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WorksheetsGEM Module 1 Mock
Total questions: 100
Worksheet time: 2hrs 40mins
Name
Class
Date
1.
A 45-year-old woman is diagnosed with breast cancer in the upper outer quadrant of her left breast. On physical examination, she has palpable lymph nodes in her left axilla. This pattern of lymphatic spread is primarily due to the drainage of the breast into which of the following nodes?
a)
Parasternal nodes
b)
Contralateral axillary nodes
c)
Supraclavicular nodes
d)
Axillary nodes
e)
Inguinal nodes
2.
A 60-year-old man with a history of smoking presents with a bronchogenic carcinoma. A chest X-ray reveals enlarged lymph nodes at the lung hilum. These hilar nodes receive lymphatic drainage from which of the following structures?
a)
Heart
b)
Lungs
c)
Oesophagus
d)
Thymus
e)
Breast
3.
During a dissection, a medical student identifies a large vein ascending in the posterior mediastinum, arching over the root of the right lung, and terminating in the superior vena cava. This vein is most likely the:
a)
Hemiazygos vein
b)
Accessory hemiazygos vein
c)
Azygos vein
d)
Left brachiocephalic vein
e)
Pulmonary vein
4.
The sternal angle (angle of Louis) is a key surface landmark. At this level, which of the following structures bifurcates?
a)
Aorta
b)
Pulmonary trunk
c)
Trachea
d)
Oesophagus
e)
Superior vena cava
5.
A patient presents with ptosis, miosis, and anhidrosis on the left side of his face. This syndrome is caused by interruption of the sympathetic innervation to the head. The pre-ganglionic neuronal cell bodies for this pathway are located in the:
a)
Superior cervical ganglion
b)
Stellate ganglion
c)
T1-L2 intermediolateral cell column
d)
Ciliary ganglion
e)
Nucleus ambiguus
6.
Which of the following capillary types is characterized by continuous endothelial cells with tight junctions and is found in the blood-brain barrier, muscle, and lung?
a)
Sinusoidal
b)
Fenestrated
c)
Continuous
d)
Discontinuous
e)
Lymphatic
7.
The thoracic duct primarily drains lymph from which of the following areas?
a)
Right arm and right side of head
b)
Right lower limb
c)
Left upper limb and left side of head
d)
The entire body below the diaphragm and the left upper quadrant
e)
The liver and spleen only
8.
A patient with testicular cancer is most at risk for metastasis to which group of lymph nodes?
a)
Axillary nodes
b)
Inguinal nodes
c)
Popliteal nodes
d)
Para-aortic nodes
e)
Cervical nodes
9.
The stratum basale of the epidermis is primarily responsible for which of the following functions?
a)
Providing a waterproof barrier
b)
Producing melanin
c)
Cell proliferation and regeneration
d)
Antigen presentation
e)
Sensation of fine touch
10.
Which of the following cell junctions forms a seal between adjacent epithelial cells to prevent paracellular leakage?
a)
Desmosomes
b)
Gap junctions
c)
Adherens junctions
d)
Tight junctions
e)
Hemidesmosomes
11.
The Na⁺/K⁺-ATPase pump is critical for maintaining the resting membrane potential. For every cycle of this pump, what is the net movement of ions?
a)
2 Na⁺ in, 3 K⁺ out
b)
3 Na⁺ in, 2 K⁺ out
c)
2 Na⁺ out, 3 K⁺ in
d)
3 Na⁺ out, 2 K⁺ in
e)
1 Na⁺ out, 1 K⁺ in
12.
Glucose absorption from the intestinal lumen into the blood relies on a coupled transport mechanism. Which of the following correctly describes this process?
a)
Facilitated diffusion of glucose via GLUT2 on the luminal membrane
b)
Passive diffusion of glucose down its concentration gradient
c)
Active transport of glucose via SGLT1 on the luminal membrane, powered by the Na⁺ gradient
d)
Endocytosis of glucose followed by exocytosis into the blood
e)
Exchange of glucose for H⁺ ions
13.
