MSRA-0996
A 67-year-old woman presents to the breast clinic with an abnormal mammogram and a small fixed lump in her right breast. What type of breast cancer is most frequently encountered?
Archives: MSRA
MSRA-0997
A 50-year-old woman comes to her GP with bloody discharge from her left nipple. She is extremely worried as she has discovered a small lump on the same breast while examining it after noticing the discharge. She has no medical history and does not take any regular medication. She mentions that her sister had breast cancer a few years ago. She denies any injury to the area. She has never given birth and still has regular periods. What is the probable diagnosis?
MSRA-0998
A 42-year-old woman is found to have breast cancer. She has no significant medical history, is premenopausal, and has no family history of breast or ovarian cancer. The cancer is in its early stages and she undergoes a wide-local excision followed by whole-breast radiotherapy. The pathology report reveals that the tumour is positive for oestrogen receptors but negative for HER2. What is the most probable adjuvant treatment that she will be recommended?
MSRA-0999
A 27-year-old woman with a BMI of 34 kg/m² presents to your GP clinic with a small lump in her right breast. She is worried about the possibility of breast cancer, although she has noticed that the lump has decreased in size over the past two weeks. She denies any direct injury but mentions playing rugby recently. There is no family history of breast or gynaecological cancer. On examination, a small, firm, poorly mobile lump is found in the lower quadrant of the right breast.
What is the most probable diagnosis?
MSRA-1000
A 36-year-old woman comes to the clinic with a lump in her left breast. She has recently lost approximately 1.5 stone in weight by attending a weight loss program. During the examination, a firm lump is detected in her left breast that is not mobile but not attached to the underlying muscle. She recalls being hit by a squash ball in this area a few months ago. What is the probable reason for her lump?
MSRA-0980
A 68-year-old woman presents to her General Practitioner to discuss some recent blood tests which were taken for tri-monthly monitoring of her methotrexate. She has rheumatoid arthritis (RA) and takes methotrexate, folic acid and co-codamol.
Investigations:
Investigation Result Normal value
Haemoglobin 91 g/l 115–165 g/l
White cell count (WCC) 5.2 × 109/l 4.0–11.0 × 109/l
Platelets 228 × 109/l 150–400 × 109/l
Neutrophils 5.4 × 109/l 2.0–7.5 × 109/l
Mean corpuscular volume (MCV) 96 fl 85–105 fl
Mean corpuscular haemoglobin (MCH) 29 pg 27–32 pg
Sodium 138 mmol/l 135–145 mmol/l
Potassium 4.1 mmol/l 3.5–5.3 mmol/l
Urea 3.2 mmol/l 2.5–7.5 mmol/l
Creatinine 68 µmol/l 53–100 µmol/l
Estimated glomerular filtration rate > 90 ml/min per 1.73m2 > 90 ml/min per 1.73m2
What is the most likely cause of this patient’s anaemia?
MSRA-0981
A 70-year-old retired car mechanic who is a smoker is diagnosed with lung cancer. Some fifteen years ago he was treated with surgery and adjuvant chemotherapy for bladder cancer. His brother had oesophageal cancer aged 66 and another brother had prostate cancer in his 70s. His 55-year-old daughter was recently diagnosed with breast cancer.
Which of the following is the most likely explanation for the cancers in your patient?
MSRA-0982
A 25-year-old woman presents to the antenatal clinic for her booking visit. She speaks very little English and is 20 weeks’ pregnant in her first pregnancy. No medical history of note can be obtained.
Investigations:
Investigation Result Normal values
Haemoglobin (Hb) 101 g/l 115–155 g/l
Haematocrit 38% 40–54%
Red blood cell count (RBC) 5.24 × 1012/l 4.0–5.0 × 1012/l
Mean corpuscular volume (MCV) 63 fl 80–100 fl
Mean corpuscular Hb (McHb) 20 pg 27–32 pg
Mean corpuscular Hb concentration 32 g/dl 32–36 g/dl
White cell count (WCC) 6.9 × 109/l 4.0–11.0 × 109/l
Platelets (PLT) 241 × 109/l 150–400 × 109/l
Foetal Hb (HbF) 0.6% < 1%
Haemoglobin A2 (HbA2) 4.5% 1.5–3.5%
Which of the following is the most likely cause of her anaemia?
MSRA-0983
A 32-year-old patient who is a vegan and very active has been experiencing fatigue and difficulty breathing for the past two months. During examination, she appears to be anaemic.
What is the most probable vitamin deficiency causing her anaemia?
MSRA-0984
A 60-year-old patient presents with jaundice and an enlarged, nodular liver. A CT scan of the abdomen reveals a cirrhotic liver with a large mass, and CT-guided biopsy of the mass confirms a malignant tumour derived from hepatic parenchymal cells. Which virus is most likely directly related to the development of this tumour?