MSRA Clinical Problem Solving 4

Question 1

A 68-year-old man presents with painless macroscopic haematuria. What is the most important diagnosis to exclude?

Accepted Answer

Bladder cancer

Answer

Urinary tract infection

Answer

Renal stones

Answer

Benign prostatic hyperplasia

Question 2

A 40-year-old woman has recurrent episodes of unilateral throbbing headache with nausea, photophobia and visual aura. What is the most likely diagnosis?

Accepted Answer

Migraine

Answer

Tension headache

Answer

Cluster headache

Answer

Temporal arteritis

Question 3

A 58-year-old smoker has a chronic cough, haemoptysis and unintentional weight loss. What is the most appropriate initial imaging?

Accepted Answer

Chest X-ray

Answer

Abdominal CT

Answer

MRI brain

Answer

Echocardiogram

Question 4

A 32-year-old woman presents with palpitations, weight loss, heat intolerance and a fine tremor. Which result would confirm hyperthyroidism?

Accepted Answer

Low TSH with high free T4

Answer

High TSH with low free T4

Answer

Normal TSH and T4

Answer

Low TSH with low free T4

Question 5

An 80-year-old falls and presents with a shortened, externally rotated right leg. What is the most likely injury?

Accepted Answer

Fractured neck of femur

Answer

Ankle sprain

Answer

Patellar dislocation

Answer

Pubic ramus fracture

Question 6

A 6-month-old infant has a fever, drawing up of the legs and episodes of inconsolable crying with 'redcurrant jelly' stools. What is the likely diagnosis?

Accepted Answer

Intussusception

Answer

Gastroenteritis

Answer

Pyloric stenosis

Answer

Constipation

Question 7

A 50-year-old man with hypertension presents with a tearing chest pain radiating to the back and a blood pressure difference between both arms. What is the most likely diagnosis?

Accepted Answer

Aortic dissection

Answer

Myocardial infarction

Answer

Pericarditis

Answer

Pulmonary embolism