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120 Cards in this Set

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Qu. 1: A pulse rate of 80/min with a regular rhythm but occasional extra beats followed by a longer pause

Choose one of the following:
Acute haemorrhage
Pulsus alternans
Aortic stenosis
Pulsus paradoxus
Aortic incompetence
Sinus arrhythmia
Atrial fibrillation
Ventricular ectopic beats
Complete heart block
Mitral incompetence
Model Answer: Ventricular ectopic beats
Qu. 2: A pulse rate of 32/min regular but associated with episodes of syncope

Choose one of the following:
Acute haemorrhage
Pulsus alternans
Aortic stenosis
Pulsus paradoxus
Aortic incompetence
Sinus arrhythmia
Atrial fibrillation
Ventricular ectopic beats
Complete heart block
Mitral incompetence
Model Answer: Complete heart block
Qu. 3: A pulse rate of 80/min with a collapsing quality in the brachial artery

Choose one of the following:
Acute haemorrhage
Pulsus alternans
Aortic stenosis
Pulsus paradoxus
Aortic incompetence
Sinus arrhythmia
Atrial fibrillation
Ventricular ectopic beats
Complete heart block
Mitral incompetence
Model Answer: Aortic incompetence
Qu. 4: A pulse rate of 80/min, which speeds up on inspiration and slows down on expiration

Choose one of the following:
Acute haemorrhage
Pulsus alternans
Aortic stenosis
Pulsus paradoxus
Aortic incompetence
Sinus arrhythmia
Atrial fibrillation
Ventricular ectopic beats
Complete heart block
Mitral incompetence
Model Answer: Sinus arrhythmia
Qu. 5: A pulse which is regular but diminishes in volume during inspiration and increases in volume in expiration

Choose one of the following:
Acute haemorrhage
Pulsus alternans
Aortic stenosis
Pulsus paradoxus
Aortic incompetence
Sinus arrhythmia
Atrial fibrillation
Ventricular ectopic beats
Complete heart block
Mitral incompetence
Model Answer: Pulsus paradoxus
Qu. 1: Anterior chest pain with decreased breath sounds, hyper resonance on percussion and absent tactile fremitus on the same side

Choose one of the following:
Acute asthma
Pericardial effusion
Atelectasis of the lung
Pleural effusion
Bronchiectasis
Pneumothorax
Healed fibrosed apical
tuberculosis
Pulmonary embolus
Left ventricular failure
Lobar pneumonia
Model Answer: Pneumothorax
Qu. 2: Cardiomegaly, breathlessness, bilateral basal crackles with symmetrical normal chest movements and normal resonant percussion

Choose one of the following:
Acute asthma
Pericardial effusion
Atelectasis of the lung
Pleural effusion
Bronchiectasis
Pneumothorax
Healed fibrosed apical
tuberculosis
Pulmonary embolus
Left ventricular failure
Lobar pneumonia
Model Answer: Left ventricular failure
Qu. 3: Decreased chest movements, dullness to percussion with bronchial breathing in a febrile patient with cough and infected sputum

Choose one of the following:
Acute asthma
Pericardial effusion
Atelectasis of the lung
Pleural effusion
Bronchiectasis
Pneumothorax
Healed fibrosed apical
tuberculosis
Pulmonary embolus
Left ventricular failure
Lobar pneumonia
Model Answer: Lobar pneumonia
Qu. 4: Decreased chest movements on one side with stony dullness to percussion, absent breath sounds and absent tactile fremitus

Choose one of the following:
Acute asthma
Pericardial effusion
Atelectasis of the lung
Pleural effusion
Bronchiectasis
Pneumothorax
Healed fibrosed apical
tuberculosis
Pulmonary embolus
Left ventricular failure
Lobar pneumonia
Model Answer: Pleural effusion
Qu. 5: Difficulty breathing, over-inflated chest, resonant chest bilaterally and bilateral expiratory wheezing

Choose one of the following:
Acute asthma
Pericardial effusion
Atelectasis of the lung
Pleural effusion
Bronchiectasis
Pneumothorax
Healed fibrosed apical
tuberculosis
Pulmonary embolus
Left ventricular failure
Lobar pneumonia
Model Answer: Acute asthma
Qu. 1: A young man loses 7 kg in weight over one month accompanied by thirst and polyuria

Choose one of the following:
Anorexia nervosa
Malabsorption
Bulimia
Thyrotoxicosis
Carcinoma of the stomach
Tuberculosis
Depression
None of the above
Diabetes mellitus
Hypercalcaemia
Model Answer: Diabetes mellitus
Qu. 2: A Somali immigrant who is severely wasted gives a history of night sweats, fever and persistent cough

Choose one of the following:
Anorexia nervosa
Malabsorption
Bulimia
Thyrotoxicosis
Carcinoma of the stomach
Tuberculosis
Depression
None of the above
Diabetes mellitus
Hypercalcaemia
Model Answer: Tuberculosis
Qu. 3: A man 60 years old, loses his appetite and loses 5 kg in weight over 6 weeks. He has epigastric discomfort and no change in bowel habit

Choose one of the following:
Anorexia nervosa
Malabsorption
Bulimia
Thyrotoxicosis
Carcinoma of the stomach
Tuberculosis
Depression
None of the above
Diabetes mellitus
Hypercalcaemia
Model Answer: Carcinoma of the stomach
Qu. 4: A woman who has always opened her bowels 2-3 times daily is about 10 kg underweight with glossitis and angular stomatitis

Choose one of the following:
Anorexia nervosa
Malabsorption
Bulimia
Thyrotoxicosis
Carcinoma of the stomach
Tuberculosis
Depression
None of the above
Diabetes mellitus
Hypercalcaemia
Model Answer: Malabsorption
Qu. 5: A thin underweight 50 year old woman with a normal appetite presents with uncontrolled atrial fibrillation. Her bowels are opened 2-3 times daily

Choose one of the following:
Anorexia nervosa
Malabsorption
Bulimia
Thyrotoxicosis
Carcinoma of the stomach
Tuberculosis
Depression
None of the above
Diabetes mellitus
Hypercalcaemia
Model Answer: Thyrotoxicosis
Qu. 1: A patient with an apical bronchial carcinoma with a ptosis and a small pupil on the same side

Choose one of the following:
3rd cranial nerve palsy
Left cerebral hemisphere infarction
6th cranial nerve palsy
Opiate overdose
Brain stem death
Right cerebral haemorrhage
Expanding pituitary tumour
Thyroid eye disease
Horner's syndrome
Large right cerebral hemisphere
tumour
Model Answer: Horner's syndrome
Qu. 2: Fixed dilated pupils bilaterally after resuscitation for a cardiac arrest

