MSRA Comprehensive MSRA 3 — Questions and Answers
Question 1: A 22-year-old presents with a non-blanching petechial rash, fever, and neck stiffness. What is the immediate priority?
- Await blood results before treating
- Give parenteral antibiotics urgently (Correct answer)
- Discharge with oral antibiotics
- Reassure and observe
Correct answer: Give parenteral antibiotics urgently
Suspected meningococcal sepsis requires immediate parenteral antibiotics without delay for investigations.
Question 2: In an SJT scenario, a patient asks you not to tell their family about their diagnosis. What should you do?
- Tell the family anyway
- Respect the patient's confidentiality if they have capacity (Correct answer)
- Refuse to treat the patient
- Document nothing
Correct answer: Respect the patient's confidentiality if they have capacity
A competent adult's confidentiality must be respected unless there is an overriding legal or public-safety reason to breach it.
Question 3: A patient on warfarin has an INR of 8.0 with no bleeding. What is the appropriate management?
- Increase the warfarin dose
- Withhold warfarin and consider oral vitamin K (Correct answer)
- Give IV heparin
- No action needed
Correct answer: Withhold warfarin and consider oral vitamin K
An INR of 8.0 without bleeding is managed by withholding warfarin and giving oral vitamin K.
Question 4: Which feature most strongly suggests a diagnosis of bacterial rather than viral tonsillitis (Centor criteria)?
- Presence of cough
- Tonsillar exudate (Correct answer)
- Runny nose
- Hoarse voice
Correct answer: Tonsillar exudate
Tonsillar exudate is a Centor criterion favouring bacterial (streptococcal) infection; absence of cough is another.
Question 5: You are asked to perform a procedure you have never done and feel unprepared for. What is the best response?
- Attempt it alone to avoid looking incompetent
- Decline and request supervision or training (Correct answer)
- Refuse and walk away without explanation
- Delegate it to a nurse
Correct answer: Decline and request supervision or training
Recognising the limits of your competence and seeking supervision protects patient safety.
Question 6: A 50-year-old presents with central crushing chest pain radiating to the left arm. What is the most appropriate immediate investigation?
- Echocardiogram
- 12-lead ECG (Correct answer)
- Chest CT
- Abdominal ultrasound
Correct answer: 12-lead ECG
A 12-lead ECG should be performed immediately to assess for acute coronary syndrome.
Question 7: Which of the following is a notifiable disease in the UK?
- Hypertension
- Measles (Correct answer)
- Type 2 diabetes
- Osteoarthritis
Correct answer: Measles
Measles is a statutorily notifiable disease that must be reported to public health authorities.
MSRA Comprehensive MSRA 3
A 22-year-old presents with a non-blanching petechial rash, fever, and neck stiffness.
What is the immediate priority?