During the initial phase of an action potential, which of the following events occurs?
a)
Voltage-gated K⁺ channels open, causing repolarisation.
b)
Voltage-gated Na⁺ channels open, causing depolarisation.
c)
The Na⁺/K⁺ pump hyperpolarises the cell.
d)
Ligand-gated Cl⁻ channels open, causing inhibition.
e)
Voltage-gated Ca²⁺ channels open, triggering exocytosis.
14.
A patient has a tumour that secretes excessive parathyroid hormone-related peptide (PTHrP). Which of the following sets of laboratory findings would be most consistent with this condition?
a)
Hypercalcaemia and hypophosphataemia
b)
Hypocalcaemia and hyperphosphataemia
c)
Hypercalcaemia and hyperphosphataemia
d)
Hypocalcaemia and hypophosphataemia
e)
Normal calcium and phosphate levels
15.
The Frank-Starling mechanism of the heart states that:
a)
Heart rate is directly proportional to venous return.
b)
Coronary blood flow is auto-regulated to match metabolic demand.
c)
The force of ventricular contraction increases with an increase in end-diastolic volume.
d)
Ejection fraction decreases with increased preload.
e)
Cardiac output is independent of venous pressure.
16.
In the context of the autonomic nervous system, the "rest and digest" response is primarily mediated by which of the following?
a)
Sympathetic nervous system via norepinephrine
b)
Parasympathetic nervous system via acetylcholine
c)
Somatic nervous system via acetylcholine
d)
Adrenal medulla via epinephrine
e)
Enteric nervous system independently
17.
Which of the following is the primary fuel for the cardiac muscle under fasting conditions?
a)
Glucose
b)
Ketone bodies
c)
Lactate
d)
Free fatty acids
e)
Amino acids
18.
During moderate, sustained exercise, which energy system becomes the dominant source of ATP for skeletal muscle?
a)
Phosphocreatine system
b)
Anaerobic glycolysis
c)
Aerobic beta-oxidation of fatty acids
d)
Protein catabolism
e)
ATP stores within the muscle
19.
The cardinal sign "tumor" (swelling) in acute inflammation is primarily due to:
a)
Arteriolar vasoconstriction
b)
Increased vascular permeability and plasma exudate
c)
Proliferation of fibroblasts
d)
Chemotaxis of neutrophils
e)
Localised haemorrhage
20.
A patient with a severe bacterial infection develops a high fever. This systemic response is primarily mediated by the action of which of the following on the hypothalamus?
a)
Histamine
b)
Prostaglandins
c)
Cytokines (IL-1, IL-6, TNF-α)
d)
Bradykinin
e)
Complement C5a
21.
A patient is prescribed a drug that is known to have a significant first-pass effect. Which of the following routes of administration would be most suitable to bypass this effect?
a)
Oral
b)
Rectal
c)
Sublingual
d)
Enteric-coated
e)
With a high-fat meal
22.
A drug that acts as a competitive antagonist at beta-1 adrenergic receptors would be expected to have which of the following effects?
a)
Tachycardia
b)
Bronchodilation
c)
Increased myocardial contractility
d)
Bradycardia
e)
Mydriasis
23.
Which of the following classes of antibiotics acts by inhibiting bacterial cell wall synthesis?
a)
Macrolides
b)
Tetracyclines
c)
Aminoglycosides
d)
Beta-lactams
e)
Sulphonamides
24.
The therapeutic effect of statins (e.g., atorvastatin) is due to their mechanism of action as which of the following?
a)
Competitive inhibitors of HMG-CoA reductase
b)
Non-competitive inhibitors of ACE
c)
Blockers of angiotensin II receptors
d)
Activators of lipoprotein lipase
e)
Inhibitors of cholesterol absorption
25.
