www.MedicalFinals.co.uk - Medical Finals Quiz

Medical Finals Quiz - February 2006 (Closing date: 1st March 2006)

By Dr Gerry Gormley & Dr Ian Bickle

Please take part in our monthly quiz. This quiz is open to all.

This month for the quiz winner, there is a very useful book on "Clinical Skill for Medical Students: A Hands on guide 2nd edition" This book is very kindly provided by PasTest. The winner will be picked at random from all entries (ie. does not matter if your answers are correct or not).

In order to contact the winner of the book, please enter your name and email address at the bottom of this page.

The closing date is 1st March 2006.

Learn as you test yourself. Detailed answers with teaching points will be given after you complete this page.

Question 1

John is a 50 year old car mechanic. He presents to his GP with an 8 week history of pains in his hands, elbows, shoulders, knees and feet. He has remarked that his joints have become quite 'swollen'. They are stiff in the morning time and take more than 30 minutes to 'warm up'. On examination you notice that his MCP joints are symmetrically swollen, red and tender. Clinically the GP diagnoses early Rheumatoid Arthritis (RA).

What would be the recommended course of action that the GP should take?

	(a) Refer to a rheumatologist only when his pains become quite severe.
	(b) GP should commence Methotrexate
	(c) Routine referral to a rheumatologist
	(d) Urgent referral to a rheumatologist
	(e) X-ray his hands

Question 2

The following patient with hypertension had an ultrasound of the abdomen due to an elevated urea and creatinine. February Quiz Ultrasound Abdomen

What is the likelihood of his sister having the same condition?

	(a) 25%
	(b) 0%
	(c) 50%
	(d) 100%
	(e) 75%

Question 3

A 21 year-old female student notices an enlarging mass in her neck. On examination it lies in the upper 1/3 of the anterior triangle. It is fluctuant in nature.

What is the most likely diagnosis?

	(a) Cystic hygroma
	(b) Branchial cyst
	(c) Thyroid cyst
	(d) Lymph node
	(e) Carotid body tumour

Question 4

A 71 year-old man complains to his GP of bony aches and pains. He is otherwise well. Bone profile sent.

Bone Profile

Ca = 2.31 mmol/l

ALP = 198 U/L

ALB = 41 g/l

Phosphate = 0.89 mmol/l

PSA = 2.1 µg/l

AST, ALT, GGT are normal.

What is the most likely diagnosis?

	(a) Prostatic carcinoma with bony metastases
	(b) Osteoporosis
	(c) Primary sclerosing Cholangitis
	(d) Paget's disease
	(e) Osteomalacia

Question 5

When assessing an antero-posterior (AP) chest x-ray (CXR) which structure(s) should be commented on with care?

	(a) Trachea
	(b) Pulmonary arteries
	(c) Heart
	(d) Lung Apices
	(e) Breast shadows

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