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

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Question 1

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)?
A
T4-T10
B
T5-T11
C
T5-T9
D
T6-T10
E
C7-T4
Question 2

Stem 2 of 5

The referral of this pain type likely indicates which differential?
A
Pleuritic chest pain
B
Ischaemic chest pain
C
Pericarditis
D
Gastro-oesophageal reflux disease
E
Hiatus hernia
Question 3

Stem 3 of 5

This 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?
A
Histamine
B
Acetylcholine
C
Gastrin
D
Prostaglandin
E
Somatostatin
Question 4

Stem 4 of 5

What is the mechanism of the first-line medication you should prescribe this patient?
A
An impenetrable raft to prevent reflux disease within the gastric lumen
B
A calcium-channel antagonist
C
An antacid to neutralise excess HCl secretion
D
An irreversible ATPase inhibitor
E
A histamine receptor antagonist
Question 4 Explanation: 
Due to the severe nature of his presentation, modern guidelines suggest immediately commencing this patient demographic on proton-pump inhibitors.
Question 5

Stem 5 of 5

Which of the following best describes the rationale for upper endoscopy in this patient demography?
A
To assess patency of the upper oesophageal sphincter
B
To ensure the gag reflex is maintained
C
To sample the gastric mucosal pH levels
D
To check for metaplasia transition of the distal oesophagus
E
To apply a balloon stent to ablate stricture formation
Question 6

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?  
A
Upper GI bleed
B
Oesophageal varices rupture
C
GORD
D
Peptic ulcer disease
E
Acute kidney injury
Question 7

Stem 2 of 6

Given the answer to the previous question, what is the most likely artery endangered by the previous lesion?
A
Coeliac trunk
B
Left gastric artery
C
Right gastroomental artery
D
Gastroduondenal artery
E
Common hepatic artery
Question 8

Stem 3 of 6

The patient’s formulary includes clarithromycin. What is the rationale for this administration?
A
An analgesia for the epigastrium pain
B
An antiemetic for symptomatic relief
C
To ensure no superimposition of infection alongside PUD
D
To protect against ulcer-induced arteritis
E
To eliminate potential H. pylori infection
Question 9

Stem 4 of 6

Which of the below mechanisms demonstrates the danger of this patient using her chosen analgesia?
A
Post-renal acute kidney injury
B
A precipitous decline in systolic blood pressure
C
Inhibition of prostaglandin formation
D
Direct increase in vagal tone
E
Masking of pain risking unnoticed progression of disease
Question 10

Stem 5 of 6

Which of the below medications should this patient immediately commence?
A
Cimetidine
B
Rennie
C
Gaviscon
D
Omeprazole
E
Ranitidine
Question 11

Stem 6 of 6

Given the pain presentation, which embryological region is most likely affected?
A
Foregut
B
Midgut
C
Hindgut
D
Mediastinum
E
None of the above
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