more free AKT questions

1. Which of the following statements about screening for colorectal cancer are true? Select three options only.

A. The presence of a latent phase with precancerous lesions makes colorectal cancer ideal for screening
B. Colonoscopy is the only screening method proven to reduce mortality
C. Of patients with colorectal cancer 90% have symptoms of rectal bleeding
D. Proposed national screening for colorectal cancer will target those aged 50-74 years
E. Flexible sigmoidoscopy in women of average risk picks up only 35% of cancers
F. Of patients with iron-deficient anaemia in general practice 11% were found to have gastrointestinal cancer

Answer: A,E, F

fecal occult blood testing isthe only screening method proven to cut death rates. the proposed screenig programme will start in 2010 an scren the age group 60-69 years. the CONCeRN study showed low sensitivity for colonoscopy in women of average risk. rectal bleeding occurs in less than 50% of colorectal cancer.

2. A patient with dyspepsia has recently had an upper gastrointestinal endoscopy. His histology comes back positive for Helicobacter pylori. Which of the following statements about the management of this situation are true? Select two answers only.

A. Serological testing is highly sensitive and specific
B. Resistance to metronidazole is common in inner city areas
C. Eradication therapy involves a combination of amoxicillin and a proton pump inhibitor
D. Serological testing can be repeated after 4 weeks to confirm eradication
E. Prescriptions for Heliclear (amoxicillin, clarithromycin and lansoprazole) treatment packs are charged three prescription charges

Answer: B, E

Breath esting, CLO testing and stol antigen tsts are senstive and senstive. eradication therapy involves high dose amoxicillin, clarithromycin and lansoprazol. serological testing tkes 6-12 months to retur to normal.

3. A 73-year-old mentions at a routine blood pressure check-up that he has to get up four or five times a night to go to the toilet. This is disturbing his wife to the point that he has moved into the spare room. Examination reveals a smooth enlarged prostate and you send blood for PSA (prostate-specific antigen) testing and a urine specimen for culture. This comes back clear and his PSA level is 3.6. Which of the following statements about his management is true?

A. He should be referred for a prostate biopsy
B. Transurethral resection of the prostate is the treatment of choice in this patient C. Finasteride will provide rapid relief from his symptoms with no risk of postural hypotension
D. Saw palmetto has been shown to have a placebo effect only
E. a-Blockers are the first-line treatment in this patient group

Answer: E

Surgery should be reserved for patients with bladder outflow obstruction or in those in whom medical therapy fails. Finasteride is effective but takes some weeks to work. Its mode of action is to shrink the prostate. Saw palmetto has been shown to be an effective treatment for prostatism.

4. A 56-year-old man presents with unprovoked, painless, macroscopic haematuria. Dipstick testing confirms the presence of blood but no leucocytes or nitrites. Which of the following may be a cause of these symptoms?

A. Renal colic
B. Beetroot consumption
C. Urinary tract infection
D. Bladder tumour
E. Renal trauma
F. all of the above.

Answe: D

Painless macroscopic haematuria should be considered to be the result of renal tract cancer until proven otherwise. A UTI would be associated with dysuria and leucocytes and nitrites. Beetroot may discolour the urine but would not affect dipstick results. Trauma and colic are associated with pain, although haematuria may be a sign of a coagulopathy.