1. ESA Style Question

2. Mr Smith, a 23 year old male presents to his GP with a persistent cough for 2 weeks. He is normally healthy and works as a builder. A chest infection is diagnosed and antibiotics are prescribed. Three days later, the cough is still unimproved and Mr Smith notices a lump in his left groin. He visits his GP again worried about the groin lump List three differential diagnosis for this presentation 3 Max. Mark

3. Mr Smith, a 23 year old male presents to his GP with a persistent cough for 2 weeks. He is normally healthy and works as a builder. A chest infection is diagnosed and antibiotics are prescribed. Three days later, the cough is still unimproved and Mr Smith notices a lump in his left groin. He visits his GP again worried about the groin lump List three differential diagnosis for this presentation Indirect hernia Direct hernia Hydrocoele Varicocele Testicular cancer Testicular torsion 3 Max. Mark

4. A diagnosis of an indirect hernia is made. Mr Smith is scheduled for surgery to avoid strangulation. List the borders of the inguinal canal Max. Mark 4

5. Roof – transversus abdominis muscle, arching fibers of the internal oblique muscle Anterior – aponeurosis of the external oblique, fibers of the internal oblique muscle Floor – inguinal ligament Posterior – conjoint tendon, tranversalis fascia A diagnosis of an indirect hernia is made. Mr Smith is scheduled for surgery to avoid strangulation. List the borders of the inguinal canal Max. Mark 4

6. (a)Disease or condition directly leading to death (b) Other disease or condition, if any, leading to (a) (c) Other disease or condition, if any, leading to (b) Unfortunately Mr Boyle dies during the surgery due to excessive blood loss. A postmortem confirms the presence of undiagnosed haemophilia A. A death certificate is completed. Fill in the three sections of the death certificate related to Mr Smith’s death Max. Mark 3

7. (a)Disease or condition directly leading to death – intra-abdominal haemorrhage (b) Other disease or condition, if any, leading to (a) – haemophilia A (c) Other disease or condition, if any, leading to (b) – surgery for indirect hernia Unfortunately Mr Boyle dies during the surgery due to excessive blood loss. A postmortem confirms the presence of undiagnosed haemophilia A. A death certificate is completed. Fill in the three section of the death certificate related to Mr Smith’s death Max. Mark 3

8. Haemophilia A is a genetic condition. From the pedigree chart state the pattern of inheritance for this condition Max. Mark 2

9. Haemophilia A is a genetic condition. From the pedigree chart state the pattern of inheritance for this condition Max. Mark 2 X- linked

10. Two weeks following Mr Smith’s death, his mother receives a census form to fill out. Using the CARTA model, outline the advantages and disadvantages of the census 5 Max. Mark AdvantageDisadvantage C A R T A

11. Two weeks following Mr Smith’s death, his mother receives a census form to fill out. Using the CARTA model, outline the advantages and disadvantages of the census 5 Max. Mark AdvantageDisadvantage Completeness 98% completeLow enumeration by some groups Accuracy Accurate to ±0.2% of population Self reported religion - Jedi Representativeness Data available for different levels Low enumeration of some groups Timeliness Only completed every 10 years Access Easily accessible online or from local councils Individual returns confidential for 100 yrs

12. Mrs Smith finds herself having a persistent low mood and she has no desire to carry out daily tasks following her sons death. She visits her GP who suggests some antidepressant medication. Mrs Smith does not like taking medication. List three reasons why doctors should take account of patents perspectives. Max. Mark 3

13. Mrs Smith finds herself having a persistent low mood and she has no desire to carry out daily tasks following her sons death. She visits her GP who suggests some antidepressant medication. Mrs Smith does not like taking medication. List three reasons why doctors should take account of patents perspectives. Max. Mark 3 Can help doctors to make accurate diagnoses Can lead to better medical outcomes for patients Can lead to greater patient satisfaction with consultation