Choose one of the following:
3rd cranial nerve palsy
Left cerebral hemisphere infarction
6th cranial nerve palsy
Opiate overdose
Brain stem death
Right cerebral haemorrhage
Expanding pituitary tumour
Thyroid eye disease
Horner's syndrome
Large right cerebral hemisphere
tumour
Model Answer: Brain stem death
Qu. 3: Right sided homonymous hemianopia

Choose one of the following:
3rd cranial nerve palsy
Left cerebral hemisphere infarction
6th cranial nerve palsy
Opiate overdose
Brain stem death
Right cerebral haemorrhage
Expanding pituitary tumour
Thyroid eye disease
Horner's syndrome
Large right cerebral hemisphere
tumour
Model Answer: Left cerebral hemisphere infarction
Qu. 4: A deviated eye looking downwards and outwards with a ptosis and a large pupil

Choose one of the following:
3rd cranial nerve palsy
Left cerebral hemisphere infarction
6th cranial nerve palsy
Opiate overdose
Brain stem death
Right cerebral haemorrhage
Expanding pituitary tumour
Thyroid eye disease
Horner's syndrome
Large right cerebral hemisphere
tumour
Model Answer: 3rd cranial nerve palsy
Qu. 5: Bilateral pin point pupils in a young comatose patient

Choose one of the following:
3rd cranial nerve palsy
Left cerebral hemisphere infarction
6th cranial nerve palsy
Opiate overdose
Brain stem death
Right cerebral haemorrhage
Expanding pituitary tumour
Thyroid eye disease
Horner's syndrome
Large right cerebral hemisphere
tumour
Model Answer: Opiate overdose
Qu. 1: Epigastric and abdominal right upper quadrant pain radiating through to the infrascapular region

Choose one of the following:
Appendicitis
Renal colic
Biliary colic
Small bowel intestinal colic
Duodenal ulcer pain
Uterine pain
Gastro-eosphageal reflux pain
Pain from an aortic aneurysm
Pancreatitis pain
Model Answer: Biliary colic
Qu. 2: Epigastric pain, worse when hungry, awaking patient at night and relieved by milk

Choose one of the following:
Appendicitis
Renal colic
Biliary colic
Small bowel intestinal colic
Duodenal ulcer pain
Uterine pain
Gastro-eosphageal reflux pain
Pain from an aortic aneurysm
Pancreatitis pain
Model Answer: Duodenal ulcer pain
Qu. 3: Epigastric and low retrosternal pain associated with acid regurgitation

Choose one of the following:
Appendicitis
Renal colic
Biliary colic
Small bowel intestinal colic
Duodenal ulcer pain
Uterine pain
Gastro-eosphageal reflux pain
Pain from an aortic aneurysm
Pancreatitis pain
Model Answer: Gastro-eosphageal reflux pain
Qu. 4: Left loin and left upper abdominal quadrant pain radiating to the groin

Choose one of the following:
Appendicitis
Renal colic
Biliary colic
Small bowel intestinal colic
Duodenal ulcer pain
Uterine pain
Gastro-eosphageal reflux pain
Pain from an aortic aneurysm
Pancreatitis pain
Model Answer: Renal colic
Qu. 5: Gripping central abdominal pain that comes and goes over relatively short intervals

Choose one of the following:
Appendicitis
Renal colic
Biliary colic
Small bowel intestinal colic
Duodenal ulcer pain
Uterine pain
Gastro-eosphageal reflux pain
Pain from an aortic aneurysm
Pancreatitis pain
Model Answer: Small bowel intestinal colic
Qu. 1: An anxious 25 year old woman complaining of breathing difficulties, lightheadedness, and carpopedal spasm

Choose one of the following:
Complete heart block
Subarachnoid heamorrage
Epileptic seizure
Transient cerebral ischaemic attack
Hyperventilation attacks
Vasovagal syncope
Hypoglycaemia
Vertebrobasilar ischaemia
Hysterical fugue state
Infarction of cerebral hemisphere
Model Answer: Hyperventilation attacks
Qu. 2: A 79 year old woman who has dizzy spells when looking up to hang out her washing

Choose one of the following:
Complete heart block
Subarachnoid heamorrage
Epileptic seizure
Transient cerebral ischaemic attack
Hyperventilation attacks
Vasovagal syncope
Hypoglycaemia
Vertebrobasilar ischaemia
Hysterical fugue state
Infarction of cerebral hemisphere
Model Answer: Vertebrobasilar ischaemia
Qu. 3: A 45 year old man who has had 2 attacks where he fell to the ground. He had bitten his tongue and been incontinent of urine.

Choose one of the following:
Complete heart block
Subarachnoid heamorrage
Epileptic seizure
Transient cerebral ischaemic attack
Hyperventilation attacks
Vasovagal syncope
Hypoglycaemia
Vertebrobasilar ischaemia
Hysterical fugue state
Infarction of cerebral hemisphere
Model Answer: Epileptic seizure
Qu. 4: A 37 year old man with a sudden onset of a severe headache at the occiput and collapse

Choose one of the following:
Complete heart block
Subarachnoid heamorrage
Epileptic seizure
Transient cerebral ischaemic attack
Hyperventilation attacks
Vasovagal syncope
Hypoglycaemia
Vertebrobasilar ischaemia
Hysterical fugue state
Infarction of cerebral hemisphere
Model Answer: Subarachnoid heamorrage
Qu. 5: A 79 year old woman who had lost her speech for 2 hours but then recovered and was neurologically normal

Choose one of the following:
Complete heart block
Subarachnoid heamorrage
Epileptic seizure
Transient cerebral ischaemic attack
Hyperventilation attacks
Vasovagal syncope
Hypoglycaemia
Vertebrobasilar ischaemia
Hysterical fugue state
Infarction of cerebral hemisphere
Model Answer: Transient cerebral ischaemic attack
Qu. 1: A 75 year old smoker with intermittent central chest pain radiating to the jaw when he walks to the shops and relieved by rest

Choose one of the following:
Acute myocardial infarct
Oesophagitis
Acute pericarditis
Pneumonia
Angina of effort
Pulmonary embolus
Dissecting thoracic aortic
aneurysm
Unstable angina
Functional chest pain
Herpes zoster infection
Model Answer: Angina of effort
Qu. 2: A 53 year old man with a sudden onset of central chest pain radiating to the left arm associated with sweating which has been present for two hours

Choose one of the following:
Acute myocardial infarct
Oesophagitis
Acute pericarditis
Pneumonia
Angina of effort
Pulmonary embolus
Dissecting thoracic aortic
aneurysm
Unstable angina
Functional chest pain
Herpes zoster infection
Model Answer: Acute myocardial infarct
Qu. 3: A 60 year old man with acute severe chest pain radiating through to the back with a wide mediastinum on chest X-ray

