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Sample questions
Original questions in the exam's style. Choose an answer, then check it.
A 42-year-old man has had severe low back pain for two days, followed this morning by pain radiating down both legs, numbness around the anus and difficulty starting urination. Anal tone is reduced on examination. What is the most appropriate next step?
Answer: A. Bilateral radicular pain, saddle anaesthesia, new urinary retention and reduced anal tone indicate cauda equina syndrome. It is a surgical emergency, and outcomes depend on decompression before sphincter function is lost. The patient should be sent to an emergency department with MRI and spinal surgery available, not managed conservatively. Based on: NICE CKS Back pain - low (without radiculopathy); GIRFT National Suspected Cauda Equina Syndrome pathway
Twenty minutes into a red cell transfusion, a 62-year-old woman develops fever, chest tightness, loin pain and a fall in blood pressure. What is the first action?
Answer: C. Fever, loin pain and hypotension early in a transfusion suggest an acute haemolytic reaction from ABO incompatibility. The transfusion must be stopped immediately, access maintained, identity of patient and bag checked, and the laboratory and transfusion service informed. The event is then reported. Based on: BSH Guideline on the administration of blood components (2017)
A lethargic 9-month-old boy weighing 8 kg is brought in with profuse watery diarrhoea. He cannot drink, has sunken eyes and a skin pinch that goes back very slowly. IV access is obtained and you follow the WHO Plan C. What is the correct initial intravenous volume of Ringer's lactate and timing?
Answer: B. Plan C for severe dehydration gives 100 mL/kg of Ringer's lactate. In infants under 12 months, 30 mL/kg is given in the first hour and 70 mL/kg over the next 5 hours. For this 8 kg infant that is 240 mL in the first hour, then 560 mL over 5 hours. The 30-minute schedule is for children aged 12 months or more. Based on: WHO Pocket Book of Hospital Care for Children: Diarrhoea (Plan C)
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Original questions, an explanation for every option, and a mock exam built to the blueprint. One exam per pass, from OMR 11.6.