Formative Assessment Final
Formative Assessment Final
Formative Assessment Final
1. A 76 year- old man develops an acute kidney injury 2 days after an elective knee replacement.
His past medical history includes mild chronic obstructive pulmonary disease and
hypertension (controlled with an angiotensin-converting enzyme (ACE) inhibitor). He is
hypotensive (80/50 mmHg), oliguric and has urea of 18 mmol/L (50.4 mg/dL), creatinine of
165 μmol/L (1.87 mg/dL), potassium of 5.1 mmol/L and a normal bicarbonate level. He has
received 30 mL/kg of intravenous fluids over the past 2 hours.
Which will be the most efficacious measure to improve his renal outcome?
Answer :
2. A 25 year -old man presents to the emergency department with a 4-day history of chest pain
and mild shortness of breath. He feels that the pain is worse on lying flat, coughing and deep
breathing; it is relieved by sitting forwards and has improved with ibuprofen. He has no
significant past medical history but was recently unwell with a non-specific viral infection. An
ECG shows widespread saddle ST elevation.
What is the most likely cause of the chest pain?
A. Aortic dissection
B. Pericarditis
C. Myocardial infarction
D. Pulmonary embolism
Answer:
3. For which of these conditions is non-invasive ventilation (bi-level positive airway pressure;
BiPAP) the first-line respiratory treatment?
A. Acute epiglottitis
B. H1N1 Influenza
C. Severe pneumonia
D. Acute exacerbation of COPD
Answer :
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4. You assess a 62 year old woman 2 days after treatment for anterior myocardial infarction. On
examination she is tachycardic and tachypnoeic, and has a harsh systolic murmur radiating
to the axilla. There are fine inspiratory crepitations audible at the lung bases. What is the
most likely explanation for these findings?
A. Aortic Incompetence
B. Papillary muscle rupture and mitral incompetence
C. Post infarction pericarditis
D. Intraventricular septal rupture and VSD
Answer:
A. Re- bleeding
B. Cerebral vasospasm
C. Hypertension
D. Pulmonary edema
Answer :
A. CT pulmonary angiogram
B. Transesophageal echocardiography
C. 12 lead ECG
D. Blood D-Dimer
Answer :
7. A 75-year-old man is admitted to HDU following an episode of severe chest pain and collapse
with transient loss of consciousness. On admission he is conscious but complaining of chest
pain radiating into his back. Blood pressure measured in the right arm is 210/110. The left
radial pulse is absent and there are signs of a left hemiparesis. What is the most likely
diagnosis?
Answer :
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8. A 56-year-old female patient with type II DM has undergone trans-sphenoidal excision of
pituitary adenoma. During the immediate post- operative period she develops polyuria with a
urine output of 600 ml over 2 hours. The urine osmolality is 324 mosmol /Kg and the specific
gravity is 1.001.
Which is the most appropriate treatment for her?
Answer :
9. An 83 -year old woman presents with acute pulmonary edema, BP 180/100 and a SaO2 of 85
% Which of the following treatment is UNLIKELY to helpful in this setting?
A. Inj furosemide
B. IV Dobutamine
C. IV infusion of NTG
D. Non invasive ventilation
Answer :
10. A 75- year old presents to her family physician with 24- hour history of rapid irregular
palpitation accompanied by fatigue. In an elderly patient, what is the most likely cause of
palpitations?
Answer :
A. Occipital headache
B. Slow leak of CSF
C. Relieved by analgesic
D. Prevented by pencil cut needle
Answer :
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12. The term orthopnea refers to breathlessness (dyspnea) in a particular situation. Which
answer below describes that situation?
Answer :A
13. A-75 year- old woman with history of palpitation presents with a painful left leg. On
examination, pulse rate 80/mt irregularly irregular, BP 170/96 mm of Hg. Left leg is pale cold
and sensations reduced. The popliteal, posterior tibial and dorsalis pedis pulse not palpable.
Her only medication is tab Asparin and clopidogrel. What is the most likely diagnosis?
Answer :
14. Which of the following physical signs is associated with left ventricular failure?
Answer :
15. In the general medical setting, what is the earliest and most sensitive sign of clinical
deterioration?
A. Heart rate
B. Blood pressure
C. Respiratory rate
D. Core temperature
Answer=
16. In the context of cardiac physiology, which of the following, is stroke volume dependent on?
A. Cardiac index
B. Pre load and contractility
C. Hemoglobin and O2 saturation
D. Jugular venous pressure
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Answer :
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