MSRA Practice and Application 2

Question 1

A 45-year-old patient on warfarin presents with an INR of 6.2 and minor gum bleeding. Which is the most appropriate immediate management?

Accepted Answer

Withhold warfarin and give oral vitamin K 1–2mg

Answer

For supratherapeutic INR with minor bleeding, withholding warfarin and giving low-dose oral vitamin K is first-line management.

Question 2

During a ward round, you notice a colleague appears intoxicated while examining patients. What is the most appropriate first action?

Accepted Answer

Immediately report your concerns to a senior colleague or supervising consultant

Answer

Patient safety takes priority; immediate escalation to a senior is required when a colleague may be impaired during clinical duties.

Question 3

A GP requests an urgent CT head for a patient with sudden-onset severe headache. The radiologist declines, stating it is not clinically indicated. How should you proceed?

Accepted Answer

Explain your clinical concern about subarachnoid hemorrhage and escalate if the decision is unchanged

Answer

Clinicians must advocate for patient safety by clearly communicating clinical concerns and escalating through appropriate channels if the disagreement persists.

Question 4

You are about to perform a lumbar puncture on a patient who previously consented but now seems confused and cannot re-confirm consent. What should you do?

Accepted Answer

Assess mental capacity at this moment before proceeding

Answer

Capacity must be assessed at the time of the procedure; prior consent does not override the need for current capacity assessment.

Question 5

A diabetic patient on metformin requires a contrast CT scan. What is the most important pre-procedure consideration?

Accepted Answer

Stop metformin 48 hours before and restart only after renal function is confirmed normal post-procedure

Answer

Metformin should be withheld around contrast administration to prevent lactic acidosis if contrast-induced nephropathy occurs.

(MSRA) Multi-Specialty Recruitment Assessment Practice Test

(MSRA) Multi-Specialty Recruitment Assessment Practice Test

MSRA Practice and Application 2