed metabolic and respiratory acidosis

Question 3

A 60-year-old woman has K⁺ 2.8 mmol/L, Na⁺ 142 mmol/L, Cl⁻ 88 mmol/L, and HCO₃⁻ 38 mmol/L. She takes furosemide. What is the diagnosis?

Accepted Answer

Metabolic alkalosis with hypokalaemia

Answer

Renal tubular acidosis

Answer

Respiratory alkalosis

Answer

Normal anion gap metabolic acidosis

Question 4

A 50-year-old male has: Hb 95 g/L, MCV 72 fL, serum ferritin 8 µg/L, TIBC 68 µmol/L. What is the diagnosis?

Accepted Answer

Iron deficiency anaemia

Answer

Anaemia of chronic disease

Answer

Vitamin B12 deficiency

Answer

Thalassaemia trait

Question 5

Troponin I at 3 hours is 0.06 µg/L (reference <0.04) and at 6 hours is 0.22 µg/L. ECG shows no ST changes. How should this rise be interpreted?

Accepted Answer

Non-ST elevation myocardial infarction (NSTEMI) requiring ACS management

Answer

Likely type 2 MI from demand ischaemia only

Answer

Laboratory error — repeat in 24 hours

Answer

Stable angina — discharge with outpatient follow-up

Question 6

LFTs show: ALP 480 U/L, GGT 510 U/L, ALT 65 U/L, bilirubin 55 µmol/L, albumin 38 g/L. What pattern do these results suggest?

Accepted Answer

Cholestatic liver disease

Answer

Hepatocellular injury

Answer

Acute hepatitis

Answer

Hepatic synthetic failure