MSRA-0190
A 28-week pregnant woman is referred to the pregnancy clinic with gestational hypertension. There is no evidence of protein in her urine.
Which of the following is the most suitable treatment?
Archives: MSRA
MSRA-0191
A 70-year-old patient was discovered to have an abdominal aortic aneurysm during a routine medical check-up. The patient is currently receiving treatment for hypertension and high cholesterol but is otherwise healthy and medically capable. The aneurysm was infra-renal and had a diameter of 4.9 cm.
What is the best course of action for managing this patient?
MSRA-0192
A 65-year-old man is referred by his general practitioner for advice regarding optimisation of secondary prevention. He has a history of non-ST-elevation myocardial infarction (NSTEMI) two years ago. He is on a combination of clopidogrel, atenolol 50 mg once daily and atorvastatin 80 mg once daily. He also has diabetes for which he takes metformin 1 g twice daily. His pulse rate is 70 bpm, and blood pressure 144/86 mmHg. His past medical history includes an ischaemic stroke two years ago, from which he made a complete recovery.
What additional therapy would you consider?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
MSRA-0193
A 60-year-old woman has effort-related angina. She has no other cardiac risk factors and no other relevant medical history. Her QRisk is calculated as 12.2%. She has already been prescribed a GTN spray which she can use for immediate relief of her symptoms.
Which of the following is the most appropriate initial treatment?
MSRA-0194
A 72-year-old man visits his General Practitioner for his annual medication review. He has hypertension and gout and is currently taking allopurinol 300 mg, amlodipine 10 mg and atorvastatin 20 mg. His home blood pressure readings average at 150/88 mmHg. His recent blood tests of glycosylated haemoglobin (HbA1c), renal profile and lipids are normal. Which of the following medications would be the most appropriate to add to his current regime?
MSRA-0195
A 65-year-old woman was diagnosed with angina after presenting to the Emergency Department with exertional chest pain. She had a positive exercise test at the Cardiology Clinic and was started on aspirin, metoprolol, rosuvastatin and a glyceryl trinitrate (GTN) spray.
Eight months later, she presented to her General Practitioner with an increasing frequency of anginal episodes. These responded to GTN spray and did not occur at rest.
Which of the following is the most appropriate additional medication?
MSRA-0196
A 65-year-old overweight man presents with worsening shortness of breath and leg swelling due to advanced heart failure. His kidney function is normal and his potassium level is 4.2 mmol/l. Which combination of medications would provide the greatest mortality benefit for him?
MSRA-0197
A 45-year-old woman presents to the Emergency Department with a 2-day history of pleuritic chest pain. She states that this started in the evening and has gotten worse since then. The pain is central and seems to improve when she leans forward. She has a past medical history of hypertension.
An electrocardiogram (ECG) is performed which shows widespread concave ST-segment elevation and PR interval depression. Extensive investigations reveal no underlying cause.
Given the likely diagnosis, which of the following is the best treatment option?
Select the SINGLE best treatment option from the list below.
MSRA-0198
A 45-year-old otherwise healthy man presents to his General Practitioner (GP) with complaints of chest pain and shortness of breath on minimal exertion that have been worsening over the past few months. Investigations reveal normal angiogram and chest x-ray results, but an echocardiogram shows severe aortic stenosis. What is the most suitable management option?
MSRA-0199
A 45-year-old man with known permanent AF (atrial fibrillation) on warfarin has a fast, irregularly irregular pulse. He has no other past medical history. The ECG confirms AF with a rate of 132 beats/min. He is haemodynamically stable and well. He denies any history of palpitations, shortness of breath or syncope.
Which of the following is the most appropriate intervention?