MSRA Category: Infectious Diseases

MSRA-1204

A 45-year-old man presents to his General Practitioner with a 7-day history of flu-like symptoms, including spiking fevers, headache, rigors, vomiting and diarrhoea.
On examination, he looks unwell, is febrile and jaundiced. His abdomen is soft, with mild, generalised tenderness and hepatosplenomegaly. He returned from Nigeria six months ago after a 8-week stay with a charity mission. He had all the appropriate travel vaccinations and took mefloquine prophylaxis.
What is the most likely diagnosis?

MSRA-1205

A 28-year-old woman comes to the doctor complaining of lower abdominal pain, pain during sexual intercourse, and an abnormal vaginal discharge. A vaginal swab reveals a positive chlamydia infection. She has no known allergies and is generally healthy. What is the most appropriate next step in managing this patient?

MSRA-1206

A 35-year-old woman presents to the Genitourinary Medicine Clinic with an 8-day history of dysuria and lower abdominal pain. She has had two sexual partners over the last three months and uses the combined oral contraceptive pill as contraception. She has noticed some spotting and post-coital bleeding since her last period and a foul-smelling vaginal discharge for the last few days. There is no past medical history of note and no known allergies.
On examination, she has lower abdominal tenderness but no guarding or palpable organomegaly. On examination, there is a thick yellow vaginal discharge and mildly tender palpable inguinal lymphadenopathy.
Given the likely diagnosis, what is the most appropriate management for this patient?
Select the SINGLE most appropriate management from the list below.
Select ONE option only.

MSRA-1207

After hepatitis B immunisation, which serological marker indicates successful immunisation? Choose ONE option from the list provided.

MSRA-1208

Legionnaires’ disease has several statements associated with it, but which one is true?

MSRA-1209

A 3-day-old infant delivered via caesarean section at 38 weeks gestation presents with limb hypoplasia, rudimentary digits, and microcephaly. What is the probable prenatal infection that the baby was exposed to?

MSRA-1210

A 28-week premature infant is born after prolonged premature rupture of membranes (PROM). The neonate develops temperature instability, respiratory distress, and lethargy about 18 hours after birth. Blood cultures confirm sepsis. What is the probable causative organism?

MSRA-1211

A 5-day-old infant presents with congenital cataracts, sensorineural deafness, and pulmonary artery stenosis. What is the probable prenatal infection that the baby has been exposed to?

MSRA-1201

A 25-year-old man visits his General Practitioner with a complaint of a sore throat that has been bothering him for the past three weeks. He reports feeling significantly fatigued, which is affecting his academic performance. On examination, he appears healthy and has tender cervical lymphadenopathy; his tonsils are enlarged but no exudate is present, and he has tender splenomegaly.
Which of the following investigation findings is most likely to be associated with this condition?
Select the SINGLE most appropriate result from the list below.

MSRA-1202

A 35-year-old man presents to his family doctor after a trip to Southeast Asia. He and his colleagues frequently ate at street food stalls during their trip, often consuming seafood. He complains of feeling unwell, loss of appetite, yellowing of the skin and dark urine. He had a fever initially, but it disappeared once the jaundice appeared. During the examination, he has an enlarged liver and tenderness in the upper right quadrant. His ALT and AST levels are ten times the upper limit of normal, while his bilirubin level is six times the upper limit of normal, but his ALP is only slightly elevated. What is the most probable diagnosis?