A patient on warfarin therapy develops a prolonged INR and bleeding after starting a new medication. The new drug is most likely which of the following?
a)
A cytochrome P450 enzyme inducer
b)
A drug that displaces warfarin from plasma albumin
c)
A potent cytochrome P450 enzyme inhibitor
d)
A drug that induces warfarin metabolism
e)
A drug with no protein binding
26.
Which of the following best describes the mechanism of action of salbutamol?
a)
Muscarinic receptor antagonist
b)
Beta-2 adrenergic receptor agonist
c)
Phosphodiesterase inhibitor
d)
Leukotriene receptor antagonist
e)
Histamine H1-receptor antagonist
27.
A drug with a large volume of distribution (Vd) is most likely to have which of the following characteristics?
a)
It is largely confined to the plasma.
b)
It is highly bound to plasma proteins.
c)
It is extensively distributed in tissues.
d)
It has a very short half-life.
e)
It is eliminated primarily by the kidneys.
28.
The "Yellow Card Scheme" in the UK is primarily used for which of the following purposes?
a)
Monitoring therapeutic drug levels
b)
Reporting suspected adverse drug reactions
c)
Prescribing controlled drugs
d)
Dispensing medications
e)
Regulating drug prices
29.
Which of the following is a Type A (Augmented) Adverse Drug Reaction?
a)
Anaphylaxis to penicillin
b)
Bleeding with warfarin
c)
Stevens-Johnson syndrome with carbamazepine
d)
Agranulocytosis with clozapine
e)
Hepatotoxicity with halothane
30.
A drug that is a partial agonist will:
a)
Have high affinity but no efficacy.
b)
Have high efficacy but low affinity.
c)
Produce a maximal response even at low receptor occupancy.
d)
Act as an antagonist in the presence of a full agonist.
e)
Be unable to bind to the receptor.
31.
A 65-year-old man with a long history of smoking has a bronchial biopsy. The normal ciliated columnar epithelium is replaced by stratified squamous epithelium. This process is best described as:
a)
Hyperplasia
b)
Hypertrophy
c)
Metaplasia
d)
Dysplasia
e)
Anaplasia
32.
The microscopic finding of "karyorrhexis" is characterised by:
a)
Shrinkage and increased basophilia of the nucleus
b)
Fragmentation of the nucleus
c)
Dissolution of the nucleus
d)
Swelling of the nucleus
e)
Reduplication of the nuclear membrane
33.
A 70-year-old woman with atrial fibrillation not on anticoagulation presents with a sudden onset of right-sided weakness and aphasia. A CT scan shows an area of liquefactive necrosis in the territory of the left middle cerebral artery. The most likely diagnosis is:
a)
Myocardial infarction
b)
Cerebral infarction
c)
Pulmonary embolism
d)
Renal infarction
e)
Gangrenous necrosis of the limb
34.
Which of the following is a characteristic feature of apoptosis, as opposed to necrosis?
a)
Inflammation is typically present.
b)
It is always a pathological process.
c)
The plasma membrane remains intact.
d)
Cellular swelling is a key feature.
e)
It affects large fields of cells.
35.
A 25-year-old man of West African descent presents with severe bone pain and anaemia. A blood film shows sickle-shaped red blood cells. This disease is caused by which type of mutation in the β-globin gene?
a)
Silent mutation
b)
Missense mutation
c)
Nonsense mutation
d)
Frameshift mutation
e)
Splice-site mutation
36.
The accumulation of lactate in ischaemic tissue primarily occurs due to a shift to anaerobic metabolism. Which of the following best explains the biochemical rationale for this?
a)
To generate more ATP than oxidative phosphorylation
b)
To consume excess pyruvate
c)
To regenerate NAD⁺ from NADH for glycolysis to continue
d)
To increase intracellular pH
e)
To provide substrate for the TCA cycle
37.
A 40-year-old woman has a biopsy of a skin lesion that shows disordered growth of epidermal cells with nuclear hyperchromasia and loss of polarity, but the changes are confined to the epithelium. This is best described as:
a)
Metaplasia
b)
Hyperplasia
c)
Dysplasia
d)
Neoplasia
e)
Anaplasia
38.
