MSRA 2026 | Questions with 100%
Correct Answers 2026 UPDATE |
Verified Solutions
Course
MSRA
Clinical Problem Solving
1. A 67-year-old man presents with crushing central chest pain radiating to his left arm. ECG
demonstrates ST-segment elevation in leads II, III, and aVF. What is the most appropriate
immediate management?
A. Start oral antibiotics
B. Immediate reperfusion therapy (primary PCI if available)
C. Discharge home with aspirin
D. Schedule outpatient stress testing
Answer: B. Immediate reperfusion therapy (primary PCI if available)
Solution:
Inferior STEMI requires urgent reperfusion, preferably primary PCI within guideline-
recommended timeframes.
2. A patient with asthma develops sudden wheezing after exposure to peanuts. Which
medication should be administered first?
A. Diphenhydramine
B. Oral prednisone
C. Intramuscular epinephrine
D. Salbutamol alone
Answer: C. Intramuscular epinephrine
Solution:
Intramuscular epinephrine is the first-line treatment for anaphylaxis.
,3. Which electrolyte abnormality most commonly causes peaked T waves on ECG?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypomagnesemia
Answer: B. Hyperkalemia
Solution:
Hyperkalemia classically produces tall peaked T waves and may progress to life-threatening
arrhythmias.
4. Which organism most commonly causes community-acquired pneumonia in adults?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
Solution:
Streptococcus pneumoniae remains the leading cause of community-acquired bacterial
pneumonia.
5. A diabetic patient becomes confused and sweaty. Bedside glucose is 42 mg/dL. What is the
priority?
A. Give insulin
B. Treat hypoglycemia immediately
C. Obtain HbA1c
D. Repeat glucose tomorrow
Answer: B. Treat hypoglycemia immediately
,Solution:
Symptomatic hypoglycemia requires prompt treatment with oral glucose (if safe) or intravenous
dextrose/glucagon as appropriate.
6. Which valve is most commonly affected in infective endocarditis?
A. Pulmonary
B. Mitral
C. Tricuspid
D. Aortic
Answer: B. Mitral
Solution:
The mitral valve is the most commonly involved native valve overall.
7. Which investigation confirms pulmonary embolism in a hemodynamically stable patient?
A. Chest X-ray
B. CT pulmonary angiography
C. ECG
D. Spirometry
Answer: B. CT pulmonary angiography
Solution:
CT pulmonary angiography is the preferred diagnostic imaging test in most stable patients when
indicated.
8. A patient presents with sudden unilateral facial weakness involving the forehead. What is the
most likely diagnosis?
A. Bell's palsy
B. Stroke
C. Migraine
, D. Trigeminal neuralgia
Answer: A. Bell's palsy
Solution:
Forehead involvement suggests a peripheral facial nerve palsy rather than a typical cortical
stroke.
9. Which vitamin deficiency causes megaloblastic anemia?
A. Vitamin C
B. Vitamin B12
C. Vitamin K
D. Vitamin D
Answer: B. Vitamin B12
Solution:
Vitamin B12 deficiency causes impaired DNA synthesis resulting in megaloblastic anemia.
10. Which investigation best confirms deep vein thrombosis?
A. Venous duplex ultrasound
B. Chest CT
C. ECG
D. MRI brain
Answer: A. Venous duplex ultrasound
Solution:
Compression duplex ultrasonography is the first-line imaging investigation.
11. Which acid-base disorder commonly results from prolonged vomiting?
A. Metabolic acidosis
B. Respiratory acidosis
Correct Answers 2026 UPDATE |
Verified Solutions
Course
MSRA
Clinical Problem Solving
1. A 67-year-old man presents with crushing central chest pain radiating to his left arm. ECG
demonstrates ST-segment elevation in leads II, III, and aVF. What is the most appropriate
immediate management?
A. Start oral antibiotics
B. Immediate reperfusion therapy (primary PCI if available)
C. Discharge home with aspirin
D. Schedule outpatient stress testing
Answer: B. Immediate reperfusion therapy (primary PCI if available)
Solution:
Inferior STEMI requires urgent reperfusion, preferably primary PCI within guideline-
recommended timeframes.
2. A patient with asthma develops sudden wheezing after exposure to peanuts. Which
medication should be administered first?
A. Diphenhydramine
B. Oral prednisone
C. Intramuscular epinephrine
D. Salbutamol alone
Answer: C. Intramuscular epinephrine
Solution:
Intramuscular epinephrine is the first-line treatment for anaphylaxis.
,3. Which electrolyte abnormality most commonly causes peaked T waves on ECG?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypomagnesemia
Answer: B. Hyperkalemia
Solution:
Hyperkalemia classically produces tall peaked T waves and may progress to life-threatening
arrhythmias.
4. Which organism most commonly causes community-acquired pneumonia in adults?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
Solution:
Streptococcus pneumoniae remains the leading cause of community-acquired bacterial
pneumonia.
5. A diabetic patient becomes confused and sweaty. Bedside glucose is 42 mg/dL. What is the
priority?
A. Give insulin
B. Treat hypoglycemia immediately
C. Obtain HbA1c
D. Repeat glucose tomorrow
Answer: B. Treat hypoglycemia immediately
,Solution:
Symptomatic hypoglycemia requires prompt treatment with oral glucose (if safe) or intravenous
dextrose/glucagon as appropriate.
6. Which valve is most commonly affected in infective endocarditis?
A. Pulmonary
B. Mitral
C. Tricuspid
D. Aortic
Answer: B. Mitral
Solution:
The mitral valve is the most commonly involved native valve overall.
7. Which investigation confirms pulmonary embolism in a hemodynamically stable patient?
A. Chest X-ray
B. CT pulmonary angiography
C. ECG
D. Spirometry
Answer: B. CT pulmonary angiography
Solution:
CT pulmonary angiography is the preferred diagnostic imaging test in most stable patients when
indicated.
8. A patient presents with sudden unilateral facial weakness involving the forehead. What is the
most likely diagnosis?
A. Bell's palsy
B. Stroke
C. Migraine
, D. Trigeminal neuralgia
Answer: A. Bell's palsy
Solution:
Forehead involvement suggests a peripheral facial nerve palsy rather than a typical cortical
stroke.
9. Which vitamin deficiency causes megaloblastic anemia?
A. Vitamin C
B. Vitamin B12
C. Vitamin K
D. Vitamin D
Answer: B. Vitamin B12
Solution:
Vitamin B12 deficiency causes impaired DNA synthesis resulting in megaloblastic anemia.
10. Which investigation best confirms deep vein thrombosis?
A. Venous duplex ultrasound
B. Chest CT
C. ECG
D. MRI brain
Answer: A. Venous duplex ultrasound
Solution:
Compression duplex ultrasonography is the first-line imaging investigation.
11. Which acid-base disorder commonly results from prolonged vomiting?
A. Metabolic acidosis
B. Respiratory acidosis
