Medical Finals Quiz - January 2007

(Closing date: 1st February 2007)

With James Taylor & Ian Bickle, Sheffield, and Gerry Gormley, Belfast

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 "Data Interpretation for Medical Students" (which gives comprehensive practice in data interpretation, which is a common feature of undergraduate annual and final exams. Includes ECGs, blood tests and radiographs, along with a wide range of common patterns and case scenarios.) 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 February 2007.

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

Question 1

A 64 year old man is being treated for his lung abscess (see chest x-ray).

He develops a headache and nausea. His family report he is increasingly irritable.

His investigations show:

Na = 121 mmol/l
K = 3.7 mmol/l
Urea = 6.7 mmol/l
Ca = 2.3 mmol/l
Glucose = 5.0 mmol/l
Hb = 15.1 g/dl
WCC = 12.5 x 109
Plasma osmolality is reported as low
Urine osmolality is high.
Urinary sodium = 55 mmol/l

What is the most likely complication to cause his symptoms?

	(a) Cranial diabetes insipidus
	(b) Severe dehydration
	(c) SIADH (Syndrome of Inappropriate ADH)
	(d) Nephrogenic diabetes insipidus
	(e) Cushing's syndrome

Question 2

One of the antibiotics considered in this man's treatment plan has side effects listed as liver enzyme induction, nausea, and red discolouration of bodily secretions.

Which is the most likely drug to cause this?

	(a) Isoniazid
	(b) Rifampicin
	(c) Ethambutol
	(d) Metronidazole
	(e) Simvastatin

Question 3

Q3. During a teaching ward round your clinical supervisor takes you to evaluate a chest x-ray of a child. On inspection you notice the heart is boot shaped and the lungs are oligaemic.

What is the most likely congenital cardiac defect?

	(a) Ventricular septal defect (VSD)
	(b) Tetralogy of fallot
	(c) Transpostiton of great vessels
	(d) Atrial septal defect (ASD)
	(e) Patent ductus arteriosus (PDA)

Question 4

This 68 year-old man attends his GP complaining of a short history of a red, hot, swollen great right toe (see image below). He has a history of hypertension for which he is on treatment.

The clinical diagnosis given by the GP is acute gout.

Which is the most likely drug to have precipitated acute gout?

	(a) Atenolol
	(b) Enalapril
	(c) Colchine
	(d) Moxonidine
	(e) Bendroflumethiazide

Question 5

This 58 year old patient presents to his GP with the following condition.

Which of the following is not a recognised complication of this condition?

	(a) Bleeding
	(b) Thrombophlebitis
	(c) Lipodermatosclerosis
	(d) Ulceration
	(e) Deep venous thrombosis

Question 6
What month are your clinical finals exam?	January February March April May June July August September October November December Don't know date of final exams yet No exams
Are your clinical finals exams in an OSCE format?	YES NO Not Sure No exams
Does data interpretation feature in your final exam?	YES NO Not Sure No exams
Does radiology feature in your final exam?	YES NO Not Sure No exams
Do you have any local courses for finals?	YES NO Not Sure
Have you/will you attend a course before finals?	YES NO Not Sure
I would like to register to receive regular updates from www.medicalfinals.co.uk:	Yes No thanks
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