Cardiac troponin is the preferred biomarker for diagnosing myocardial infarction because it:
a)
Rises immediately after the onset of chest pain.
b)
Has a very short half-life, allowing for quick diagnosis of re-infarction.
c)
Is highly specific to cardiac muscle.
d)
Is not affected by renal failure.
e)
Is the most sensitive marker for unstable angina.
39.
A patient with a history of gastro-oesophageal reflux disease (GORD) has an endoscopy which shows that the normal stratified squamous epithelium of the lower oesophagus has been replaced by columnar epithelium. This condition is known as:
a)
Gastric metaplasia
b)
Barrett's oesophagus
c)
Oesophageal varices
d)
Duodenal metaplasia
e)
Hiatus hernia
40.
In the context of acute inflammation, the process of neutrophils adhering to the endothelium is primarily mediated by:
a)
Selectins and integrins
b)
Histamine and bradykinin
c)
Prostaglandins and leukotrienes
d)
C3a and C5a
e)
Antibodies and complement
41.
The genetic code is described as "degenerate." This means that:
a)
One codon can code for multiple amino acids.
b)
One amino acid can be coded for by multiple codons.
c)
The code is universal across all organisms.
d)
The code is read in a non-overlapping manner.
e)
There are more codons than amino acids.
42.
A patient presents with intellectual disability, a musty odour, and fair skin. This is most likely due to a deficiency in an enzyme involved in the metabolism of which amino acid?
a)
Phenylalanine
b)
Tyrosine
c)
Tryptophan
d)
Methionine
e)
Leucine
43.
During the translation of mRNA, the growing polypeptide chain is held in which site of the ribosome?
a)
A-site
b)
P-site
c)
E-site
d)
T-site
e)
R-site
44.
Which of the following inheritance patterns is characterised by affected males passing the trait to all their daughters but none of their sons?
a)
Autosomal dominant
b)
Autosomal recessive
c)
X-linked dominant
d)
X-linked recessive
e)
Mitochondrial
45.
The primary purpose of alternative splicing of mRNA is to:
a)
Remove introns from the primary transcript.
b)
Protect the mRNA from degradation.
c)
Allow one gene to produce multiple different proteins.
d)
Facilitate the export of mRNA from the nucleus.
e)
Initiate the process of translation.
46.
A child is diagnosed with Tay-Sachs disease, a condition caused by the accumulation of GM2 ganglioside in neurons. This is most likely due to a defect in which of the following organelles?
a)
Peroxisome
b)
Lysosome
c)
Mitochondrion
d)
Rough Endoplasmic Reticulum
e)
Golgi Apparatus
47.
In a metabolic pathway, the enzyme that catalyzes the committed step is most likely to be regulated by which of the following mechanisms?
a)
Competitive inhibition by the pathway's substrate
b)
Allosteric activation by the pathway's end-product
c)
Allosteric inhibition by the pathway's end-product
d)
Induction by a hormone
e)
Covalent modification by a kinase
48.
A nonsense mutation in a gene results in:
a)
The substitution of one amino acid for another.
b)
No change in the amino acid sequence.
c)
The insertion of a premature stop codon.
d)
A shift in the reading frame.
e)
The retention of an intron in the mRNA.
49.
The β-oxidation of fatty acids occurs in which cellular compartment?
a)
Cytosol
b)
Mitochondrial matrix
c)
Endoplasmic reticulum
d)
Peroxisome
e)
Lysosome
50.
Which of the following is a key feature of mitochondrial inheritance?
a)
Male-to-male transmission does not occur.
b)
All children of an affected mother will be affected.
c)
It is only passed from father to child.
d)
It affects males more severely than females.
e)
It demonstrates anticipation.
51.
