MSRA Core Knowledge and Fundamentals 2

Question 1

A 58-year-old man presents with sudden-onset tearing chest pain radiating to the back. His BP is 160/90 mmHg in the right arm and 130/80 mmHg in the left arm. What is the most likely diagnosis?

Accepted Answer

Aortic dissection

Answer

Inter-arm BP difference >20 mmHg combined with tearing back pain strongly suggests aortic dissection.

Question 2

Which electrolyte abnormality is most commonly associated with prolonged QT interval on ECG?

Accepted Answer

Hypocalcemia

Answer

Hypocalcemia prolongs the ST segment and QT interval, increasing the risk of torsades de pointes.

Question 3

A patient on warfarin presents with an INR of 8.2 but has no active bleeding. What is the most appropriate management?

Accepted Answer

Hold warfarin and give oral vitamin K 1-2 mg

Answer

For supratherapeutic INR without bleeding, withholding warfarin and giving low-dose oral vitamin K is the recommended approach.

Question 4

Which of the following is the most sensitive test for diagnosing pulmonary embolism in a haemodynamically stable patient?

Accepted Answer

CT pulmonary angiography

Answer

CT pulmonary angiography (CTPA) is the gold standard and most sensitive test for diagnosing PE in stable patients.

Question 5

A 35-year-old woman at 32 weeks gestation presents with BP 158/104 mmHg and 3+ proteinuria. She has severe headache. What is the most appropriate initial management?

Accepted Answer

Administer magnesium sulfate and antihypertensives

Answer

Severe pre-eclampsia with neurological symptoms requires magnesium sulfate for seizure prophylaxis and urgent antihypertensive therapy.

(MSRA) Multi-Specialty Recruitment Assessment Practice Test

(MSRA) Multi-Specialty Recruitment Assessment Practice Test

MSRA Core Knowledge and Fundamentals 2