Medical Finals Quiz - September 2007

(Closing date: 15th October 2007)

With: Polly Drew, Nottingham

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 "Essential Skills Practice for OSCEs in Medicine" By: Dr. D McCluskey - is divided into 'skills' sections - History Taking, Clinical signs, Clinical Examination, Communication Skills, Therapeutics and Pharmacology, Radiology, Interpretation of Data. Each section includes 15 to 20 OSCEs in question & answer format. 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 15th October 2007.

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

Question 1

A 93 year old gentleman suffered a fall at his nursing home and was bought into A&E by ambulance. He complained of a headache that he described as 'the worst headache of my life'. On examination he showed signs of neck stiffness and photophobia. The physician ordered an urgent CT scan of the head.

What is the likely cause of this gentleman's symptoms?

	(a) Subarachnoid haemorrhage
	(b) Subdural haemorrhage
	(c) Extradural haemorrhage
	(d) Transient ischaemic attack
	(e) Meningitis

Question 2

A 18 year old male presents to the emergency GP with sudden onset of pain in his right testis. He began feeling nauseous and vomited whilst in the GP's. The GP examined the testis, which appeared red and swollen. The GP arranged for immediate transfer to hospital.

What is the most likely diagnosis?

	(a) Orchitis
	(b) Tosion of hydatid of morgagni
	(c) Strangulated inguinal hernia
	(d) Testicular torsion
	(e) Testicular tumour

Question 3

A 63 year old male presents to his GP with an acutely painful right toe, following a drinking binge. On examination the toe is swollen, erythematous with red and shiny overlying skin, and is extremely tender to touch. The patient is currently taking furosemide, atenolol, ramipril and aspirin.

Which of the following would be the most useful investigation to obtain a diagnosis?

	(a) Serum uric acid
	(b) Plain radiograph
	(c) Synovial fluid aspirate
	(d) Full blood count
	(e) Blood cultures

Question 4

A 60 year old gentleman, who recently emigrated from Australia, attends the dermatology clinic with a growth on his left ear. The dermatologist examines his ear and notes a 3cm and 2cm lesion with a pearly rolled edge. The lesion is not pigmented; it is painless and is not associated with any discharge.

What is the most likely diagnosis of this gentleman's lesion?

	(a) Bowen's disease
	(b) Basal Cell Carcinoma
	(c) Superficial spreading malignant melanoma
	(d) Squamous cell carcinoma
	(e) Dysplastic naevi

Question 5

A 60 year old ship worker is admitted to the respiratory ward with progressive breathlessness and a cough. On examination there is gross finger clubbing and bibasal end-inspiratory crackles. A chest x-ray reveals symmetrical basal parenchymal changes and pleural plaques.

Which type of lung cancer is this patient at increased risk of developing?

	(a) Squamous cell carcinoma
	(b) Adenocarcinoma
	(c) Small cell carcinoma
	(d) Oat cell carcinoma
	(e) Mesothelioma

Question 6
Select which charity medicalfinals.co.uk should next give donations from 2007 to:
StreetReach - provides support services for adults and young people involved in prostitution or sexual exploitation. www.StreetReach.org.uk Treeton church tower - restoration of St Helen's church tower in Treeton, Yorkshire. Treeton partnership projects Tearfund's "Work a Miracle" project - aims to reduce HIV transmission to babies in Africa by giving anti-HIV drugs to the mother just before delivery. www.TearFund.org.uk/Miracle "Shine a Light" - Billy McCrory (52), from Belfast, who has suffered from a heart condition for 10 years, founded Shine A Light in 1997 in order to give children with cancer a better life. Newspaper writeup MIND - leading mental health charity in England and Wales. Works to create a better life for everyone with experience of mental distress. www.mind.org.uk
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