Choose one of the following:
Acute myocardial infarct
Oesophagitis
Acute pericarditis
Pneumonia
Angina of effort
Pulmonary embolus
Dissecting thoracic aortic
aneurysm
Unstable angina
Functional chest pain
Herpes zoster infection
Model Answer: Dissecting thoracic aortic aneurysm
Qu. 4: A 76 year old obese man who presented with episodes of low retrosternal burning pain and discomfort on swallowing

Choose one of the following:
Acute myocardial infarct
Oesophagitis
Acute pericarditis
Pneumonia
Angina of effort
Pulmonary embolus
Dissecting thoracic aortic
aneurysm
Unstable angina
Functional chest pain
Herpes zoster infection
Model Answer: Oesophagitis
Qu. 5: A postoperative 40 year old woman who complains of right-sided chest pain, worse on deep breathing and coughing and haemoptysis

Choose one of the following:
Acute myocardial infarct
Oesophagitis
Acute pericarditis
Pneumonia
Angina of effort
Pulmonary embolus
Dissecting thoracic aortic
aneurysm
Unstable angina
Functional chest pain
Herpes zoster infection
Model Answer: Pulmonary embolus
Qu. 1: An internal jugular pulsation with 'a' and 'v' waves visible at the level of the clavicle

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Visible distension and pulsation of the internal jugular vein is a common sign in medicine. For each of the clinical scenarios below, all of which have jugular vein signs, select the most likely diagnosis from the list above. Assume the patients are reclining at 45? in bed.
Model Answer: A normal jugular venous pulsation
Qu. 2: Distended jugular veins bilaterally with distended veins on the upper thorax and no obvious venous pulsation

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Qu. 1: An internal jugular pulsation with 'a' and 'v' waves visible at the level of the clavicle

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Visible distension and pulsation of the internal jugular vein is a common sign in medicine. For each of the clinical scenarios below, all of which have jugular vein signs, select the most likely diagnosis from the list above. Assume the patients are reclining at 45? in bed.
Model Answer: Superior vena caval obstruction
Qu. 3: A jugular venous pressure of 15 cm with no 'a' wave in a patient with an irregular pulse, peripheral oedema and breathlessness

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Qu. 1: An internal jugular pulsation with 'a' and 'v' waves visible at the level of the clavicle

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Visible distension and pulsation of the internal jugular vein is a common sign in medicine. For each of the clinical scenarios below, all of which have jugular vein signs, select the most likely diagnosis from the list above. Assume the patients are reclining at 45? in bed.
Model Answer: Atrial fibrillation and congestive cardiac failure
Qu. 4: A patient with a heart rate of 32 beats per minute and occasional cannon waves visible in the internal jugular pulse

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Qu. 1: An internal jugular pulsation with 'a' and 'v' waves visible at the level of the clavicle

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Visible distension and pulsation of the internal jugular vein is a common sign in medicine. For each of the clinical scenarios below, all of which have jugular vein signs, select the most likely diagnosis from the list above. Assume the patients are reclining at 45? in bed.
Model Answer: Complete heart block
Qu. 5: Regular large waves distending the internal jugular coinciding with systole in a patient with a systolic murmur loudest at the lower end of the sternum

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Qu. 1: An internal jugular pulsation with 'a' and 'v' waves visible at the level of the clavicle

Choose one of the following:
A normal jugular venous pulsation
Pericardial constriction
Atrial fibrillation and congestive
cardiac failure
Superior vena caval obstruction
Complete heart block
Tricuspid incompetence
Congestive cardiac failure
None of the above
Cor pulmonale
Overtransfusion

Visible distension and pulsation of the internal jugular vein is a common sign in medicine. For each of the clinical scenarios below, all of which have jugular vein signs, select the most likely diagnosis from the list above. Assume the patients are reclining at 45? in bed.
Model Answer: Tricuspid incompetence
Qu. 1: A healthy 50 year old woman on long term oral steroids for asthma who develops acute severe mid thoracic back pain

Choose one of the following:
Ankylosing Spondylitis
Spinal cord compression
Bony metastases
Spondylolisthesis
Cauda Equina Syndrome
Tuberculosis of the spine
L 3/4 Disc with L4 signs
Vertebral crush fracture
L 4/5 Disc with S1 signs
Paget's disease
Model Answer: Vertebral crush fracture
Qu. 2: A 25 year old banker who presents with an acute onset of severe low back pain and left-sided sciatica. On examination he has an absent left ankle jerk

Choose one of the following:
Ankylosing Spondylitis
Spinal cord compression
Bony metastases
Spondylolisthesis
Cauda Equina Syndrome
Tuberculosis of the spine
L 3/4 Disc with L4 signs
Vertebral crush fracture
L 4/5 Disc with S1 signs
Paget's disease
Model Answer: L 4/5 Disc with S1 signs
Qu. 3: A 20 year old man presents with a long history of low back pain and stiffness in the morning with a very raised ESR

Choose one of the following:
Ankylosing Spondylitis
Spinal cord compression
Bony metastases
Spondylolisthesis
Cauda Equina Syndrome
Tuberculosis of the spine
L 3/4 Disc with L4 signs
Vertebral crush fracture
L 4/5 Disc with S1 signs
Paget's disease
Model Answer: Ankylosing Spondylitis
Qu. 4: A 65 year old woman with longstanding low back pain has an exacerbation of pain associated with urinary retention, saddle anaesthesia and absent ankle jerks

Choose one of the following:
Ankylosing Spondylitis
Spinal cord compression
Bony metastases
Spondylolisthesis
Cauda Equina Syndrome
Tuberculosis of the spine
L 3/4 Disc with L4 signs
Vertebral crush fracture
L 4/5 Disc with S1 signs
Paget's disease
Model Answer: Cauda Equina Syndrome
Qu. 5: An ill looking 75 year old English man who has an 8 week history of weight loss and persistent diffuse back pain, worse at night, with percussion tenderness

Choose one of the following:
Ankylosing Spondylitis
Spinal cord compression
Bony metastases
Spondylolisthesis
Cauda Equina Syndrome
Tuberculosis of the spine
L 3/4 Disc with L4 signs
Vertebral crush fracture
L 4/5 Disc with S1 signs
Paget's disease
Model Answer: Bony metastases
Qu. 1: A 75 year old man with sudden severe abdominal pain and an expansile pulsatile central abdominal mass

Choose one of the following:
Aortic Aneurysm
Pancreatic pseudocyst
Carcinoma of the caecum
Polycystic kidneys
Carcinoma of the stomach
Splenomegaly
Hepatomegaly
Inguinal hernia
Palpable gall bladder
Model Answer: Aortic Aneurysm
Qu. 2: A 71 year old woman with a severe iron deficiency anaemia and a mass in the right iliac fossa

