MSRA-0178
A 62-year-old man is undergoing a drug therapy evaluation following a myocardial infarction (MI).
Which of the following options has not been shown to have a beneficial effect on mortality after an MI?
Archives: MSRA
MSRA-0179
A 55-year-old woman had a recent acute myocardial infarction (MI).
Which medication has been proven to reduce mortality after an MI?
MSRA-0180
A 35-year-old man is being monitored by his general practitioner for primary prevention of cardiovascular disease. He is a smoker and has a strong family history of premature death from ischaemic heart disease. Following lifestyle modifications, his fasting cholesterol concentration is 7.2 mmol/l. Upon consulting the local guidelines, it is found that his Qrisk2 score is > 17%. What drug therapy would you recommend?
MSRA-0181
A 68-year-old man with hypertension has an annual review. He is medicated with amlodipine 10 mg once daily. He has never smoked and does not have diabetes. His past medical history is unremarkable. He has a blood pressure of 126/74 mmHg, total cholesterol:HDL-cholesterol ratio of 6.3, and QRISK2-2017 of 26.1%.
Target blood pressure in people aged <80 years, with treated hypertension: <140/90 mmHg.
Target blood pressure in people aged ≥80 years, with treated hypertension: <150/90 mmHg.
Total cholesterol: HDL-cholesterol ratio: high risk if >6.
You decide to initiate statin therapy for primary prevention of cerebrovascular disease (CVD).
Which of the following drugs is most appropriate for this patient?
Select the SINGLE drug from the slit below. Select ONE option only.
MSRA-0182
A 35-year-old woman visits her general practice surgery to discuss her plans to become pregnant. She is taking medication for hypertension but is otherwise fit and well. She has not had any previous pregnancies.
On examination, her blood pressure (BP) is 120/78 mmHg.
Which of the following drugs can this patient continue to take during pregnancy?
MSRA-0183
A 42-year-old woman is brought to the Emergency Room with a 3-day history of flu-like symptoms. She is now experiencing severe central chest pain that worsens with coughing and improves when she sits upright. Upon examination, she has a rapid heart rate and a temperature of 38.5 °C. A third heart sound is heard upon auscultation.
What is the probable cause of this patient’s chest pain?
MSRA-0184
A 32-year-old woman attends her booking appointment with the community midwife. She is at 14 weeks gestation in her second pregnancy. She has no underlying medical conditions.
Which of the following haemodynamic changes is most likely to present in this patient?
MSRA-0185
A 45-year-old man attends for a truck driver medical assessment. His blood pressure (BP) is noted to be 190/100 mmHg. He is a heavy drinker. He is feeling generally well in himself. You request blood tests:
Result Normal
Sodium (mmol/l) 138 135-145
Potassium (mmol/l) 4.0 3.5-5.0
Urea (mmol/l) 4.8 1.7-8.3
Creatinine (µmol/l) 152 59-104
You decide to perform a work-up to exclude a secondary cause for his hypertension. An ultrasound scan of the renal tract reveals a small atrophic left kidney.
Which of the following is the most likely diagnosis?
MSRA-0186
A 55-year-old woman is brought into the Emergency Department with a sudden onset of severe back pain lasting 30 minutes. The pain is constant and not exacerbated by coughing or sneezing.
On examination, the patient is in shock, with a palpable 7 cm mass deep in the epigastrium above the umbilicus. Her past medical history includes a 5 cm abdominal aortic aneurysm diagnosed three years ago at the time of appendectomy. The patient is a non-smoker and drinks one glass of wine a week.
What is the most likely diagnosis?
MSRA-0170
You are asked by the nursing staff to review an elderly patient in recovery overnight. As you arrive, the nurse looking after the patient informs you that she is just going to get a bag of fluid for him.
On examination, the patient is unresponsive with an obstructed airway (snoring). You notice on the monitor that his heart rate is 33 beats per minute (bpm) and blood pressure 89/60 mmHg. His saturation probe has fallen off.
What is the most appropriate immediate management option?