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A 75-year-old man presents to the gastroenterology clinic with a three-month history of progressive dysphagia and a hoarse voice. Which of the following investigations would you carry out first?CorrectIncorrect
An 82-year-old woman presents to A&E with a short history of sudden-onset, severe epigastric pain that is aggravated by movement. She has a long history of osteoarthritis, for which she takes regular Voltarol. The most likely diagnosis is:CorrectIncorrect
Which of the following symptoms generally occurs first in small-bowel obstruction?CorrectIncorrect
Which of the following statements is true regarding primary varicose veins?CorrectIncorrect
A 56-year-old unemployed man presents to clinic with a three-month history of right-calf claudication at 8.0 yards (7.2 metres). This is relieved by rest and not associated with rest pain, ulcers or gangrene. He is a heavy smoker and has a medical history of hypertension. Examination reveals a good right femoral, popliteal and dorsalis pedis pulse, with an absent right posterior tibial pulse. Right-leg ABPIs = 0.6. The most appropriate next step is:CorrectIncorrect
CONGENITAL HEART DISEASE
You are called acutely to the postnatal ward to see a 48-hour-old baby girl. She was seen the day before by your colleague, who performed her baby check and found no abnormalities. On arrival, you find a baby who is grunting and cyanotic. All pulses are palpable, and there are no murmurs upon auscultation of the chest. You transfer her to the neonatal unit where you find her oxygen saturations is 55% on room air.
Which of the following congenital cardiac lesions would be consistent with these findings?CorrectIncorrect
BLOOD GASES (1)
A 12-year-old boy with a history of type 1 diabetes is seen in the emergency department. He has been vomiting for the last 24 hours. His blood sugar is high, and he is breathing much harder than usual. You cannulate him to give him some fluid and take a venous blood gas.
PaCO₂ 2.8 kPa
Base excess -9
Normal reference ranges for venous blood gases:
PaCO₂ 4.7-6.0 kPa, 35-45 mmHg
Base excess ± 2
Which of the following is your interpretation of this blood gas?CorrectIncorrect
THE CHOKING CHILD
You are at a wedding sitting next to your 4-year-old nephew. He was eating a sausage and suddenly starts coughing vigorously. He is very agitated and continues to cough. He has been coughing for over a minute, and he is now crying between coughs.
You suspect an inhaled foreign body; which of the following would be your next course of action?CorrectIncorrect
DIAGNOSIS OF ACUTE ASTHMA
A 12-year-old boy presents to the emergency department with worsening shortness of breath and a wheeze for the last 24 hours. On examination, he has a respiratory rate of 35/min and has bilateral wheeze on auscultation. You suspect he has a severe exacerbation of asthma.
What would you expect his peak flow to be?CorrectIncorrect
A 20-year-old woman says that her mind is racing- so much that she can barely speak fast enough to express all her thoughts. She speaks rapidly, frequently changing the subject without explaining her meaning.
Which of the following terms best describes this thought disorder?CorrectIncorrect