Choose one of the following:
Aortic Aneurysm
Pancreatic pseudocyst
Carcinoma of the caecum
Polycystic kidneys
Carcinoma of the stomach
Splenomegaly
Hepatomegaly
Inguinal hernia
Palpable gall bladder
Model Answer: Carcinoma of the caecum
Qu. 3: A 69 year old woman with a mass in the left upper quadrant and generalised lymphadenopathy

Choose one of the following:
Aortic Aneurysm
Pancreatic pseudocyst
Carcinoma of the caecum
Polycystic kidneys
Carcinoma of the stomach
Splenomegaly
Hepatomegaly
Inguinal hernia
Palpable gall bladder
Model Answer: Splenomegaly
Qu. 4: A 45 year old woman with bilateral loin masses. She has a family history of loin pain and hypertension

Choose one of the following:
Aortic Aneurysm
Pancreatic pseudocyst
Carcinoma of the caecum
Polycystic kidneys
Carcinoma of the stomach
Splenomegaly
Hepatomegaly
Inguinal hernia
Palpable gall bladder
Model Answer: Polycystic kidneys
Qu. 5: A 56 year old man with jaundice and spider naevi and a mass in the right upper quadrant

Choose one of the following:
Aortic Aneurysm
Pancreatic pseudocyst
Carcinoma of the caecum
Polycystic kidneys
Carcinoma of the stomach
Splenomegaly
Hepatomegaly
Inguinal hernia
Palpable gall bladder
Model Answer: Hepatomegaly
Qu. 1: A 68 year old man with loss of sensation to pin-prick up to the knee

Choose one of the following:
Arteriopathy
Nephropathy
Arthropathy
Peripheral Neuropathy
Autonomic neuropathy
Retinopathy
Charcots arthropathy
Uropathy
Haemoglobinopathy
Ischaemic Heart Disease
Model Answer: Peripheral Neuropathy
Qu. 2: A 75 year old man with postural hypotension

Choose one of the following:
Arteriopathy
Nephropathy
Arthropathy
Peripheral Neuropathy
Autonomic neuropathy
Retinopathy
Charcots arthropathy
Uropathy
Haemoglobinopathy
Ischaemic Heart Disease
Model Answer: Autonomic neuropathy
Qu. 3: A 60 year old man with 3 cold black toes

Choose one of the following:
Arteriopathy
Nephropathy
Arthropathy
Peripheral Neuropathy
Autonomic neuropathy
Retinopathy
Charcots arthropathy
Uropathy
Haemoglobinopathy
Ischaemic Heart Disease
Model Answer: Arteriopathy
Qu. 4: An 80 year old man with a raised urea and creatinine

Choose one of the following:
Arteriopathy
Nephropathy
Arthropathy
Peripheral Neuropathy
Autonomic neuropathy
Retinopathy
Charcots arthropathy
Uropathy
Haemoglobinopathy
Ischaemic Heart Disease
Model Answer: Nephropathy
Qu. 5: A 70 year old woman with a gallop rhythm and intermittent nocturnal breathlessness

Choose one of the following:
Arteriopathy
Nephropathy
Arthropathy
Peripheral Neuropathy
Autonomic neuropathy
Retinopathy
Charcots arthropathy
Uropathy
Haemoglobinopathy
Ischaemic Heart Disease
Model Answer: Ischaemic Heart Disease
Qu. 1: A 65 year old man with shortness of breath, swollen legs and a raised JVP

Choose one of the following:
Acute viral hepatitis B
Liver abscess
Alcoholic liver disease
Metastatic liver disease
Congestive cardiac failure
Primary liver cell cancer
Epstein-Barr virus infection
Glycogen storage disease
Haemochromatosis
Model Answer: Congestive cardiac failure
Qu. 2: A 45 year old publican with spider naevi, multiple bruises, confusion and jaundice

Choose one of the following:
Acute viral hepatitis B
Liver abscess
Alcoholic liver disease
Metastatic liver disease
Congestive cardiac failure
Primary liver cell cancer
Epstein-Barr virus infection
Glycogen storage disease
Haemochromatosis
Model Answer: Alcoholic liver disease
Qu. 3: A 50 year old woman treated 3 years previously with radiotherapy and chemotherapy for breast cancer

Choose one of the following:
Acute viral hepatitis B
Liver abscess
Alcoholic liver disease
Metastatic liver disease
Congestive cardiac failure
Primary liver cell cancer
Epstein-Barr virus infection
Glycogen storage disease
Haemochromatosis
Model Answer: Metastatic liver disease
Qu. 4: A 23 year old intravenous drug abuser with jaundice, abdominal pain and fever

Choose one of the following:
Acute viral hepatitis B
Liver abscess
Alcoholic liver disease
Metastatic liver disease
Congestive cardiac failure
Primary liver cell cancer
Epstein-Barr virus infection
Glycogen storage disease
Haemochromatosis
Model Answer: Acute viral hepatitis B
Qu. 5: A 50 year old man with pigmented skin, diabetes and raised serum transaminases

Choose one of the following:
Acute viral hepatitis B
Liver abscess
Alcoholic liver disease
Metastatic liver disease
Congestive cardiac failure
Primary liver cell cancer
Epstein-Barr virus infection
Glycogen storage disease
Haemochromatosis
Model Answer: Haemochromatosis
Qu. 1: A 25 year old patient from the Indian subcontinent with fever and night sweats and a single enlarged cervical node

Choose one of the following:
Carcinoma of the lung
Sarcoidosis
Chronic lymphocytic leukaemia
Systemic lupus erythematosus
Glandular fever
Toxoplasmosis
HIV Infection
Tuberculous lymphadenitis
Hodgkin's Lymphoma
Rheumatoid arthritis
Model Answer: Tuberculous lymphadenitis
Qu. 2: A 65 year old man with an enlarged spleen and a very high total white cell count

Choose one of the following:
Carcinoma of the lung
Sarcoidosis
Chronic lymphocytic leukaemia
Systemic lupus erythematosus
Glandular fever
Toxoplasmosis
HIV Infection
Tuberculous lymphadenitis
Hodgkin's Lymphoma
Rheumatoid arthritis
Model Answer: Chronic lymphocytic leukaemia
Qu. 3: A 30 year old woman with joint pain, fever and a facial rash

Choose one of the following:
Carcinoma of the lung
Sarcoidosis
Chronic lymphocytic leukaemia
Systemic lupus erythematosus
Glandular fever
Toxoplasmosis
HIV Infection
Tuberculous lymphadenitis
Hodgkin's Lymphoma
Rheumatoid arthritis
Model Answer: Systemic lupus erythematosus
Qu. 4: An 18 year old student with a three week history of sore throat, fever, malaise and enlarged lymph nodes

