Questions 11-20

This section is devoted to SBA style questions on Case 2.

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Question 11

A patient presents to the doctor after intermittent chest pain over the last month. They had said after one month of symptoms, if they did not go away, they would see a doctor about it.

  1. Interpersonal crisis
  2. Perceived social interference
  3. Sanctioning
  4. Temporalisation
  5. Interference with vocational activities

The correct answer is option d Temporalisation

d is correct as they are using a length of time before seeing the doctor
a. Incorrect as there is no social crisis in the patients life
b. Incorrect as there is no social interferance
c. Incorrect as there is noevidence of a friend/family member making the patient seeing the doctor
e. Incorrect as there is no sign of interferance of activities

Question 12

Which of the following is a cardinal symptom for heart disease?

  1. Oedema
  2. Dysuria
  3. Expectoration
  4. Confusion
  5. Hypocholesteraemia

The correct answer is option a Oedema

a is correct as the heart disease causes a fluid buildup leading to oedema
b. This is decreased urine, which isn’t a cardinal symptom
c. This is fluid in the trachea and broncioles, this is not a cardinal symptom of heart disease
d. This is an acute state of the lack of awarness, this is not a cardinal symptom of heart disease
e. This is low choleterol, this is not a cardinal symptom of heart disease

Question 13

A patient presents to the doctor after intermittent chest pain over the last month. They were worried it was something bad, and this would cause problems in caring for their elderly mother. Which of the following Zola’s triggers to consultation is this?

  1. Perceived interference with vocational and physical activity
  2. Temporalising
  3. Social intolerance
  4. Interpersonal crisis
  5. Sanctioning

The correct answer is option a Perceived interference with vocational and physical activity

This is correct as there is an onterferance with their caring roll for the ir mother
Incorrect as there is no time reasoning in seeing a doctor
Incorrect as there is no evidence of intererance with social links
Incorrect as there is no crisis in the patients situation
Incorrect as there is no pressure from social contacts

Question 14

Which of the following embryological cells become the placenta

  1. Hypoblast
  2. Trophoblasts
  3. Embryoblast
  4. Endoderm
  5. Mesoderm

The correct answer is option b Trophoblasts

Correct, the trophoblasts form the placenta
a. Incorrect, the hypoblast forms the yold sac
c. Incorrect, the embryoblast forms the structure of the foetus
d. Incorrect, the Endoderm forms the internal organs such as the liver and stomach
e. Incorrect, the mesoderm forms the heart and neural tube

Question 15

A defect in CNCCs causes which condition?

  1. Heart Faliure
  2. Myocardial Infarction
  3. Wolff-Parkinson-White syndrome
  4. Tetralogy of fallot
  5. Left ventricular hypertrophy

The correct answer is option d Tetralogy of fallot

Correct as the CNCC stops migration of the secondary heart field, causing the tetralogy of fallot
a. Incorrect, heart faliure is caused by mechanical heart faliure
Incorrect, Myocardial infarction is caused by occlusion of the coronary artery
c. Incorrect, Wolff-Parkinson-White syndrome is caused by a congenital accessory electrical pathway
e. Incorrect, Left ventricular hypertrophy is caused by a compensatory mechanism from left sided heart faliure

Question 16

When does the heart develop?

  1. Day 1
  2. Week 1
  3. Day 10
  4. Day 21
  5. Week 6

The correct answer is option d Day 21

Correct, the heart is formed from day 21
a. Incorrect, the heart develops at day 21, not day 1
b. Incorrect, the heart develops at day 21, not week 1
c. Incorrect, the heart develops at day 21, not day 10
e. Incorrect, the heart develops at day 21, not week 6

Question 17

An elderly gentleman presents for a follow up at the cardiology clinic for review of his heart failure. He is complaining of gynaecomastia. Which of the following drugs is most likely to be responsible?

  1. Bisoprolol
  2. Lisinipril
  3. Losartan
  4. Furosemide
  5. Spironolactone

The correct answer is option e Spironolactone, as Spironolactone is a steroid and as a consequence has cross agonism with oestrogen and progesterone receptors. All of the above drugs can be used in the management of heart failure

e is correct as spironolactone can be an agonist of Oestrogen and Progesterone receptors
a. Bisoprolol is a beta blocker and has no cross antagonism that would cause gynaechomastia
b. Lisinopril is a ACE inhibitor and has no cross antagonism that would cause gynaechomastia
c. Losartan is an ARB and has no cross antagonism that would cause gynaechomastia
d. Furosermide is a loop diuretic and has no cross antagonism that would cause gynaechomastia

Question 18

Which of the following is a branch of the aortic arch?

  1. Right common carotid
  2. Right external carotid
  3. Left subclavian artery
  4. Left internal thoracic artery
  5. Coronary arteries

The correct answer is option c Left subclavian artery, the branches are The right brachiocephalic trunk, Left common carotid and Left subclavian. The external carotid is a branch of the common carotid. The Internal thoracic artery is a branch of the subclavian. The brachiocephalic artery very quickly splits into the right subclavian and the right common carotid. The coronary arteries come from the ascending aorta

c is correct as it is the only branch of the aortic arch
a. Right common carotid is a branch of the right brachiocephalic trunk
b. Incorrect as the Right external carotid is a branch of the right common carotid
d. This is a branch of the subclavian artery
e. This is a branch of the ascending aorta

Question 19

A 50 year old Afro-Carribean woman presents to her GP for a check up after recently moving to the UK. She has a past medical history of asthma. Her blood pressure is found to be 165/115. What stage of hypertension is this?

  1. Not hypertensive
  2. Stage 1
  3. Stage 2
  4. Stage 3
  5. Stage 4

The correct answer is option c Stage 2

This is stage 2 as atage 2 is -/-
Is incorrect as not hypertensive is below 140/90
Is incorrect as stage 1 is between 140-159/90-99
Is incorrect as stage is between 180-199/110-119
Is incorrect as stage 4 does not exist