A Gram stain of a sputum sample from a patient with pneumonia shows numerous neutrophils and lancet-shaped Gram-positive diplococci. The most likely causative organism is:
a)
Staphylococcus aureus
b)
Streptococcus pneumoniae
c)
Klebsiella pneumoniae
d)
Haemophilus influenzae
e)
Mycoplasma pneumoniae
52.
The lipid A component of lipopolysaccharide (LPS) found in the outer membrane of Gram-negative bacteria is responsible for which of the following?
a)
Adherence to host cells
b)
Inhibition of phagocytosis
c)
Endotoxin activity
d)
Antigenic variation
e)
Motility
53.
A patient presents with a diffuse rash following the use of amoxicillin for a viral infection. This type of hypersensitivity reaction is most likely:
a)
Type I (IgE-mediated)
b)
Type II (Antibody-mediated cytotoxic)
c)
Type III (Immune complex-mediated)
d)
Type IV (T-cell-mediated delayed)
e)
Type V (Stimulatory)
54.
Which of the following classes of antibodies is primarily involved in mucosal immunity?
a)
IgG
b)
IgM
c)
IgA
d)
IgD
e)
IgE
55.
A 25-year-old woman presents with a sore throat. A throat swab cultured on blood agar shows beta-haemolysis, and the organism is bacitracin-sensitive. The most likely causative agent is:
a)
Streptococcus pyogenes (Group A)
b)
Streptococcus agalactiae (Group B)
c)
Streptococcus pneumoniae
d)
Staphylococcus aureus
e)
Corynebacterium diphtheriae
56.
The DTaP vaccine protects against all of the following diseases EXCEPT:
a)
Diphtheria
b)
Tetanus
c)
Pertussis
d)
Polio
e)
(It protects against all of these)
57.
A patient with HIV has a CD4+ T-cell count of 180 cells/μL. He presents with headache, fever, and confusion. A CSF India ink test is positive. The most likely causative organism is:
a)
Cryptococcus neoformans
b)
Toxoplasma gondii
c)
JC virus
d)
Mycobacterium tuberculosis
e)
Candida albicans
58.
Which of the following best describes the primary function of MHC Class II molecules?
a)
Presentation of endogenous antigens to CD8+ T-cells
b)
Presentation of exogenous antigens to CD4+ T-cells
c)
Binding to T-cell receptors for innate immunity
d)
Acting as co-stimulatory molecules for B-cells
e)
Direct lysis of infected cells
59.
A 5-year-old child develops a "slapped-cheek" rash and arthralgias. The most likely causative agent is:
a)
Parvovirus B19
b)
Rubella virus
c)
Measles virus
d)
Varicella-Zoster virus
e)
Human Herpesvirus 6
60.
The Quellung reaction is a laboratory test used to identify certain bacteria by observing capsular swelling. This test is most useful for identifying which organism?
a)
Streptococcus pneumoniae
b)
Neisseria meningitidis
c)
Haemophilus influenzae type B
d)
Klebsiella pneumoniae
e)
All of the above
61.
A competent 38-year-old patient with terminal cancer refuses further chemotherapy, stating he wishes to die peacefully at home. His family is distraught and begs you to convince him to continue treatment. What is the most appropriate initial action?
a)
Respect the patient's decision and arrange for palliative care.
b)
Ask a psychiatrist to assess the patient for depression.
c)
Administer the chemotherapy as it is in his best medical interest.
d)
Defer to the family's wishes to maintain harmony.
e)
Seek a court order to compel treatment.
62.
During a consultation, a patient discloses sensitive information about their sexual health. Under which of the following circumstances is it permissible to breach confidentiality without the patient's consent?
a)
The patient's partner calls, concerned about their own risk.
b)
The patient has a minor, treatable sexually transmitted infection.
c)
The patient is a teacher and you are concerned about the schoolchildren.
d)
A judge orders you to release the medical records for a legal case.
e)
The patient's parents are paying for the treatment and request information.
63.
