Question: A couple has just finished their detox regime and wants a drug with a pharmacological action to serve as a deterrent when they take alcohol. What drug is the appropriate choice?
a. Disulfiram
b. Acamprosate
c. Vitamin supplement
d. Naloxone
e. Naltrexone
Answer: (b)
Question: A 68 year old woman presents to the ED with confusion. Temperature=39.3C and productive cough. Sputum is rusty after 2 days. CXR shows right lower lobe consolidation. What is the most likely organism?
a. Streptococcus pneumonia
b. Staphylococcus aureus
c. Coxiella burnetti
d. Mycoplasma pneumonia
Answer: (a)
Question: A 70 year old man with prostatic cancer has had severe acute back pain waking him up at night for 6 weeks. What is the most appropriate investigation?
a. MRI spine
b. Radionuclide bone scan
c. DEXA scan
d. Serum ALP concentration
e. Serum calcium concentration
Answer: (b)
Question: An asymptomatic 56 year old man who has never consumed alcohol came for a routine checkup. Examination: increased skin pigmentation, spider angioma, cardiomegaly, S3 gallop, liver firm with 8cm span, no ascites. He is at risk of which condition?
a. Cerebellar degeneration
b. Werniecke’s encephalopathy
c. Renal failure
d. Hepatoma
e. Hepatic vein thrombosis
Answer: (d)
Question: A 39 year old male presents with visual symptoms. Ophthalmoscopy shows papilloedema. Which anatomical site is most likely to be affected?
a. Optic nerve
b. Optic disc
c. Optic radiation
d. Oculomotor nerve
e. Optic chiasma
Answer: (b)
Question: A 75 year old man has been attending the clinic for lower urinary tract symptoms. His mood is very low and he says he feels unhappy, anxious and unable to sleep. He has been diagnosed with moderate depression. What tx would be most effective for this patient?
a. Amitriptyline
b. Citalopram
c. CBT
d. Dosulepin
e. Diazepam
Answer: (b)
Question: A 48 year old patient after surgical removal of mandibular ca presents with perioral paresthesia and severe pain which is not relieved by oral morphine. What is the next step in treating this patient?
a. Oral amitriptyline (2nd line)
b. Oral oxycodone
c. PCA
d. IV morphine
e. Fentanyl patch
f. Gabapentin (1st line)
Answer: (f)
Question: A 34 year old man was slapped over his right ear in a fight. There is blood coming from his external auditory canal and he has pain, deafness and ringing in his ears. What is the most appropriate initial investigation?
a. CT
b. MRI
c. Otoscopy
d. Skull XR
e. Facial XR
Answer: (a)
Question: A 45 year old man has developed an annular rash with a scaly edge on his thigh. The rash has been spreading over the last 3 weeks. He has some general aches and pains. What is the single most useful investigation?
a. ANA
b. Biopsy lesion
c. Lyme antibodies
d. Skin scrape for mycology
e. Skin swab for bacteria
Answer: (c)
Question: A 80 year old man with prostatic cancer has confusion, thirst, abdominal pain and an abnormal ECG. What is the most appropriate investigation?
a. MRI spine
b. Radionuclide bone scan
c. DEXA scan
d. Serum ALP concentration
e. Serum calcium concentration
Answer: (e)