SHR Written paper 1

Six 5 marks questions and six 15 marks questions.

5 marks questions

1. List symptoms faced by an elderly widow, few weeks after the death of her husband.
2. Describe the differences between vasovagal collapse and syncope.
3. Describe anorexia nervosa
4. 5 causes of constipation in bed-bound cancer patient
5. 5 components of CBT in managing major depressive disorder
6. A young boy falls on outstretched hand. Presents with pain in anatomical snuffbox. Normal plain X-ray. Diagnosis, management and complication.
   

15 marks questions

1. Differences between acute, chronic and cancer pain. Answer in table form
2. 87 year old female, lives alone, presents with decline in function over the last 6 weeks. Has multiple co morbidities and lots of medications. Still driving. Has slightly reduced score in MMSE. Describe your management of this patient.
3. A young tourist poisoned by bright-coloured octopus. Presents to ED. Which organism (blue-ringed octopus), what type of toxin and mechanism of toxin. Initial assessment and management. Treatment and expected outcome
4. 38 year old women, previously well, presents to ED with back pain. Normal neuro exam and MRI. Has relationship problem with her partner but has resolved. 3 differential diagnosis. How to assess the different diagnosis in Hx and MSE.
5. 40 year old train driver, presents with history of frequent alcohol drinking. In the last few weeks, he had panic attacks while driving the train and this is alleviated by drinking alcohol. DDx (6 marks). How to assess him in hx and MSE (9 marks)
6. 40 year old policeman, presents with delusion and hallucination. He needs to do something to protect himself. Describe a thorough risk assessment (11 marks). Ethical principles faces by GP in this patient (4 marks)

Few of the questions were a bit difficult to answer. Those questions test the capacity of your memory.

The question on octopus was in a way interesting. I knew the type of the octopus but I didn't know the toxin nor its mechanism of action. In fact, I wrongly guessed the management in this question. There goes my 15 marks.