Choose one of the following:
Carcinoma of the lung
Sarcoidosis
Chronic lymphocytic leukaemia
Systemic lupus erythematosus
Glandular fever
Toxoplasmosis
HIV Infection
Tuberculous lymphadenitis
Hodgkin's Lymphoma
Rheumatoid arthritis
Model Answer: Glandular fever
Qu. 5: A 45 year old smoker with weight loss and clubbing

Choose one of the following:
Carcinoma of the lung
Sarcoidosis
Chronic lymphocytic leukaemia
Systemic lupus erythematosus
Glandular fever
Toxoplasmosis
HIV Infection
Tuberculous lymphadenitis
Hodgkin's Lymphoma
Rheumatoid arthritis
Model Answer: Carcinoma of the lung
Qu. 1: A distended abdomen in a patient who lies still with rebound tenderness, guarding and absent bowel sounds

Choose one of the following:
Ascites
Intestinal ileus
Carcinoma of the sigmoid colon
Large bowel obstruction
Crohn's disease of the ileum
Ovarian tumour
Distended bladder
Peritonitis
Flatus alone
Pregnancy
Hepatic metastases
Small bowel obstruction
Model Answer: Peritonitis
Qu. 2: A distended abdomen in a postmenopausal woman with a midline mass arising from the pelvis and no urinary symptoms

Choose one of the following:
Ascites
Intestinal ileus
Carcinoma of the sigmoid colon
Large bowel obstruction
Crohn's disease of the ileum
Ovarian tumour
Distended bladder
Peritonitis
Flatus alone
Pregnancy
Hepatic metastases
Small bowel obstruction
Model Answer: Ovarian tumour
Qu. 3: A distended tympanitic abdomen 4 days after an abdominal operation with absent bowel sounds and no flatus passed P.R.

Choose one of the following:
Ascites
Intestinal ileus
Carcinoma of the sigmoid colon
Large bowel obstruction
Crohn's disease of the ileum
Ovarian tumour
Distended bladder
Peritonitis
Flatus alone
Pregnancy
Hepatic metastases
Small bowel obstruction
Model Answer: Intestinal ileus
Qu. 4: A distended abdomen with dullness to percussion in the flanks and suprapubically which shifts on rolling the patient from side to side

Choose one of the following:
Ascites
Intestinal ileus
Carcinoma of the sigmoid colon
Large bowel obstruction
Crohn's disease of the ileum
Ovarian tumour
Distended bladder
Peritonitis
Flatus alone
Pregnancy
Hepatic metastases
Small bowel obstruction
Model Answer: Ascites
Qu. 5: A distended tympanitic abdomen in a patient with 2 days of vomiting, central abdominal colicky pain, increases bowel sounds, and absent faeces and flatus

Choose one of the following:
Ascites
Intestinal ileus
Carcinoma of the sigmoid colon
Large bowel obstruction
Crohn's disease of the ileum
Ovarian tumour
Distended bladder
Peritonitis
Flatus alone
Pregnancy
Hepatic metastases
Small bowel obstruction
Model Answer: Small bowel obstruction
Qu. 1: A 24 year old woman with type I diabetes presenting to A&E who is comatose with a blood glucose of 1.5 mmol/L

Choose one of the following:
0.9% saline and short-acting insulin
IV
Gliclazide
0.9% saline, short-acting insulin
and potassium
Heparin
50% glucose and short-acting
insulin
Metformin
50ml 5% glucose IV
Octreotide
50ml 50% glucose IV
Oral glucose solution
Acarbose
Short-acting insulin
Model Answer: 50ml 50% glucose IV
Qu. 2: A 30 year old man with type I diabetes with a metabolic acidosis, raised blood glucose, and serum potassium

Choose one of the following:
0.9% saline and short-acting insulin
IV
Gliclazide
0.9% saline, short-acting insulin
and potassium
Heparin
50% glucose and short-acting
insulin
Metformin
50ml 5% glucose IV
Octreotide
50ml 50% glucose IV
Oral glucose solution
Acarbose
Short-acting insulin
Model Answer: 0.9% saline and short-acting insulin IV
Qu. 3: A 64 year old woman with maturity onset (type II) diabetes who is unconscious with a very raised blood glucose and a raised serum sodium who has already been started on intravenous insulin and saline

Choose one of the following:
0.9% saline and short-acting insulin
IV
Gliclazide
0.9% saline, short-acting insulin
and potassium
Heparin
50% glucose and short-acting
insulin
Metformin
50ml 5% glucose IV
Octreotide
50ml 50% glucose IV
Oral glucose solution
Acarbose
Short-acting insulin
Model Answer: Heparin
Qu. 4: A conscious 18 year old man with type I diabetes who developed sweating, anxiety and tachycardia due to hypoglycaemia in a GP surgery

Choose one of the following:
0.9% saline and short-acting insulin
IV
Gliclazide
0.9% saline, short-acting insulin
and potassium
Heparin
50% glucose and short-acting
insulin
Metformin
50ml 5% glucose IV
Octreotide
50ml 50% glucose IV
Oral glucose solution
Acarbose
Short-acting insulin
Model Answer: Oral glucose solution
Qu. 5: A 70 year old diabetic man taking only metformin who has a persistently high blood glucose and HbA1C

Choose one of the following:
0.9% saline and short-acting insulin
IV
Gliclazide
0.9% saline, short-acting insulin
and potassium
Heparin
50% glucose and short-acting
insulin
Metformin
50ml 5% glucose IV
Octreotide
50ml 50% glucose IV
Oral glucose solution
Acarbose
Short-acting insulin
Model Answer: Gliclazide
Qu. 1: A 55 year old man presenting with a three hour history of severe chest pain and an ECG showing acute inferior myocardial infarction with ST segment elevation and bradycardia

Choose one of the following:
Aspirin
Intravenous glyceryl trinitrate
Aspirin, atenolol
LMW heparin
Aspirin, atenolol , streptokinase
Low molecular weight heparin,
atenolol
Aspirin, atenolol, heparin, glyceryl
trinitrate
Oral atenolol
Aspirin, heparin, glyceryl
trinitrate
Oral glyceryl trinitrate
Aspirin, streptokinase
Sub-lingual nifedipine
Model Answer: Aspirin, streptokinase
Qu. 2: A 70 year old woman with asthma presenting with a one hour history of chest pain and an ECG showing anterior ST segment depression indicative of ischaemia

Choose one of the following:
Aspirin
Intravenous glyceryl trinitrate
Aspirin, atenolol
LMW heparin
Aspirin, atenolol , streptokinase
Low molecular weight heparin,
atenolol
Aspirin, atenolol, heparin, glyceryl
trinitrate
Oral atenolol
Aspirin, heparin, glyceryl
trinitrate
Oral glyceryl trinitrate
Aspirin, streptokinase
Sub-lingual nifedipine
Model Answer: Aspirin, heparin, glyceryl trinitrate
Qu. 3: A 45 year old man with a blood pressure of 240/140mmHg, grade IV hypertensive retinopathy and proteinuria

