Welcome to this block one mock exam. Allow yourself one minute per question, as per the exam, and try to do them all closed book. Each question matches learning outcomes across anatomy, imaging, pharmacology and physiology. Good luck!
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Warwick Medical School Block One Mock - Part One
Stem 1 of 5
A 72 year old male presents with recurrent, severe “heartburn”-like pain in his epigastrium after each evening meal. He has taken OTC Rennie which improves his symptoms transiently.
Which of the following is the best-matched root value of epigastrium dermatome(s)?
Stem 2 of 5The referral of this pain type likely indicates which differential?
Pleuritic chest pain
Ischaemic chest pain
Gastro-oesophageal reflux disease
Stem 3 of 5This patient has a significant increase in HCl formation in the gastric lumen. Which of the following are responsible for the direct increase in this secretion?
Stem 4 of 5What is the mechanism of the first-line medication you should prescribe this patient?
An impenetrable raft to prevent reflux disease within the gastric lumen
A calcium-channel antagonist
An antacid to neutralise excess HCl secretion
An irreversible ATPase inhibitor
A histamine receptor antagonist
Stem 5 of 5Which of the following best describes the rationale for upper endoscopy in this patient demography?
To assess patency of the upper oesophageal sphincter
To ensure the gag reflex is maintained
To sample the gastric mucosal pH levels
To check for metaplasia transition of the distal oesophagus
To apply a balloon stent to ablate stricture formation
Stem 1 of 6
A 66 year old female presents with epigastrium “stabbing” sensation and regular flatus. The pain is worse hours after eating, improving at mealtime. She has taken ad hoc ibuprofen to manage the pain unsuccessfully.
The patient’s stool has been darker than usual for several months. Which is the single best-matched diagnosis?
Upper GI bleed
Oesophageal varices rupture
Peptic ulcer disease
Acute kidney injury
Stem 2 of 6Given the answer to the previous question, what is the most likely artery endangered by the previous lesion?
Left gastric artery
Right gastroomental artery
Common hepatic artery
Stem 3 of 6The patient’s formulary includes clarithromycin. What is the rationale for this administration?
An analgesia for the epigastrium pain
An antiemetic for symptomatic relief
To ensure no superimposition of infection alongside PUD
To protect against ulcer-induced arteritis
To eliminate potential H. pylori infection
Stem 4 of 6Which of the below mechanisms demonstrates the danger of this patient using her chosen analgesia?
Post-renal acute kidney injury
A precipitous decline in systolic blood pressure
Inhibition of prostaglandin formation
Direct increase in vagal tone
Masking of pain risking unnoticed progression of disease
Stem 5 of 6Which of the below medications should this patient immediately commence?
Stem 6 of 6Given the pain presentation, which embryological region is most likely affected?
None of the above