The concept of "beneficence" in medical ethics primarily refers to the obligation to:
a)
Respect the patient's right to self-determination.
b)
Do no harm.
c)
Act in the patient's best interest.
d)
Treat all patients fairly and equally.
e)
Be honest and truthful with patients.
64.
A medical student is asked by a consultant to perform a venepuncture on a patient. The student has only observed the procedure and has not been formally trained. What is the most appropriate action for the student to take?
a)
Perform the procedure as it is a good learning opportunity.
b)
Refuse outright as they are not competent.
c)
Inform the consultant that they are not yet competent and require supervision.
d)
Ask the patient if it is okay for a student to perform the procedure.
e)
Attempt the procedure and ask for help if they encounter difficulty.
65.
When obtaining informed consent for a surgical procedure, which of the following is the LEAST essential element that must be discussed with the patient?
a)
The nature of the procedure
b)
The serious, but rare, risks of the procedure
c)
The alternatives to the procedure, including no treatment
d)
The surgeon's personal success rate for the procedure
e)
The expected benefits of the procedure
66.
A 16-year-old girl requests a prescription for the combined oral contraceptive pill. She asks you not to tell her parents. According to UK law and guidelines (Gillick competence/Fraser guidelines), what is the most appropriate response?
a)
Prescribe the pill and respect her confidentiality.
b)
Refuse to prescribe until she involves her parents.
c)
Prescribe the pill only if you judge her to be competent to understand the implications.
d)
Inform her parents regardless of her competence.
e)
Report her to social services for safeguarding concerns.
67.
The duty of candour is a statutory obligation for healthcare organisations in the UK. What is the primary requirement of this duty?
a)
To always be polite to patients.
b)
To apologise and be open with patients when a notifiable safety incident occurs.
c)
To share all patient information with their next of kin.
d)
To report underperforming colleagues to the GMC.
e)
To obtain written consent for every procedure.
68.
During a ward round, a consultant makes a derogatory comment about a patient's lifestyle in the corridor where other people can hear. This action is primarily a breach of which ethical principle?
a)
Justice
b)
Beneficence
c)
Confidentiality
d)
Non-maleficence
e)
Autonomy
69.
A patient with a learning disability is admitted for a minor procedure. To ensure valid consent is obtained, what is the most important approach?
a)
Rely on the consent of the next of kin.
b)
Assess the patient's capacity to consent to this specific decision.
c)
Proceed with the procedure as it is in their best interests.
d)
Delay the procedure until the patient can be assessed by a psychiatrist.
e)
Use a pre-written leaflet to explain the procedure.
70.
Research involving human subjects must adhere to the Declaration of Helsinki. Which of the following is a core principle of this declaration?
a)
The results of the research must be commercially viable.
b)
The interests of science and society always outweigh the interests of the individual subject.
c)
Freely given informed consent is essential for all participants.
d)
Research on children is strictly forbidden.
e)
Placebo groups should be used in all clinical trials.
71.
A 55-year-old man presents with central chest pain radiating to his jaw and left arm, associated with nausea and sweating. An ECG shows ST-segment elevation in the anterior leads. The most appropriate immediate pharmacological treatment is:
a)
Oral Aspirin 300mg
b)
Sublingual Glyceryl Trinitrate (GTN)
c)
Intramuscular Morphine
d)
Intravenous Beta-blocker
e)
Subcutaneous Heparin
72.
A 70-year-old woman with osteoporosis trips and falls, sustaining a fracture of the distal radius. This type of fracture is commonly known as a:
a)
Smith's fracture
b)
Colles' fracture
c)
Boxer's fracture
d)
Scaphoid fracture
e)
Bennett's fracture
73.
A 30-year-old woman presents with palpitations, heat intolerance, and weight loss despite an increased appetite. On examination, she has a tremor and exophthalmos. The most likely diagnosis is:
a)
Addison's disease
b)
Cushing's syndrome
c)
Graves' disease
d)
Hashimoto's thyroiditis
e)
Pheochromocytoma
74.