Choose one of the following:
Aspirin
Intravenous glyceryl trinitrate
Aspirin, atenolol
LMW heparin
Aspirin, atenolol , streptokinase
Low molecular weight heparin,
atenolol
Aspirin, atenolol, heparin, glyceryl
trinitrate
Oral atenolol
Aspirin, heparin, glyceryl
trinitrate
Oral glyceryl trinitrate
Aspirin, streptokinase
Sub-lingual nifedipine
Model Answer: Oral atenolol
Qu. 4: A 60 year old woman with an acute thrombotic stroke

Choose one of the following:
Aspirin
Intravenous glyceryl trinitrate
Aspirin, atenolol
LMW heparin
Aspirin, atenolol , streptokinase
Low molecular weight heparin,
atenolol
Aspirin, atenolol, heparin, glyceryl
trinitrate
Oral atenolol
Aspirin, heparin, glyceryl
trinitrate
Oral glyceryl trinitrate
Aspirin, streptokinase
Sub-lingual nifedipine
Model Answer: Aspirin
Qu. 5: A 55 year old man with acute pulmonary oedema and a blood pressure of 160/105mmHg

Choose one of the following:
Aspirin
Intravenous glyceryl trinitrate
Aspirin, atenolol
LMW heparin
Aspirin, atenolol , streptokinase
Low molecular weight heparin,
atenolol
Aspirin, atenolol, heparin, glyceryl
trinitrate
Oral atenolol
Aspirin, heparin, glyceryl
trinitrate
Oral glyceryl trinitrate
Aspirin, streptokinase
Sub-lingual nifedipine
Model Answer: Intravenous glyceryl trinitrate
Qu. 1: A 60 year old man with a seven day history of palpitations and an ECG showing atrial fibrillation with a ventricular rate of 120/min

Choose one of the following:
Amiodarone and warfarin
Intravenous adenosine
Atenolol and heparin
Lignocaine
DC shock and adrenaline
Low molecular weight heparin
Digoxin
Oral adenosine
Digoxin and warfarin
Verapamil
Flecainide
Model Answer: Digoxin and warfarin
Qu. 2: A previously healthy 30 year old woman with a four hour history of palpitations and an ECG showing atrial fibrillation with a ventricular rate of 140/min

Choose one of the following:
Amiodarone and warfarin
Intravenous adenosine
Atenolol and heparin
Lignocaine
DC shock and adrenaline
Low molecular weight heparin
Digoxin
Oral adenosine
Digoxin and warfarin
Verapamil
Flecainide
Model Answer: Flecainide
Qu. 3: A 60 year old woman with ischaemic heart disease presenting with a ventricular tachycardia and a blood pressure of 180/90 mmHg

Choose one of the following:
Amiodarone and warfarin
Intravenous adenosine
Atenolol and heparin
Lignocaine
DC shock and adrenaline
Low molecular weight heparin
Digoxin
Oral adenosine
Digoxin and warfarin
Verapamil
Flecainide
Model Answer: Lignocaine
Qu. 4: A 70 year old man with pulseless ventricular tachycardia

Choose one of the following:
Amiodarone and warfarin
Intravenous adenosine
Atenolol and heparin
Lignocaine
DC shock and adrenaline
Low molecular weight heparin
Digoxin
Oral adenosine
Digoxin and warfarin
Verapamil
Flecainide
Model Answer: DC shock and adrenaline
Qu. 5: A 40 year old man with a regular narrow-complex tachycardia of uncertain type

Choose one of the following:
Amiodarone and warfarin
Intravenous adenosine
Atenolol and heparin
Lignocaine
DC shock and adrenaline
Low molecular weight heparin
Digoxin
Oral adenosine
Digoxin and warfarin
Verapamil
Flecainide
Model Answer: Intravenous adenosine
Qu. 1: A 60 year old man 3 months after an acute myocardial infarction with hypercholesterolaemia, normal left-ventricular function and mild exertional angina

Choose one of the following:
Aspirin and atenolol
Bendrofluazide
Methyldopa and enalapril
Aspirin and simvastatin
Bendrofluazide and enalapril
Simvastatin
Aspirin, atenolol and bezafibrate
Enalapril and nifedipine
Aspirin, atenolol and simvastatin
Frusemide
Atenolol
High salt diet
Atenolol and simvastatin
Methyldopa
Model Answer: Aspirin, atenolol and simvastatin
Qu. 2: A 25 year old man with familial hypercholesterolaemia and a family history of premature cardiovascular disease

Choose one of the following:
Aspirin and atenolol
Bendrofluazide
Methyldopa and enalapril
Aspirin and simvastatin
Bendrofluazide and enalapril
Simvastatin
Aspirin, atenolol and bezafibrate
Enalapril and nifedipine
Aspirin, atenolol and simvastatin
Frusemide
Atenolol
High salt diet
Atenolol and simvastatin
Methyldopa
Model Answer: Simvastatin
Qu. 3: A 70 year old woman with mild hypertension and COPD

Choose one of the following:
Aspirin and atenolol
Bendrofluazide
Methyldopa and enalapril
Aspirin and simvastatin
Bendrofluazide and enalapril
Simvastatin
Aspirin, atenolol and bezafibrate
Enalapril and nifedipine
Aspirin, atenolol and simvastatin
Frusemide
Atenolol
High salt diet
Atenolol and simvastatin
Methyldopa
Model Answer: Bendrofluazide
Qu. 4: A 55 year old man with mild hypertension and gout

Choose one of the following:
Aspirin and atenolol
Bendrofluazide
Methyldopa and enalapril
Aspirin and simvastatin
Bendrofluazide and enalapril
Simvastatin
Aspirin, atenolol and bezafibrate
Enalapril and nifedipine
Aspirin, atenolol and simvastatin
Frusemide
Atenolol
High salt diet
Atenolol and simvastatin
Methyldopa
Model Answer: Atenolol
Qu. 5: A 50 year old man with poorly controlled hypertension despite taking bendrofluazide and atenalol

Choose one of the following:
Aspirin and atenolol
Bendrofluazide
Methyldopa and enalapril
Aspirin and simvastatin
Bendrofluazide and enalapril
Simvastatin
Aspirin, atenolol and bezafibrate
Enalapril and nifedipine
Aspirin, atenolol and simvastatin
Frusemide
Atenolol
High salt diet
Atenolol and simvastatin
Methyldopa
Model Answer: Bendrofluazide and enalapril
Qu. 1: Immediate relief of exertional chest pain in a 50 year old man with chronic stable angina

Choose one of the following:
Adenosine
Indomethacin
Atenolol
Intravenous low molecular weight
heparin
Atropine
Low dose aspirin
Clopidogrel
Streptokinase
Enalapril
Subcutaneous low molecular weight
heparin
Frusemide
Sub-lingual GTN
Model Answer: Sub-lingual GTN
Qu. 2: Treatment of hypertension in a 70 year old man with symptoms of angina

