Free Trial MCQ Questions

A 66-year-old male patient is on the surgical ward recovering from a liver resection. Three days post-op the patient has started to become acutely short of breath and his heart rate has increased from 70 earlier this morning to 125 now. An ECG is performed which shows sinus tachycardia. The patient is apyrexial and his morning routine bloods today were unremarkable. The patient is now on 4L of oxygen and saturating at 96% and the patient’s respiratory rate is 25. A CTPA is ordered urgently and an arterial blood gas is performed. What is the correct interpretation of the arterial blood gas?

A 70-year-old female patient attends her GP with symptoms of lethargy and backache. She has been unable to do her usual gardening for the last few weeks because the back pain has been so persistent and because she is feeling tired and dizzy on exertion. The patient describes the pain as a constant dull ache and it has woken her up from sleep on a number of occasions. She has tried regular paracetamol however this is not managing the pain very well. The patient is usually fit and well however over the last 3 months she has had 3 urinary tract infections and most recently the patient has been unwell with influenza a few weeks ago. The GP decides to perform some blood tests. What is the most likely diagnosis?

A 78-year-old female patient has fallen in the street carrying her supermarket shopping home. The patient tells the ambulance crew who attend the scene that she tripped over an uneven paving stone and she has landed awkwardly onto her right hand which she instinctively put out as she fell down. She has 10/10 pain in her right wrist and can not move her right hand. On examination of the right arm there is a dinner fork deformity to the right wrist and hand. The patient has reduced grip and altered sensation in the right hand, left arm is normal on examination. Which of the following is the most likely fracture that this patient has sustained?

A 28-year-old female patient has an emergency c-section and is recovering on the birthing suite with her newborn baby boy. The patient was stable initially in recovery however after being transferred to the ward the midwives are concerned about the patient. The patient has no significant past medical history and was well in herself leading up to the delivery. The patient’s observations are BP 110/60, HR 150 irregularly irregular, temperature 41.5°C, O2 saturations 98% on 4L O2 through a nasal cannula, respiratory rate 20. An ECG is performed and shows that the patient is in atrial fibrillation. On general inspection it is noted that the patient has brown rash bilaterally on the anterior aspect of the lower legs, with mild non pitting oedema. On closer examination the rash consists of red/brown waxy papules and plaques. There is no PV bleeding identified on inspection of external genitalia. The patient is not orientated to time or place and is having visual and auditory hallucinations. What is the most likely diagnosis?

A 75-year-old female patient attends her GP with bilateral droop of the eyelids. The patient states that over the last week she has noticed that both eyelids are drooped. She notes that when she rises in the morning the eyelids appear normal however as the day progresses the eyelids become more and more drooped. She is experiencing some double vision and is also having difficulty raising her head up for longer periods of time which she noticed when she was looking for a cookbook on the top shelf of her bookcase. In addition, the patient has noticed that her hands appear to be weaker than normal and she struggled to pick up a full mug of tea today. She is also having difficulty chewing and swallowing a full meal. The patient is usually in good health and has a past medical history of thyroid disease. On examination the patient was asked to look up for 20 seconds and fatigable ptosis was noted of the eyelids. On sustained lateral gaze, fatigable diplopia was noticed. The patient struggled to maintain sustained abduction of the arms. What is the most likely condition responsible for these symptoms?

A 48 year old man presents to the Emergency Department with sudden onset central chest pain. He reports that it started this morning and has been constant since, he describes the pain as a stabbing pain which radiates up to his collar bone. It is made worse by breathing in and improves on sitting forward. The pain is 8/10 in severity despite GTN spray and aspirin been given by the paramedic. He has a past medical history of hypertension and takes amlodipine 5mg and ramipril 2.5mg. Observations: sats 97%, HR 95bpm, RR 20, BP 125/87, temp 37.4 CXR: nil acute changes ECG: widespread concave ST elevation What is the most likely diagnosis?

A 32 year old man is pre-alerted to the Emergency Department with low GCS and the department with drowsiness, tachycardia and hypotension. He has a history of depression and anxiety and is taking amitriptyline 25mg BD. The paramedics crew report that on arrival he was lying in bed, with multiple empty packets of amitriptyline on the floor. A- Patent, maintaining own airway B- RR 18, sats 97% RA. Equal air entry bilaterally, nil added sounds C- Regular pulse, 130bpm. BP 105/76, cap refill <2 seconds. HS 1+2+0 D- GCS 14 An initial ECG is performed. What finding might you expect on ECG in amitriptyline overdose in addition to tachycardia?

A 45 year old lady presents to the Emergency Department with a 5 days history of right upper quadrant pain. She reports that it was initially intermittent pain, but has become constant in that last 3 days. She describes an 8/10 severity stabbing pain, which is non-radiating. She has also been feeling nauseous, and clammy and had a temperature of 37.9 degrees at home. She has no past medical history and does not take any regular medications. On examination she is tender and guarding in the right upper quadrant. Blood results are below. Given the initial assessment, what is the most likely diagnosis?

A 35 year old lady presents to the Emergency Department with a 1/7 history of right sided back pain. She describes an intermittent gripping 10/10 pain and comes on every few minutes. She is unable to get comfortable and the paracetamol she has been taking at home has not helped. She has no abdominal pain, no nausea/vomiting, and is passing urine and opening her bowels as normal. Her LMP was 3 weeks ago and she has the contraceptive implant. Given the likely diagnosis, which investigation would be most appropriate for this patient?

An 8 year old girl presents to the GP surgery with her mum. Over the past few weeks she has had dry itchy skin particularly affecting her elbows and knees and her mum has been applying emollients regularly. Her mum has noticed she has been scratching her face and neck over the past 3 days and this morning she developed blisters around her mouth which are weeping a yellow fluid. She is otherwise systemically well in herself and has no past medical history. According to NICE guidelines, what is the initial management?