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

Low serum osmolality with inappropriately concentrated urine and elevated urine sodium in the context of SSRI use is diagnostic of SIADH.

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

The low pH with elevated PaCO₂ and normal bicarbonate indicates an acute respiratory acidosis with inadequate renal compensation, consistent with acute respiratory failure.

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

Elevated bicarbonate with hypokalaemia and hypochloraemia in a patient on loop diuretics is classic contraction metabolic alkalosis from volume and chloride loss.

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

Microcytic anaemia with low ferritin and elevated TIBC confirms iron deficiency anaemia; ferritin is the most sensitive marker of iron stores.

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

A rising troponin pattern (delta change >20% over 3–6 hours) with symptoms consistent with ACS confirms NSTEMI requiring antiplatelet therapy and cardiology input.

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

MSRA MSRA Data Interpretation