The most common cause of community-acquired pneumonia in adults is:
a)
Haemophilus influenzae
b)
Streptococcus pneumoniae
c)
Staphylococcus aureus
d)
Klebsiella pneumoniae
e)
Mycoplasma pneumoniae
75.
A 5-year-old boy is brought to A&E with a 2-hour history of severe, colicky abdominal pain, vomiting, and redcurrant jelly stools. The most likely diagnosis is:
a)
Appendicitis
b)
Intussusception
c)
Gastroenteritis
d)
Meckel's diverticulum
e)
Hirschsprung's disease
76.
Which of the following is a first-line pharmacological treatment for a patient with newly diagnosed, uncomplicated hypertension?
a)
Furosemide
b)
Spironolactone
c)
Ramipril (an ACE inhibitor)
d)
Verapamil
e)
Doxazosin
77.
A 60-year-old man presents with painless haematuria. He has a 40-pack-year smoking history. The most important initial investigation is:
a)
Renal function tests
b)
Urine cytology
c)
CT urogram
d)
Cystoscopy
e)
Renal ultrasound
78.
The most common type of renal stone is composed of:
a)
Uric acid
b)
Cystine
c)
Struvite (Magnesium Ammonium Phosphate)
d)
Calcium oxalate
e)
Calcium phosphate
79.
A 25-year-old type 1 diabetic patient is brought to A&E. He is drowsy, dehydrated, and has deep, sighing respirations. His blood glucose is 35 mmol/L. The most likely diagnosis is:
a)
Hypoglycaemic coma
b)
Diabetic Ketoacidosis (DKA)
c)
Hyperosmolar Hyperglycaemic State (HHS)
d)
Lactic acidosis
e)
Sepsis
80.
Which of the following is a modifiable risk factor for ischaemic stroke?
a)
Age
b)
Atrial fibrillation
c)
Family history
d)
Male gender
e)
Ethnicity
81.
A full blood count shows: Hb 70 g/L (low), MCV 105 fL (high). This pattern is most suggestive of which type of anaemia?
a)
Microcytic anaemia
b)
Normocytic anaemia
c)
Macrocytic anaemia
d)
Haemolytic anaemia
e)
Aplastic anaemia
82.
The most common cause of hyperthyroidism in the UK is:
a)
Toxic multinodular goitre
b)
Graves' disease
c)
Thyroid adenoma
d)
Subacute thyroiditis
e)
Excessive thyroxine ingestion
83.
A 45-year-old woman presents with bilateral symmetrical joint pain and stiffness in her hands and wrists, which is worse in the morning. She also complains of fatigue. The most likely diagnosis is:
a)
Osteoarthritis
b)
Rheumatoid Arthritis
c)
Gout
d)
Systemic Lupus Erythematosus
e)
Fibromyalgia
84.
The "triple therapy" used for the eradication of Helicobacter pylori typically includes all of the following EXCEPT:
a)
A Proton Pump Inhibitor (PPI)
b)
Amoxicillin
c)
Clarithromycin
d)
Metronidazole
e)
(It includes all of these)
85.
A 50-year-old man presents with acute shortness of breath and pleuritic chest pain. He recently returned from a long-haul flight. On examination, his oxygen saturation is 88% on room air. The most likely diagnosis is:
a)
Myocardial Infarction
b)
Pneumonia
c)
Pulmonary Embolism
d)
Pneumothorax
e)
Heart Failure
86.
Which of the following is the most common site for a peptic ulcer?
a)
Stomach body
b)
Gastric antrum
c)
Pyloric canal
d)
First part of the duodenum
e)
Oesophagus
87.
A 65-year-old man presents with painless jaundice, weight loss, and a palpable gallbladder (Courvoisier's sign). The most likely diagnosis is:
a)
Gallstone obstruction of the common bile duct
b)
Alcoholic hepatitis
c)
Pancreatic head carcinoma
d)
Viral hepatitis
e)
Cholangiocarcinoma
88.
