Archives: MSRA

MSRA-0723

A 26-year-old man with a history of ulcerative colitis presents to the GP with symptoms of feeling unwell. He has been experiencing up to 8 bowel movements a day for the past 3 days, with blood present in his stool each time. He denies having a fever. Urgent blood tests reveal the following results:

Hb 110 g/L Male: (135-180) Female: (115 – 160)
Platelets 384 * 109/L (150 – 400)
WBC 16 * 109/L (4.0 – 11.0)
Na+ 138 mmol/L (135 – 145)
K+ 4.2 mmol/L (3.5 – 5.0)
Urea 2.4 mmol/L (2.0 – 7.0)
Creatinine 58 µmol/L (55 – 120)
CRP 109 mg/L (< 5) What is the initial treatment plan for this patient, given the severity of his symptoms?

MSRA-0724

A 28-year-old man with Crohn’s disease visits his primary care physician complaining of discomfort in the area around his anus. He mentions the presence of malodorous pus when he cleans himself. During the examination, a draining opening is observed on his perineum. A digital rectal exam confirms the diagnosis of a perianal fistula. What imaging modality is the best option for this condition?

MSRA-0725

What advice should you give a young adult (who is NOT pregnant) if they ask what is the recommended amount of alcohol they can consume?

MSRA-0726

A 28-year-old man comes to your clinic seeking advice on how to improve his health after his uncle passed away from a heart attack at the age of 50. He mentions that he has already begun going to the gym three times a week and has increased his consumption of fruits and vegetables. However, he works in finance and is finding it difficult to reduce his alcohol consumption. What is the highest recommended weekly alcohol limit for men in the UK?

MSRA-0727

A 25-year-old woman presents to the neurology clinic with a unilateral hand tremor. Her family has noticed changes in her behavior, mood, and speech over the past year. During the examination, a resting tremor is observed in her right hand, along with bradykinesia and a lack of movement. Additionally, dark circular marks are visible around her iris. The patient mentions that her uncle passed away from liver cirrhosis at the age of 42. What is the probable diagnosis?

MSRA-0728

You are assessing a 50-year-old man who has been diagnosed with Barrett’s oesophagus following difficult to control symptoms. Biopsies did not reveal any dysplasia. What is the most strongly linked risk factor modification for the development of Barrett’s oesophagus?

MSRA-0729

A 35-year-old woman comes back from a trip. During her final day overseas, she had lunch from an unlicensed street food vendor. After eight days of returning home, she encounters bloating, abdominal discomfort, and non-bloody diarrhea, and she observes that her stools are floating in the toilet bowl. The patient’s symptoms persist for nine weeks. What is the probable pathogen responsible for the patient’s symptoms?

MSRA-0730

Which of the following characteristics is more prevalent in Crohn’s disease compared to ulcerative colitis?

MSRA-0701

An 80-year-old man comes to the liver clinic for his regular check-up. He has been a patient of the clinic for a while due to his liver cirrhosis caused by alcohol abuse. During the examination, he appears cachexic and jaundiced. Upon closer inspection of his abdomen, it is distended, and the shifting dullness test indicates the presence of free fluid in the abdomen. A sample of the fluid is collected, which shows 17g/l of fluid protein. What medication would be the most appropriate to prescribe?

MSRA-0702

A 56-year-old woman presents with dyspepsia and an endoscopy reveals a gastric ulcer. A CLO test confirms H. pylori infection and she is treated with eradication therapy. However, at her follow-up appointment six weeks later, her symptoms persist. What is the best test to confirm H. pylori eradication?