Archives: MSRA

MSRA-0390

A 59-year-old man with type 2 diabetes visits his GP for a check-up. He has discontinued his modified-release metformin due to experiencing nausea and diarrhoea. Lately, he has been feeling increasingly fatigued and thirsty. His blood pressure measures 150/110 mmHg and he reports no issues with his eyesight. Laboratory tests reveal an HbA1c level of 56 mmol/mol. The QRISK score is calculated and shows 23%. He is a non-smoker and non-alcoholic.

What would be the most suitable course of action for his management?

MSRA-0391

You assess a 75-year-old patient with a complex medical history and taking multiple medications. The patient presents with significant bilateral breast tissue growth. Which medication is the most probable cause of this condition?

MSRA-0392

As a foundation doctor in the endocrine department, if you were to assess a patient with hypoparathyroidism resulting in hypocalcaemia, what findings may you discover during your investigation?

MSRA-0393

A 55-year-old man arrives at the emergency department with complaints of abdominal pain, nausea, and vomiting. His urine and serum tests reveal elevated ketone levels, and his serum glucose level is 3 mmol/L. An ABG is conducted, and the results are as follows:
pH 7.24
PaO2 14.7 kPa
PCO2 3.5 kPa
HCO3 13 mEq/L
What is the most probable cause of these findings?

MSRA-0394

A 63-year-old male visits his primary care physician for a diabetic check-up. He has been dealing with type-two diabetes mellitus for a while, but has not been able to control it completely. Despite making all the necessary lifestyle changes and taking metformin and gliclazide, he complains of polyuria and his Hba1c is 62 mmol/mol. He has a history of hypertension, which is managed with amlodipine, and recurrent urinary tract infections. He is hesitant to use insulin due to his fear of needles. What is the best course of action for managing his condition?

MSRA-0370

A 27-year-old female presents to a dermatology appointment with several new scaly plaques on her scalp that are causing itching and redness, especially around the occipital region. She has a past medical history of chronic plaque psoriasis that is typically managed well with topical treatment and emollients. The dermatologist confirms a diagnosis of scalp psoriasis. What is the best course of action for treating her recent diagnosis?

MSRA-0371

A 28 year-old carpenter complains of itchy and painful skin on his hands and wrists. He suspects that it might be due to something he is exposed to at work. What test would be most appropriate to investigate this hypothesis?

MSRA-0372

You are examining a 65-year-old individual with acanthosis nigricans. You suggest screening for diabetes. Due to the widespread skin alterations, including some oral changes, what other potential underlying condition should be taken into account?

MSRA-0373

A 75-year-old patient presents for a follow-up appointment after undergoing private health screening. The patient has been advised to seek medical attention regarding her thyroid function tests (TFTs).
TSH levels are at 9.2 mU/L and free thyroxine levels are at 14 pmol/L. Despite her age, the patient is currently in good health and shows no symptoms. What is the best course of action for managing her condition?

MSRA-0374

A 38-year-old man visits his GP complaining of feeling generally unwell. He reports experiencing daily frontal headaches for the past three months, which have not improved with regular paracetamol. Additionally, he has noticed some unusual symptoms such as his wedding ring no longer fitting, his shoe size apparently increasing, and a small amount of milky discharge from both nipples. During examination, his blood pressure is found to be 168/96 mmHg. What is the probable diagnosis?