The most common cause of acute pancreatitis in the UK is:
a)
Alcohol
b)
Gallstones
c)
Hypertriglyceridaemia
d)
Drugs
e)
Trauma
89.
A 70-year-old man has a slowly progressive, asymmetric tremor that is most prominent at rest and improves with voluntary movement. He also has cogwheel rigidity and bradykinesia. The most likely diagnosis is:
a)
Benign Essential Tremor
b)
Parkinson's Disease
c)
Cerebellar Tremor
d)
Wilson's Disease
e)
Huntington's Disease
90.
Which of the following is the most common type of dementia?
a)
Vascular Dementia
b)
Dementia with Lewy Bodies
c)
Frontotemporal Dementia
d)
Alzheimer's Disease
e)
Creutzfeldt-Jakob Disease
91.
A 40-year-old woman presents with generalised fatigue, weight gain, and feeling cold. On examination, she has dry skin and delayed relaxation of the ankle reflexes. The most diagnostic initial blood test is:
a)
Free T4
b)
Total T3
c)
Thyroid Stimulating Hormone (TSH)
d)
Thyroid peroxidase antibodies
e)
Cortisol level
92.
The "opisthotonos" posture, characterised by extreme arching of the back, is classically associated with which of the following conditions?
a)
Meningitis
b)
Tetanus
c)
Parkinson's Disease
d)
Cerebral Palsy
e)
Strychnine poisoning
93.
A 30-year-old man presents with acute monoarthritis of the first metatarsophalangeal (MTP) joint. Synovial fluid analysis reveals negatively birefringent needle-shaped crystals. The most likely diagnosis is:
a)
Rheumatoid Arthritis
b)
Septic Arthritis
c)
Gout
d)
Pseudogout
e)
Osteoarthritis
94.
Which of the following is a characteristic feature of Henoch-Schönlein Purpura (HSP)?
a)
Petechial rash on the lower limbs and buttocks
b)
Target lesions on the palms and soles
c)
Photosensitive malar rash
d)
Vesicular rash in a dermatomal distribution
e)
Bullous eruptions
95.
A 20-year-old student presents with fever, sore throat, and lymphadenopathy. A Monospot test is positive. The most likely causative organism is:
a)
Cytomegalovirus (CMV)
b)
Streptococcus pyogenes
c)
Epstein-Barr Virus (EBV)
d)
Adenovirus
e)
Toxoplasma gondii
96.
A 55-year-old man with a history of alcohol excess presents with confusion, ataxia, and ophthalmoplegia. These findings are most suggestive of:
a)
Korsakoff's syndrome
b)
Wernicke's encephalopathy
c)
Delirium tremens
d)
Hepatic encephalopathy
e)
Alcohol withdrawal
97.
The most common cause of iron deficiency anaemia in adult men and post-menopausal women is:
a)
Poor dietary intake
b)
Malabsorption
c)
Chronic blood loss
d)
Haemolysis
e)
Pregnancy
98.
A 60-year-old woman presents with sudden onset of the "worst headache of her life," followed by vomiting and neck stiffness. The most likely diagnosis is:
a)
Migraine
b)
Tension Headache
c)
Subarachnoid Haemorrhage
d)
Meningitis
e)
Cluster Headache
99.
Which of the following is a recognised complication of long-term corticosteroid therapy?
a)
Cushing's syndrome
b)
Addison's disease
c)
Hyperthyroidism
d)
Acromegaly
e)
SIADH
100.
A 75-year-old woman is admitted after a fall. She is found to be hyponatraemic. Her plasma osmolality is low, urine osmolality is high, and urine sodium is high. She is clinically euvolaemic. The most likely diagnosis is:
a)
Syndrome of Inappropriate ADH (SIADH)
b)
Diuretic overuse
c)
Heart Failure
d)
Cirrhosis
e)
Addison's disease
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