UKMLA Official Practice Papers

Question 1

Aortic stenosis with LVEF less than 55% - management?

Answer 1

Refer for aortic valve replacement

Question 2

Myaesthenia gravis pathophysiological process?

Answer 2

Autoimmune !!

• autoimmune antibodies target the acetylcholine receptors at the
  neuromuscular junction, resulting in impaired transmission of nerve impulses to the muscle

Question 3

Sensation over big toe - nerve root?

Answer 3

L5

(look at dermatomes)

Question 4

Normal INR on warfarin?

Answer 4

Between 2.0 and 3.0

Question 5

CK level in rhabdomyolysis

Answer 5

> 10,000

Question 6

protozoan parasite that can cause diarrhoea in
immunocompromised patients

Answer 6

Cryptosporidium parvum

Question 7

Tongue deviation to the right due to surgical damage?

Answer 7

Right hypoglossal nerve damage

Question 8

UMN + LMN signs + positive Romberg’s test =

Answer 8

B12 deficiency

• usually caused by pernicious anaemia

Question 9

Diuretic used in initial management of nephrotic syndrome?

Answer 9

Furosemide

Question 10

Treatment for Bowen’s disease ?

Answer 10

Topical 5-fluorouracil

Question 11

Initial treatment for postpartum thyroiditis?

Answer 11

Propanolol

Question 12

Describe arterial ulcers

Answer 12

Pressure/distal points
Reduced ABPI
Deep

Question 13

What medication should be stopped before CT abdo with contrast?

Answer 13

Metformin

(increases risk of contrast-induced nephropathy)

Question 14

Serum osmolality calculation?

Answer 14

2(Na) + Urea + glucose

Question 15

First line for trigeminal neuralgia?

Answer 15

Carbamazepine

Question 16

Albuminuria - which class of antihypertensive to add?

Answer 16

ACE inhibitor

Question 17

Heart failure - which diagnostic investigation?

Answer 17

Echocardiography

Question 18

When is duloxetine contraindicated in CKD?

Answer 18

eGFR <30

= can’t give duloxetine

Question 19

What is angiodysplasia?

Answer 19

Abnormal blood vessels in GI tract can cause PAINLESS bleeding

Question 20

Acute liver injury - best marker to demonstrate restoration of liver function?

Answer 20

Prothrombin time

Question 21

Sinus arrhythmia clinical presentation?

Answer 21

Nothing
- normal variation in heart rate that occurs during breathing

Question 22

premature ventricular beats vs premature supraventricular beats clinical presentation?

Answer 22

Premature ventricular beats = Palpitations, “missed beat” sensation
Premature supraventricular beats = asymptomatic/mild palpitations

Question 23

premature ventricular beats vs premature supraventricular beats ECG presentation?

Answer 23

PVCs = Wide, bizarre-looking QRS (>120 ms)

PSVCs = Narrow QRS, usually normal-looking

Question 24

Testicular mass does not transilluminate - what is it?

Answer 24

• TUMOUR
• Varicocele
• Hernia
• Haematocele
• Epididymitis/Orchitis

(basically, solid/vascular/complex vs fluid-filled)

Question 25

Testicular mass transilluminates - what is it?

Answer 25

Hydrocele Spermatocele Possibly a cyst (basically, solid/vascular/complex vs fluid-filled)

Question 26

When to give digoxin?

Answer 26

AF with heart failure (for rate control)

Question 27

Bilateral renal masses =

Answer 27

Polycystic kidney disease

Question 28

Sinusitis, oral ulceration and haemoptysis + bilateral pulmonary nodules on chest X-ray Diagnosis? + what to expect on urinalysis

Answer 28

GPA + red cell casts on urinalysis

Question 29

Mesenteric adenitis (compared to appendicitis)

Answer 29

- Pain starts in RIF - Coryzal symptoms due to viral infection before hand - No anorexia or vomiting like appendicitis - Higher fever - More normal CRP and WBC - Self-limiting in 24-48 hours

Question 30

Simple management of acne vulgaris

Answer 30

Mild to Moderate Acne: Topical combo therapy (apply once daily): Benzoyl peroxide + topical retinoid (e.g. adapalene), or Benzoyl peroxide + topical antibiotic (e.g. clindamycin) ✅ Avoid topical antibiotic monotherapy ✅ Avoid combining oral + topical antibiotics 🔹 Moderate to Severe Acne: Oral antibiotic (e.g. doxycycline or lymecycline) + topical retinoid + benzoyl peroxide (NO topical antibiotic with oral antibiotic) ⏱ Max 3 months on oral antibiotics ideally 🎯 Reassess after 12 weeks Special Circumstances: - Women with hormonal acne? - Consider combined oral contraceptive pill - Severe acne / scarring / unresponsive to treatment? - Refer to dermatology for oral isotretinoin

Question 31

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