MSRA Clinical Problem Solving 5

Question 1

A 45-year-old woman presents with fatigue, conjunctival pallor and a microcytic anaemia. What is the most likely underlying cause?

Accepted Answer

Iron deficiency

Answer

Vitamin B12 deficiency

Answer

Folate deficiency

Answer

Hypothyroidism

Question 2

A 25-year-old man presents with acute testicular pain, swelling and a high-riding testis after sudden onset. What is the immediate concern?

Accepted Answer

Testicular torsion

Answer

Epididymitis

Answer

Hydrocele

Answer

Varicocele

Question 3

A 62-year-old man with COPD presents with increased breathlessness, green sputum and wheeze. What is the most appropriate first-line treatment for an infective exacerbation?

Accepted Answer

Antibiotics and bronchodilators

Answer

Long-term oxygen therapy

Answer

Immediate intubation

Answer

Inhaled steroids alone

Question 4

A 30-year-old woman with a positive pregnancy test presents with unilateral lower abdominal pain and vaginal bleeding. What must be excluded first?

Accepted Answer

Ectopic pregnancy

Answer

Urinary tract infection

Answer

Ovarian cyst

Answer

Appendicitis

Question 5

A 55-year-old diabetic presents drowsy with a glucose of 2.1 mmol/L. What is the most appropriate immediate treatment if he can swallow safely?

Accepted Answer

Fast-acting oral glucose

Answer

IV insulin

Answer

Oral metformin

Answer

Reassurance

Question 6

A 70-year-old woman presents with a sudden painful red eye, halos around lights, nausea and a fixed mid-dilated pupil. What is the most likely diagnosis?

Accepted Answer

Acute angle-closure glaucoma

Answer

Conjunctivitis

Answer

Anterior uveitis

Answer

Cataract

Question 7

A 48-year-old man presents with severe sudden pain in the first metatarsophalangeal joint, which is red, hot and swollen. What is the most likely diagnosis?

Accepted Answer

Gout

Answer

Septic arthritis

Answer

Osteoarthritis

Answer

Rheumatoid arthritis