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

Painless visible haematuria in an older adult requires urgent investigation to exclude bladder malignancy.

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

Unilateral throbbing headache with aura, nausea and photophobia is typical of migraine.

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

A chest X-ray is the appropriate first-line investigation for suspected lung cancer.

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

Primary hyperthyroidism is confirmed by a suppressed TSH alongside an elevated 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

A shortened, externally rotated leg after a fall in the elderly is the classic sign of a hip (neck of femur) fracture.

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

MSRA Clinical Problem Solving 4