A 75 year old man presents to the ED with burning epigastric abdominal pain You note that he has rheumatoid arthritis and is on diclofenac.
Which step would have been the most beneficial in preventing the development ot ulcers in this patient?

• A.Combining diclofenac with omeprazole
• B.Eradication of Helicobacter pylori
• C.Use of enteric coated medication
• D.Starting misoprostol
• E.Change diclofenac to indomethacm

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A 72 year old diabetic man develops an oculomotor nerve palsy.
Which clinical sign are you most likely to find?

• A.Deviation of the eye inferolaterally
• B.Increased lacrimation
• C.Absence of sweating on the face
• D.Absent corneal reflex
• E.Constriction of the pupil

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You plan to use a local anaesthetic to provide intravenous regional anaesthesia to reduce a patient's wrist fracture Which local anaesthetic is most appropriate?

• A.Ropivacame
• B.Tetracaine
• C.Lidocaine
• D.Bupivacaine
• E.Prilocaine

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A two year old child is diagnosed with meningitis likely due to Neisseria meningitidis A medical student asks you why this organism is able to cross the blood brain barrier more easily than other pathogens To which characteristic is your explanation most likely to refer?

• A.IgA protease production
• B.Adhesins on the fimbriae
• C.Binding to CD4 antigen
• D.Attachment using haemagglutmin antigen
• E.Expression of Protein A

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You are managing a patient with life threatening asthma and you start IV aminophylline Which electrolyte is it most important to monitor in this patient?

• A.Chloride
• B.Potassium
• C.Calcium
• D.Magnesium
• E.Sodium

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