Archives: MSRA

MSRA-0899

A 72-year-old man has been admitted to the orthopaedic ward following a left hemiarthroplasty. He has a history of hypertension, type 2 diabetes and chronic myeloid leukaemia (CML).

The nurse has requested an urgent review of the patient as he is displaying signs of confusion. His blood pressure is 96/54 mmHg and his heart rate is 135 bpm. The patient has been passing 10 ml of urine an hour through his catheter and the nurse has observed that the urine in the catheter bag is bright red.

Upon examination, the patient has petechial bruising over his arms and blood is slowly oozing from his peripheral cannula. What blood test results would you anticipate?

MSRA-0900

A 65-year-old man visits you to discuss his recent blood tests, which were part of a routine health screening conducted three days ago. He is currently on day five of antibiotics for community-acquired pneumonia, which was treated by one of your colleagues. Apart from this recent infection, he has no medical history and no new symptoms to report. His renal function is normal, and the rest of his blood tests are as follows:
– Hb: 110 g/l
– Platelets: 540 * 109/l
– WBC: 13 * 109/l
– MCV: 76 * 109/l
– Ferritin: 330 * 109/l
All values were normal one year ago. What is the most likely cause of his anemia?

MSRA-0882

A 23-year-old woman with sickle cell disease is admitted to the haematology unit after experiencing increasing fatigue and general malaise for the past week following a recent febrile illness. Upon examination, she appears pale and has multiple petechiae and bruises over her trunk and upper and lower limbs. Blood tests reveal a Hb of 82 g/L (135-180), platelets of 29 * 109/L (150 – 400), and WBC of 1.3 * 109/L (4.0 – 11.0). What is the most likely cause of this patient’s presentation?

MSRA-0883

A 50-year-old woman who recently finished a round of chemotherapy reports experiencing tingling sensations and difficulty using her hands. Additionally, she has noticed hesitancy in her urinary function. Which specific cytotoxic medication is the likely culprit for these symptoms?

MSRA-0884

A 56-year-old man with a history of epilepsy and ischaemic heart disease presents to the clinic with a complaint of feeling lethargic for the past 3 months. Upon conducting blood tests, the following results were obtained: Hb 9.6 g/dl, MCV 123 fl, Plt 164 * 109/l, WCC 4.6 *109/l. Which medication is the most likely cause of his symptoms?

MSRA-0885

A 72-year-old patient with chronic lymphocytic leukaemia presents to the emergency department with haematemesis. Urgent blood tests are taken and blood products ordered from the laboratory.

A full blood count shows:

Hb 76 g/L Male: (135-180) Female: (115 – 160)

Platelets 26 * 109/L (150 – 400)

WBC 21.8 * 109/L (4.0 – 11.0)

Which blood product carries the highest risk for this immunocompromised patient?

MSRA-0886

A 50-year-old woman is found to have a proximal deep vein thrombosis four weeks after undergoing surgery for a broken ankle. She is prescribed warfarin (initially accompanied by low molecular weight heparin) with a desired INR range of 2.0-3.0. What other treatment option should be presented to this patient?

MSRA-0887

A 65-year-old woman is being evaluated one week after being diagnosed with a deep vein thrombosis in her left leg. She has been administered low-molecular weight heparin for five days and has now been prescribed warfarin. The patient has a medical history of osteoporosis, breast cancer, type 2 diabetes, and depression. Which medication she is currently taking is most likely to have contributed to her increased risk of developing a deep vein thrombosis?

MSRA-0888

Which cytotoxic agent is commonly linked to pulmonary fibrosis?

MSRA-0889

A 72-year-old man visits his doctor complaining of fatigue, back pain, and frequent urination and thirst for the past 3 months. Upon examination, the doctor orders a urine protein electrophoresis and a serum-free light-chain assay, which confirm the diagnosis. What is the most probable result on the patient’s blood film?