MSRA-0875
A 5-year-old boy with sickle cell anaemia complains of abdominal pain. During the physical examination, the doctor observes splenomegaly and signs of anaemia. What is the probable diagnosis?
Archives: MSRA
MSRA-0876
A 32-year-old woman presents with heavy menstrual bleeding and a haemoglobin level of 102 g/L. Iron studies are ordered to investigate for iron-deficiency anaemia. What result would support this diagnosis?
MSRA-0877
A 70-year-old man with metastatic prostate cancer is experiencing increased pain and vomiting while taking morphine sulphate 60mg bd. It has been decided to switch to subcutaneous administration. What is the recommended 24-hour dose of morphine for continuous subcutaneous infusion?
MSRA-0878
A 49-year-old homeless man has been admitted to the emergency department after collapsing with sudden onset left side hemiparesis and facial droop. A CT scan has revealed a large intracerebral haemorrhage, which is likely to have occurred spontaneously. The patient’s medical and family history is unknown, but you suspect that coagulopathy may be the cause of the spontaneous bleed. The clotting profile and specific clotting factor levels are as follows:
– PT prolonged
– APTT prolonged
– Factor VIII high
– Factor II low
– Factor V low
– Factor VII low
– Factor IX low
– Von Willebrand factor high
What is the most probable reason for the coagulopathy?
MSRA-0879
A 55-year-old woman presents with weight loss and anaemia. She has no significant medical history. Upon examination, she has massive splenomegaly and pale conjunctivae. Her full blood count shows a Hb of 10.9 g/dl, platelets of 702 * 109/l, and a WCC of 56.6 * 109/l. Leucocytosis is noted on her film, with all stages of granulocyte maturation seen. What is the most probable diagnosis?
MSRA-0880
A 56-year-old man has been experiencing fatigue and bone pain, prompting his regular GP to conduct investigations. Blood tests revealed an elevated paraprotein level, leading to further investigations to rule out multiple myeloma as the primary differential. What other potential cause could result in a raised paraprotein level?
MSRA-0881
A 72-year-old man with metastatic breast cancer presents to surgery with his wife. He has known bone metastases in his pelvis and ribs, but his pain is not adequately managed with paracetamol, diclofenac, and MST 30 mg bd. His wife reports that he is using 10mg of oral morphine solution approximately 6-7 times a day for breakthrough pain. The hospice palliative care team attempted to use a bisphosphonate, but it resulted in persistent myalgia and arthralgia. What is the next appropriate step?
MSRA-0849
A 6-year-old girl is presenting with swelling of her hands and feet and an abnormally wide neck. Upon karyotyping, it is discovered that she has monosomy X and 45X. During physical examination, mild aortic stenosis is observed. What congenital condition is most likely linked to this patient’s symptoms?
MSRA-0850
A 45-year old woman became pregnant unexpectedly. She had given birth to five healthy children in her 20s and 30s with her now 47-year-old husband. Chorionic villus biopsy and karyotype analysis revealed that she was carrying a fetus with trisomy 21 (Down syndrome).
What is the most likely cause of the condition?
MSRA-0851
A 45-year old teacher is diagnosed with a medical condition that is inherited in an autosomal dominant manner.
Which of the following diseases is best described as being inherited in an autosomal dominant manner?