Archives: MSRA

MSRA-0145

A 35-year-old man presents to the Emergency Department with a sudden onset of central abdominal pain. He claims this is radiating to his back and that it started this afternoon. He is currently still in pain and has been started on some analgesia. His blood pressure is 135/80 mmHg and his heart rate is 100 bpm.
His past medical history includes amputation of the big toe on the left lower limb and femoral-popliteal bypass on the right. He smokes around 20 cigarettes daily.
Which of the following tests should be done urgently to determine the underlying cause of his symptomatology?

MSRA-0146

A 16-year-old boy with Marfan syndrome is seen in the Cardiology Clinic. He has been researching possible complications of his condition online and is worried about potential cardiac issues.
Which of the following cardiac abnormalities is most probable in this patient?

MSRA-0147

A 54-year-old woman with isolated systolic hypertension, who also has urinary tract infections, osteoporosis and diabetes, attends outpatient clinic with a blood pressure reading of 192/88 mmHg.
Which of the following medications would you prescribe for this patient?

MSRA-0148

A 42-year-old woman with a history of angina and a recent episode of dizziness is prescribed clopidogrel.
What is the primary mechanism of action of this medication?

MSRA-0149

A 65-year-old woman presents with difficulty breathing and feeling lightheaded. During the examination, an irregularly irregular pulse is noted. An ECG taken at the time shows the absence of p waves. What medical condition in her past could be responsible for her symptoms?

MSRA-0150

A 30-year-old medical student noticed that he had a murmur when he tested his new stethoscope. On assessment in the Cardiology Clinic, he was found to have a harsh systolic murmur over his precordium, which did not change with inspiration. His electrocardiogram (ECG) showed features of biventricular hypertrophy.
Which of the following is the most likely diagnosis?

MSRA-0151

A 72-year-old man has recently been diagnosed with heart failure. He is currently taking ramipril for his high blood pressure. What is the most appropriate medication to help manage his heart failure?

MSRA-0152

A 45-year-old man presents to the Emergency Department with a 7-day history of fever and night sweats. His parameters include a blood pressure of 110/80 mmHg, oxygen saturation of 99%, heart rate of 115 bpm and a temperature of 38.5°C.
On examination, a murmur is elicited at the right upper sternal edge. Infective endocarditis is suspected and an echocardiogram is done which shows multiple vegetations on the aortic valve.
Which of the following is the best next step to confirm the diagnosis?
Select the SINGLE best management option from the list below.
Select ONE option only.

MSRA-0153

A 55-year-old man presents to the Emergency Department with a 2-day history of malaise, fever and night sweats. He also complains that he has recently developed increased sensitivity in his fingertips and states that every time he touches something his fingers hurt.
His past medical history includes diabetes and end-stage chronic kidney disease, for which he receives regular haemodialysis. His parameters include a blood pressure of 130/95 mmHg, oxygen saturation of 98%, heart rate 120 bpm and a temperature of 38.2°C.
Which of the following investigations would be needed to make a diagnosis?
Select the SINGLE best investigation from the list below.
Select ONE option only.

MSRA-0154

A 32-year-old woman presents with dizziness to her General Practitioner. She reports a similar episode six months ago, which was also accompanied by some discomfort in her chest lasting for a short period. Upon further questioning, she admits to feeling her heart beating rapidly in her chest. She is currently stable, with a blood pressure of 120/80 mmHg, oxygen saturation of 99%, and a heart rate of 110 bpm. What is the best investigation to guide further management?