Medical Finals Quiz - November 2006

(Closing date: 1st December 2006)

With Paul Hamilton, Ann Johnson & 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 "Therapeutics & Pharmacology" (A systems-based easy reference for busy students. Provides guidance on all aspects of pharmacology, including usage for each drug, dose, characteristics, side effects and how it works. Helps answer questions from patients and your tutor, and has practice questions in preparation for medical finals.) 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 December 2006.

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

Question 1

A 55 year-old women is acutely short of breath 2 days following a left hemi-colectomy. A CXR showed a small left sided pleural effusion. The lungs were clear.

The consultant surgeon was concerned that his patient may have had a post-operative pulmonary embolus and requested a CT pulmonary angiogram (shown below).

What do you think the cause of her shortness of breath is due to?

	(a) A left sided pleural effusion
	(b) Heart failure
	(c) A pulmonary embolus
	(d) Post-operative pneumonia
	(e) Musculoskeletal chest pain

Question 2

An 18 year old girl presents to the emergency department extremely unwell. She is short of breath, cold and clammy to touch. She states she is very thirsty. The triage nurse reports to you that her blood glucose level is 21.2 mmol/l, and that she has ++++ ketones on urinalysis. Treatment is commenced.

What electrolyte should you be most concerned with monitoring over the next 24 hours?

	(a) Sodium
	(b) Potassium
	(c) Magnesium
	(d) Calcium
	(e) Phosphate

Question 3

Which of the following signs are not associated with severe pulmonary hypertension?

	(a) Hepatomegaly
	(b) Right ventricular heave
	(c) Large V waves in the JVP
	(d) Pan-systolic murmur loudest at the lower left sternal edge in expiration
	(e) Peripheral oedema

Question 4

An ambulance is called to a pop concert, after a 14 year girl collapsed. Her friends state that she collapsed and had a few rhythmical jerks of her limbs. She was not injured, did not bite her tongue, but was incontinent of urine. When she regained consciousness she said that before blacking-out her vision faded and that her hearing became muffled.

What investigations are required?

	(a) CT brain
	(b) EEG
	(c) None
	(d) ECG
	(e) Tilt table testing

Question 5

A 42 year old man presented to his GP with troublesome headaches mainly occurring at night. He describes them as excruciating, and during an attack his wife states that he becomes aggressive, noisy and has been known to kick furniture and walls. The headaches usually last about 60 minutes and occasionally his left eye becomes red and injected. It sometimes droops, making his wife think that he is having a stroke. He can sometimes have up to 6 attacks per night. Bad bouts occur every 3-4 months. He is well in between these episodes.

What is the diagnosis?

	(a) Chronic migraine
	(b) Paroxysmal hemicrania
	(c) Short lasting unilateral neuralgiform headache with conjunctival injection and tearing
	(d) Cluster headache
	(e) Herald bleeds

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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