Choose one of the following:
Adenosine
Indomethacin
Atenolol
Intravenous low molecular weight
heparin
Atropine
Low dose aspirin
Clopidogrel
Streptokinase
Enalapril
Subcutaneous low molecular weight
heparin
Frusemide
Sub-lingual GTN
Model Answer: Atenolol
Qu. 3: Thrombolytic therapy for a 50 year old man with an acute myocardial infarction

Choose one of the following:
Adenosine
Indomethacin
Atenolol
Intravenous low molecular weight
heparin
Atropine
Low dose aspirin
Clopidogrel
Streptokinase
Enalapril
Subcutaneous low molecular weight
heparin
Frusemide
Sub-lingual GTN
Model Answer: Streptokinase
Qu. 4: Anticoagulation therapy for a patient admitted with unstable angina

Choose one of the following:
Adenosine
Indomethacin
Atenolol
Intravenous low molecular weight
heparin
Atropine
Low dose aspirin
Clopidogrel
Streptokinase
Enalapril
Subcutaneous low molecular weight
heparin
Frusemide
Sub-lingual GTN
Model Answer: Subcutaneous low molecular weight heparin
Qu. 5: Anti-platelet therapy for a patient with known coronary atherosclerosis

Choose one of the following:
Adenosine
Indomethacin
Atenolol
Intravenous low molecular weight
heparin
Atropine
Low dose aspirin
Clopidogrel
Streptokinase
Enalapril
Subcutaneous low molecular weight
heparin
Frusemide
Sub-lingual GTN
Model Answer: Low dose aspirin
Qu. 1: A 57 year old obese man with maturity onset (type II) diabetes mellitus who has poorly controlled blood sugars despite dietary changes and is taking no other medication

Choose one of the following:
Chlorpheniramine
Low-dose aspirin
Frusemide
Metformin
Glibenclamide
Reduced calorie diabetic diet with
low sodium content.
Glucagon
Rosiglitazone
Long-acting insulin
Short-acting insulin
Losartan
Spironolactone
Model Answer: Metformin
Qu. 2: Control of peri-operative blood glucose in a 75 year old woman with maturity onset (type II) diabetes mellitus

Choose one of the following:
Chlorpheniramine
Low-dose aspirin
Frusemide
Metformin
Glibenclamide
Reduced calorie diabetic diet with
low sodium content.
Glucagon
Rosiglitazone
Long-acting insulin
Short-acting insulin
Losartan
Spironolactone
Model Answer: Short-acting insulin
Qu. 3: Alternative hypoglycaemic therapy for a 60 year old man who has poorly controlled blood sugars despite maximum doses of a oral hypoglycaemic drugs

Choose one of the following:
Chlorpheniramine
Low-dose aspirin
Frusemide
Metformin
Glibenclamide
Reduced calorie diabetic diet with
low sodium content.
Glucagon
Rosiglitazone
Long-acting insulin
Short-acting insulin
Losartan
Spironolactone
Model Answer: Long-acting insulin
Qu. 4: A 40 year old overweight man with mild type II diabetes and mild hypertension

Choose one of the following:
Chlorpheniramine
Low-dose aspirin
Frusemide
Metformin
Glibenclamide
Reduced calorie diabetic diet with
low sodium content.
Glucagon
Rosiglitazone
Long-acting insulin
Short-acting insulin
Losartan
Spironolactone
Model Answer: Reduced calorie diabetic diet with low sodium content.
Qu. 5: A 45 year old man with maturity onset (type II) diabetes mellitus who has symptoms of hyperglycaemia and has recently been diagnosed with chronic renal failure

Choose one of the following:
Chlorpheniramine
Low-dose aspirin
Frusemide
Metformin
Glibenclamide
Reduced calorie diabetic diet with
low sodium content.
Glucagon
Rosiglitazone
Long-acting insulin
Short-acting insulin
Losartan
Spironolactone
Model Answer: Glibenclamide
Qu. 1: Initial treatment in hospital of a 22 year old woman with a high fever, rigors and abdominal pain caused by acute pyelonephritis

Choose one of the following:
Amoxycillin and flucloxacillin
Intravenous erythromycin
Cefotaxime
Oral gentamicin
Clarithromycin
Oral nitrofurantoin
Erythromycin and amoxycillin
Rifampicin
Flucloxacillin and fusidic acid
Tetracycline
Intravenous cefuroxime
Vancomycin
Model Answer: Intravenous cefuroxime
Qu. 2: Initial treatment in hospital of a 67 year old man with community acquired lobar pneumonia

Choose one of the following:
Amoxycillin and flucloxacillin
Intravenous erythromycin
Cefotaxime
Oral gentamicin
Clarithromycin
Oral nitrofurantoin
Erythromycin and amoxycillin
Rifampicin
Flucloxacillin and fusidic acid
Tetracycline
Intravenous cefuroxime
Vancomycin
Model Answer: Erythromycin and amoxycillin
Qu. 3: Initial treatment in hospital of meningitis in a teenager

Choose one of the following:
Amoxycillin and flucloxacillin
Intravenous erythromycin
Cefotaxime
Oral gentamicin
Clarithromycin
Oral nitrofurantoin
Erythromycin and amoxycillin
Rifampicin
Flucloxacillin and fusidic acid
Tetracycline
Intravenous cefuroxime
Vancomycin
Model Answer: Cefotaxime
Qu. 4: Out patient prophylaxis of recurrent urinary tract infections in a 30 year old woman

Choose one of the following:
Amoxycillin and flucloxacillin
Intravenous erythromycin
Cefotaxime
Oral gentamicin
Clarithromycin
Oral nitrofurantoin
Erythromycin and amoxycillin
Rifampicin
Flucloxacillin and fusidic acid
Tetracycline
Intravenous cefuroxime
Vancomycin
:Model Answer: Oral nitrofurantoin
Qu. 5: Treatment in hospital of osteomyelitis caused by Staph. aureus infection in a 40 year old intravenous drug abuser

Choose one of the following:
Amoxycillin and flucloxacillin
Intravenous erythromycin
Cefotaxime
Oral gentamicin
Clarithromycin
Oral nitrofurantoin
Erythromycin and amoxycillin
Rifampicin
Flucloxacillin and fusidic acid
Tetracycline
Intravenous cefuroxime
Vancomycin
Model Answer: Flucloxacillin and fusidic acid
Qu. 1: A 50 year old man being treated for atrial fibrillation presents with nose bleeds

