Free MSRA Practice Questions & Answers

Question 1
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A 40 year old presents with sweating, loose stools, weight loss and heat intolerance. On examination there are three thyroid nodules with observations as follows: T – 36.8, HR – 92, BP – 129/83. Suggest the most likely diagnosis.
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A. Sick Euthyroid
B. Thyroid storm
C. Graves’ Disease
D. Thyroid cancer
E. Multinodular Goitre


Correct Answer: E. With the multiple nodules and thyrotoxic symptoms, multinodular goitre is the more likely diagnosis, compared to Graves’ Disease which usually presents with a smooth goitre. Whilst this may develop into a thyroid storm if not promptly treated, the current symptoms and observations do not suggest a thyroid storm.



Question 2
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​A 50 year old gentleman who had completed a half-marathon one week ago, developed 3 days of flu like symptoms with chest pain. Presently he is talking in full sentences with a pulse of 110. Choose the most likely diagnosis from the options below.
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A. Pulmonary Emboli
B. Myocarditis
C. Pleural Effusion
D. Myocardial Infarction
E. Costochondritis
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Correct Answer: B This case demonstrates the challenge of the MSRA. A number of these options are plausible and reality further investigation (eg. ECG, Troponin and CXR) would be required in order to exclude a number of the causes. However, given the three day history and recent flu like symptoms, Myocarditis is the most likely diagnosis.



Question 3
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Which class of drugs are used in the management of urge incontinence in females?
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​A. Antimuscarinics
B. Alpha blocker
C. Tricyclic Antidepressants
D. SSRI
E. SNRI
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Correct Answer: A Following bladder training, should symptoms persist, antimuscarinic medications such as oxybutynin and tolterodine can be used.



Question 4
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Which class of drugs used in the first line management of male patients with predominantly voiding symptoms?
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A. Tricyclics 
B. SNRI
C. Alpha Blocker
D. Antimuscarinics
E. 5-alpha reductase inhibitor


Correct Answer: C This is a relatively straightforward question that most candidates should feel confident answering without hesitation.



Question 5
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A 75 year old gentleman with known AF, presents with a cough and fine bilateral crepitations. His JVP is not raised. HR: 72 Regular, Oxygen Saturations: 95%, Temperature: 36.8 C, Rate of Respiration: 18. What is the most likely diagnosis?
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A. Pulmonary Oedema
B. Consolidation
C. Aspergilloma
D. Pulmonary Fibrosis
E. Pleural Effusion


Correct Answer: D The arguably conflicting information in this question can suggest multiple diagnoses, however the key information is the ‘fine’ crackles with a normal JVP. The AF is intended to misguide doctors. Hence, the most likely diagnosis is Pulmonary Fibrosis.



Question 6
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Which of the following would be most appropriate medication in the management of an 80 year old inpatient with delirium, who has pulled his third cannula out today?
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A. Oral Haloperidol
B. IM Chlorpromazine
C. Oral Quatiepine
D. Rectal Diazepam
E. IM Diazepam


Question 7
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An 80 year old male overweight male presents with cramping leg pain, worse on exercising. He drinks 30 units of alcohol/day and smokes 15 cigarettes/day. Which of the following would be the most useful initial advice?
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A. Mediterranean Diet
B. Lose Weight
C. Increase Exercise
D. Reduce Alcohol Intake
E. Stop Smoking


Question 8
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A 34 year old female secretary presents with 7 months of bloating, change in bowel habit and abdominal pain made worse by eating and relieved by defecation. Which of the following would be the most appropriate next step?
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  1. FBC, ESR, CRP and Coeliac Screen
  2. No further investigation necessary
  3. FODMAP Dietary Advice
  4. Flexible Sigmoidoscopy
  5. OGD & Colonoscopy
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Question 9
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An 8 year old boy with a family history of atopy presents in July with sneezing, eye itching and nasal discharge of 6 weeks duration. Which of the following would be the most appropriate next step to confirm the diagnosis?

A. RAST test
B. Skin prick test
C. Patch test
D. No further investigation required
E. ELISA test


Question 10
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A 35 year old lady who is breastfeeding present with a painful, erythematous, inflamed left breast for the last 12 hours. Which of the following is the most appropriate initial management? T – 36.8, HR – 90, BP – 116/80.
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A. Reassure and advise continued breastfeeding
B. Avoid breastfeeding from the affected breast
C. Empirical Antibiotics
D. Empirical antibiotics and avoid breastfeeding from the affected breast
E. Urgent Hospital Admission