Discuss the cause of acute gastroenteritis
A 74-year-old man presents with a oneweek history of nausea, polyuria and drowsiness. He has no past medical history of
note. He lives with his wife, is usually independent, occasionally drinks alcohol and is
an ex-smoker. Physical examination did not
reveal any focal abnormalities, but he scored
poorly on a brief cognitive assessment. An
ECG and chest X-ray are unremarkable. His
blood tests are as shown below.
Which is the most likely underlying
cause of this man’s hypercalcaemia?
B. multiple myeloma
C. primary hyperparathyroidism
D. prostate cancer
E. squamous cell lung cancer
Norovirus is a common cause of acute
gastroenteritis in healthcare settings.
Which of the following statements is
most likely to be correct?
A. a five- to seven-day incubation period
B. after norovirus infection, hospital
staff should be 24 hours symptomfree before returning to work
C. alcohol hand-sanitiser gel is similarly
effective to handwashing with soap
D. spread in healthcare settings is predominantly mediated by contact with
E. the duration of symptoms in frail older
people is typically three to nine days
A 67-year-old man presents with sudden loss of vision to his right eye. He is
a type 2 diabetic with evidence of microalbuminuria. He describes his vision as
having ‘lots of floaters’. Vision in this eye
is finger counting only. There is no relative afferent pupillary defect (RAPD) in
either eye. You attempt to examine his
eye with an ophthalmoscope and notice
an absent red reflex in the affected eye.
What is your diagnosis for the right eye?
B. diabetic papillopathy
C. exudative diabetic maculopathy
D. rubeosis iridis
E. vitreous haemorrhage
A 76-year-old woman with anaemia
related to chronic renal failure comes
to the acute medical unit complaining
of increased tiredness. She is currently
using erythropoietin (EPO) injections
three times per week and is concerned
that she requires an increased dose.
Which of the following is the most
A. arrange IV iron supplementation
B. check transferrin saturation
C. do nothing
D. increase the dose of EPO
E. increase the injection
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