www.MedicalFinals.co.uk - Medical Finals Quiz

Medical Finals Quiz - December 2005 (Closing date: 5th January 2006)

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

This month to mark the start of this new medicalfinals feature we will be giving away one free ticket to The 1st Belfast SCRUBS Undergraduate Trauma & Acute Medicine Conference as a prize for those who enter. It will be picked at random from all entries (ie. does not matter if answers are correct or not).

So that we can contact the winner of the ticket, please enter your name and email address at the bottom of this page.

The closing date is 5th January 2006.

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

Question 1:

This 65 year-old retired bus driver presented to hospital with shortness of breath and haemoptysis. He also complained of tender wrists bilaterally.

What do you think is the most likely cause for his painful wrists?

	(a) Inflammatory arthritis
	(b) Pathological wrist fractures
	(c) Osteomyelitis
	(d) Malignant infiltration of the brachial pleuxus
	(e) Hypertrophic pulmonary osteoarthropathy (HPOA)

Question 2:

Treeton Hospital's medical SHO performed a pleural aspiration on the 50 year-old women whose chest x-ray is shown below.

PLEURAL ASPIRATION ANALYSIS

Total Protein = 2.35 G/L

Lactic Dehydrogenase (LDH) = 156 IU/L

pH = 7.36

Microbiology (Gram stain and culture) = Nil Growth

What is the most likely cause of the effusion from your interpretation?

	(a) Bronchial carcinoma
	(b) Hypothyroidism
	(c) Pneumonia
	(d) Rheumatoid disease
	(e) Pulmonary embolus

Question 3:

This 45 year-old women was admitted with abdominal pain and became short of breath. CT chest was performed.

What abnormality is seen on the CT scan?

	(a) Bilateral pneumonia
	(b) Bilateral pleural thickening
	(c) A pulmonary nodule
	(d) Bilateral pleural effusions
	(e) Bilateral sub-phrenic abscesses

Question 4:

Whilst acting as a medical volunteer for the St John's Ambulance at a local fete a 21 year-old lady is brought to you with grossly swollen lips, face and wheeze following a bee sting. He is finding it difficult to breath and his BP is 83/45 from a manual reading,

What should be done next?

	(a) Give 1:1000 IV adrenaline + IV hydrocortisone
	(b) Observe and arrange transfer to casualty
	(c) Give IV hydrocortisone
	(d) Give 1:1000 IM adrenaline + IV hydrocortisone
	(e) Give 1:10,000 IV adrenaline + IV hydrocortisone

Question 5:

A 26 year-old student takes a household substance in excess during a suicide attempt

ABG

pH = 7.27

pCO₂ = 3.0

pO₂ = 14.3

HCO3^- = 16.2

BE = -7.4

U & E

Na⁺ = 143

K⁺ = 4.5

Cl^- = 105

Urea = 12.4

Creatinine = 87

What is the patient's anion gap?

	(a) 26.3
	(b) 21.3
	(c) 23.1
	(d) 47.7
	(e) 2.13

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