More Part 2 Questions

1)
An 84-year-old man is admitted via A&E. He was found wandering outside in his pyjamas. He is obviously confused and is talking to people who are not there. The nurses are concerned when he starts wandering about the ward and feel he is going to prove difficult to look after. What is the best management plan for this man?
A : Haloperidol 0.5mg orally given 2hourly to a maximum of 5g in 24 hours
B : Bedrails on both sides of the bed
C : Risperidone 0.5mg orally and repeated 2 hourly up to 3mg in 24 hours
D : Regular reassurance, being placed in a calm environment
E : Lorazepam 0.5mg as required, but no more than tds.

ANSWER: D

2)A 55-year-old female with a recent onset of joint pain and was prescribed with medications by her GP presents with a 5-day history of a widespread erythematous skin eruption and mouth ulcers. She complained of dysuria. She has lesions on the palms and some areas of skin are beginning to blister and ulcerate. What is the most likely diagnosis?
A : Bullous pemphigoid
B : Fixed drug eruption
C : Stevens-Johnson syndrome
D : Pemphigus vulgaris
E : Erythema multiforme.

ANSWER: C

3)A 60-year-old man presents with a palpable, non-blanching rash on the lower legs. Which of the following investigations is least likely to help with the underlying diagnosis?
A : Antistreptolysin-O test (ASOT)
B : Antinuclear antibodies (ANA)
C : Hepatitis B antibodies
D : Thyroid function tests
E : Cryoglobulins.

ANSWER: D

4) You are called to the resuscitation room to see a 20-year-old tall man whose condition has suddenly deteriorated. He had arrived 30 minutes earlier with a 2-hour history of central pleuritic chest pain and breathlessness. He collapsed while awaiting radiograph and now is agitated and cyanosed with pulse 120/min and BP 80/40. Oxygen saturation is reading 72%, with the patient breathing high flow oxygen via a re-breathe mask. Respiratory examination reveals reduced breath sounds in the right lung field with deviation of the trachea towards the left. Percussion is resonant bilaterally. CVS examination reviewed diastolic murmur over left sternal edge with collapsing pulse? What is your diagnosis?
A : Spontaneous pneumothorax
B : Marfan’s syndrome
C : Dissecting aneurysm
D : Acute exacerbation of asthma
E : Parapenumonic effusion

ANSWER: B

5)An 85-year-old man is admitted from home because he has become increasingly confused and is not coping. He is known to have metastatic carcinoma of the prostate and takes Zoladex 3 monthly. You note that he has bruising over the left side of his forehead. Which of the following investigations will not help you diagnose and treat his confusion?
A : CT scan of the head
B : Midstream urine sample
C : Calcium
D : Urea and electrolytes
E : Prostatic specific antigen (PSA).

ANSWER: E