By Sukhpreet Singh Dubb; et al

500 SBA-style questions offer worthy information and exam perform for these in guidance for scientific finals and beyond.

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D. E. Magnetic resonance imaging (MRI) scans of the abdomen and pelvis Measurement of random plasma catecholamines Measurement of urinary metanephrines over several 24 hour periods Glucose tolerance test Pharmacological provocation using clonidine 32. Chest pain (4) A 56-year-old man presents to the accident and emergency department with a 2-hour history of central chest pain radiating to the left arm. He is anxious, nauseated and sweaty. His pulse rate is 120/minute in sinus rhythm and the ECG reveals ST elevation in leads II, III and aVF.

E. Hoarse voice Miosis Anhydrosis Exopthalmos Ptosis 18. Cough A 50-year-old Afro-Caribbean man, with no past medical history, presents with a four-month history of dry cough and shortness of breath on exertion. The patient’s GP referred him to the chest clinic after performing blood tests which revealed a raised erythrocyte sedimentation rate (ESR) and serum angiotensin-converting enzyme (ACE) level. You review the patient’s chest x-ray which reveals bilateral hilar lyphadenopathy. From the list below, select the most likely diagnosis: A.

C. D. E. Arrange for his medication to be given under direct observation Add spironolactone to his medication Arrange urinary catecholamine assays Request an adrenal CT scan Add verapamil to his medication Answers 17 ANSWERS Myocardial infarction 1 D Time equates to muscle. Judging from the urgency, this male presented with an ST elevation MI (STEMI) which is an indication for urgent primary percutaneous coronary intervention (PCI). Compare this to a non-ST elevation MI (NSTEMI) which indicates ischaemia rather than infarction and PCI should be carried out within 48 hours (answers A and C).

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