A 42 year old lady presents with a 3 days history of severe, cramping abdominal pain. Of the following, which is the most important initial investigation?

• CT abdomen pelvis

• LFTs

• Pregnancy test

• Serum amylase

A 25 year old presents tired all the time. Her bloods show an iron deficiency anaemia and normal thyroid function, renal function and vitamin D levels. What is the next most appropriate course of action?

• Add on anti-TTG

• Ask a doctor to prescribe iron supplementation as per BNF

• Enquire about mood and depression screen

• Refer to haematology

A 65 year old man presents with dysphasia, left upper limb dense hemiparesis and left facial droop. What is the classification of this stroke?

• Left PACS

• Left LACS

• Right PACS

• Right TACS

A 60 year old man with significant smoking history presents with confusion. Bloods show hyponatraemia and CXR shows a large medial mass in the right lung. What is the most likely histological diagnosis?

• Adenocarcinoma

• Large cell carcinoma

• Small cell carcinoma

• Squamous cell carcinoma

Which of the following artery occlusions is the most likely to cause a homonymous hemianopia?

• Anterior cerebral artery

• Anterior communicating artery

• Posterior inferior cerebellar artery

• Posterior cerebral artery

A 53 year old patient presents with sudden onset, painless jaundice and is unfortunately diagnosed with pancreatic cancer. Staging CT shows locally advanced tumour obstructing the bile duct. What are her bloods most likely to show?

• Normal bilirubin. normal ALP, raised Ca-19-9

• Raised bilirubin, raised ALP, raised Ca15-3

• Raised bilirubin, raised ALP, raised Ca-19-9

• Raised bilirubin, normal ALP, normal Ca19-9

Which of the following is NOT a feature of life-threatening asthma?

• Drowsiness/confusion

• PEF <33% best or predicted

• Prefers sitting up to laying down

• Silent chest

Which scoring system is used to calculate the clinical probability of appendicitis in a person presenting with abdominal pain?

• Alvarado score

• APACHE II score

• Glasgow-Imrie score

• P-Possum score

Which of the following is a poor prognostic factor in acute pancreatitis according to Glasgow-Imrie criteria?

• Aged <55years

• Hypocalcaemia

• Hypoglycaemia

• Respiratory rate <25

Which of the following are an indication for thrombolysis (in the absence of any contra-indications) in a patient with a known pulmonary embolus?

• Increased respiratory rate

• Hypotension (systolic <90mmHg or sudden drop >40mmHg)

• Haemoptysis

• Evidence of right heart strain and cardiogenic shock