Choose one of the following:
Diamorphine
Low-dose aspirin
Digoxin
Simvastatin
Doxazosin
Verapamil
Ibuprofen
Warfarin
Intravenous adenosine
Lignocaine
Model Answer: Warfarin
Qu. 2: A 60 year old man presents with unsteadiness and falls. Measurement of his BP shows a postural drop

Choose one of the following:
Diamorphine
Low-dose aspirin
Digoxin
Simvastatin
Doxazosin
Verapamil
Ibuprofen
Warfarin
Intravenous adenosine
Lignocaine
Model Answer: Doxazosin
Qu. 3: A 46 year old man complains of muscle aches and pains 3 months after a myocardial infarction

Choose one of the following:
Diamorphine
Low-dose aspirin
Digoxin
Simvastatin
Doxazosin
Verapamil
Ibuprofen
Warfarin
Intravenous adenosine
Lignocaine
Model Answer: Simvastatin
Qu. 4: A 65 year old woman on monotherapy for hypertension presents with constipation and ankle swelling

Choose one of the following:
Diamorphine
Low-dose aspirin
Digoxin
Simvastatin
Doxazosin
Verapamil
Ibuprofen
Warfarin
Intravenous adenosine
Lignocaine
Model Answer: Verapamil
Qu. 5: Two weeks after treatment for atrial fibrillation was increased a 75 year old woman complains of nausea, constipation, abdominal discomfort and disturbed vision

Choose one of the following:
Diamorphine
Low-dose aspirin
Digoxin
Simvastatin
Doxazosin
Verapamil
Ibuprofen
Warfarin
Intravenous adenosine
Lignocaine
Model Answer: Digoxin
Qu. 1: reduce leg oedema in a 60 year old man with chronic heart failure

Choose one of the following:
Digoxin
Nifedipine
Enalapril
Oral frusemide
Ibuprofen
Salbutamol
Intravenous adenosine
Spironolactone
Intravenous glyceryl trinitrate
Warfarin
Lignocaine
Model Answer: Oral frusemide
Qu. 2: reduce long term mortality in a 50 year old woman with chronic heart failure caused by ischaemic heart disease

Choose one of the following:
Digoxin
Nifedipine
Enalapril
Oral frusemide
Ibuprofen
Salbutamol
Intravenous adenosine
Spironolactone
Intravenous glyceryl trinitrate
Warfarin
Lignocaine
Model Answer: Enalapril
Qu. 3: reduce ventricular rate in a patient with heart failure and atrial fibrillation

Choose one of the following:
Digoxin
Nifedipine
Enalapril
Oral frusemide
Ibuprofen
Salbutamol
Intravenous adenosine
Spironolactone
Intravenous glyceryl trinitrate
Warfarin
Lignocaine
Model Answer: Digoxin
Qu. 4: prevent embolic stroke in a 57 year old man with heart failure caused by dilated cardiomyopathy

Choose one of the following:
Digoxin
Nifedipine
Enalapril
Oral frusemide
Ibuprofen
Salbutamol
Intravenous adenosine
Spironolactone
Intravenous glyceryl trinitrate
Warfarin
Lignocaine
Model Answer: Warfarin
Qu. 5: cause deterioration in symptoms in a 46 year old man with severe left ventricular dysfunction on multiple treatments for heart failure

Choose one of the following:
Digoxin
Nifedipine
Enalapril
Oral frusemide
Ibuprofen
Salbutamol
Intravenous adenosine
Spironolactone
Intravenous glyceryl trinitrate
Warfarin
Lignocaine
Model Answer: Ibuprofen
Qu. 1: Which treatment would be most useful to reduce his anxiety levels

A 70 year old man presents with sudden onset shortness of breath. He is very anxious and distressed, unable to lie flat and is coughing up frothy sputum. His jugular venous pressure is elevated and he has mild bilateral ankle oedema. He is apyrexial but examination of his chest reveals bilateral inspiratory crackles in lower and mid zones.

Choose one of the following:
60% oxygen by face mask
intravenous streptokinase
intravenous adrenaline
oral aspirin
intravenous atenolol
oral digoxin
intravenous diamorphine
none of the above
intravenous frusemide
intravenous glyceryl trinitrate
Model Answer: intravenous diamorphine
Qu. 2: Which treatment would be expected to reduce his venous pressure most effectively

A 70 year old man presents with sudden onset shortness of breath. He is very anxious and distressed, unable to lie flat and is coughing up frothy sputum. His jugular venous pressure is elevated and he has mild bilateral ankle oedema. He is apyrexial but examination of his chest reveals bilateral inspiratory crackles in lower and mid zones.

Choose one of the following:
60% oxygen by face mask
intravenous streptokinase
intravenous adrenaline
oral aspirin
intravenous atenolol
oral digoxin
intravenous diamorphine
none of the above
intravenous frusemide
intravenous glyceryl trinitrate
Model Answer: intravenous glyceryl trinitrate
Qu. 3: Which treatment has been shown in randomised controlled trials to reduce mortality in this situation

A 70 year old man presents with sudden onset shortness of breath. He is very anxious and distressed, unable to lie flat and is coughing up frothy sputum. His jugular venous pressure is elevated and he has mild bilateral ankle oedema. He is apyrexial but examination of his chest reveals bilateral inspiratory crackles in lower and mid zones.

Choose one of the following:
60% oxygen by face mask
intravenous streptokinase
intravenous adrenaline
oral aspirin
intravenous atenolol
oral digoxin
intravenous diamorphine
none of the above
intravenous frusemide
intravenous glyceryl trinitrate
Model Answer: none of the above
Qu. 4: Which treatment is absolutely contraindicated in this case

A 70 year old man presents with sudden onset shortness of breath. He is very anxious and distressed, unable to lie flat and is coughing up frothy sputum. His jugular venous pressure is elevated and he has mild bilateral ankle oedema. He is apyrexial but examination of his chest reveals bilateral inspiratory crackles in lower and mid zones.

Choose one of the following:
60% oxygen by face mask
intravenous streptokinase
intravenous adrenaline
oral aspirin
intravenous atenolol
oral digoxin
intravenous diamorphine
none of the above
intravenous frusemide
intravenous glyceryl trinitrate
Model Answer: intravenous atenolol
Qu. 5: An ECG shows that he has had a completed Q wave myocardial infarction in the past. Which treatment would you now add

A 70 year old man presents with sudden onset shortness of breath. He is very anxious and distressed, unable to lie flat and is coughing up frothy sputum. His jugular venous pressure is elevated and he has mild bilateral ankle oedema. He is apyrexial but examination of his chest reveals bilateral inspiratory crackles in lower and mid zones.

Choose one of the following:
60% oxygen by face mask
intravenous streptokinase
intravenous adrenaline
oral aspirin
intravenous atenolol
oral digoxin
intravenous diamorphine
none of the above
intravenous frusemide
intravenous glyceryl trinitrate
Model Answer: oral aspirin