PAINT: A Framework for Multilingual Pain Representation from Medical Licensing Exams to Real-World Clinical Texts
Paper • 2610.18269 • Published
Datasets:
row_index int64 0 267 | Question_ID int64 1 49 | file_name stringclasses 6
values | Question stringlengths 158 846 | Question_EN stringlengths 158 846 | ensemble_pain_related stringclasses 3
values | ensemble_pain_presence stringclasses 3
values | ensemble_location stringlengths 3 37 ⌀ | ensemble_pain_type stringclasses 29
values | ensemble_severity stringclasses 2
values | ensemble_age float64 0 92 ⌀ | ensemble_gender stringclasses 2
values | ensemble_ethnicity stringclasses 2
values | ensemble_occupation stringclasses 5
values |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
0 | 2 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 78 year old man develops increasing confusion on the ward at night. He is wandering around naked asking for his wife, shouting, and threatening staff and patients. He was admitted earlier in the day with a productive cough and fever. He has idiopathic Parkinson disease.
His temperature is 37.6°C, pulse 100 bpm, BP 1... | A 78 year old man develops increasing confusion on the ward at night. He is wandering around naked asking for his wife, shouting, and threatening staff and patients. He was admitted earlier in the day with a productive cough and fever. He has idiopathic Parkinson disease.
His temperature is 37.6°C, pulse 100 bpm, BP 1... | False | False | null | null | null | 78 | male | null | null |
1 | 3 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 78 year old woman has had back pain for 2 weeks and bilateral leg weakness for 2 days. She had surgery for breast cancer 14 years ago. She had a minor fall at home a few days ago.
She has weakness of hip flexion bilaterally with brisk knee reflexes, extensor plantar responses and reduced sensation to pinprick in her... | A 78 year old woman has had back pain for 2 weeks and bilateral leg weakness for 2 days. She had surgery for breast cancer 14 years ago. She had a minor fall at home a few days ago.
She has weakness of hip flexion bilaterally with brisk knee reflexes, extensor plantar responses and reduced sensation to pinprick in her... | True | True | back | null | null | 78 | female | null | null |
2 | 4 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 28 year old man has polyuria and polydipsia. He has bipolar disorder for which he has taken lithium carbonate for 2 years.
Initial investigations:
Sodium 145 mmol/L (135–146)
Potassium 3.9 mmol/L (3.5–5.3)
Serum osmolality 296 mOsmol/kg (275–295)
Urinary osmolality 356 mOsmol/kg (350–1000)
Fasting glucose 5.8 mmol/L... | A 28 year old man has polyuria and polydipsia. He has bipolar disorder for which he has taken lithium carbonate for 2 years.
Initial investigations:
Sodium 145 mmol/L (135–146)
Potassium 3.9 mmol/L (3.5–5.3)
Serum osmolality 296 mOsmol/kg (275–295)
Urinary osmolality 356 mOsmol/kg (350–1000)
Fasting glucose 5.8 mmol/L... | False | False | null | null | null | 28 | male | null | null |
3 | 5 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 65 year old woman is seen in clinic 2 weeks following a stroke.
CT scan of the head shows a left frontal lobe infarct.
She is currently taking aspirin, atorvastatin and ramipril.
Investigations:
ECG: atrial fibrillation, heart rate 68 bpm, otherwise normal.
What is the most appropriate long-term anti-thrombotic t... | A 65 year old woman is seen in clinic 2 weeks following a stroke.
CT scan of the head shows a left frontal lobe infarct.
She is currently taking aspirin, atorvastatin and ramipril.
Investigations:
ECG: atrial fibrillation, heart rate 68 bpm, otherwise normal.
What is the most appropriate long-term anti-thrombotic t... | False | False | null | null | null | 65 | female | null | null |
4 | 7 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 67 year old man is due to have a CT scan of the chest, abdomen and pelvis with intravenous contrast as assessment for possible lymphoma. He had a renal transplant 5 years previously. He takes prednisolone, tacrolimus and lisinopril.
His BP is 131/86 mmHg.
Investigations:
Urea 12.9 mmol/L (2.5–7.8)
Creatinine 165 µm... | A 67 year old man is due to have a CT scan of the chest, abdomen and pelvis with intravenous contrast as assessment for possible lymphoma. He had a renal transplant 5 years previously. He takes prednisolone, tacrolimus and lisinopril.
His BP is 131/86 mmHg.
Investigations:
Urea 12.9 mmol/L (2.5–7.8)
Creatinine 165 µm... | False | False | null | null | null | 67 | male | null | null |
5 | 8 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 78 year old woman is admitted after being found collapsed at home. She has been lying on the floor overnight. She has hypertension and takes amlodipine. A urinary catheter is passed and she passes 60 mL of urine over the next 2 hours.
Her temperature is 35.8°C, pulse 88 bpm and irregular, and BP 102/60 mmHg.
Invest... | A 78 year old woman is admitted after being found collapsed at home. She has been lying on the floor overnight. She has hypertension and takes amlodipine. A urinary catheter is passed and she passes 60 mL of urine over the next 2 hours.
Her temperature is 35.8°C, pulse 88 bpm and irregular, and BP 102/60 mmHg.
Invest... | False | False | null | null | null | 78 | female | null | null |
6 | 9 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 76 year old woman has become increasingly confused over the previous 2 weeks. She has hypertension for which she takes bendroflumethiazide, doxazosin, amlodipine, ramipril and atenolol.
Her BP is 108/71 mmHg.
Investigations:
Sodium 121 mmol/L (135–146)
Potassium 3.5 mmol/L (3.5–5.3)
Urea 10.0 mmol/L (2.5–7.8)
Creat... | A 76 year old woman has become increasingly confused over the previous 2 weeks. She has hypertension for which she takes bendroflumethiazide, doxazosin, amlodipine, ramipril and atenolol.
Her BP is 108/71 mmHg.
Investigations:
Sodium 121 mmol/L (135–146)
Potassium 3.5 mmol/L (3.5–5.3)
Urea 10.0 mmol/L (2.5–7.8)
Creat... | False | False | null | null | null | 76 | female | null | null |
7 | 10 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 92 year old woman has severe neck, chest and back pain following a fall. She has bruising around her right eye.
Investigations: Full blood count and clotting screen: normal
Chest X-ray: lung fields clear, left sided 4th and 5th rib fractures
CT scan of head: no intracranial injury or bleed, mild small vessel disease... | A 92 year old woman has severe neck, chest and back pain following a fall. She has bruising around her right eye.
Investigations: Full blood count and clotting screen: normal
Chest X-ray: lung fields clear, left sided 4th and 5th rib fractures
CT scan of head: no intracranial injury or bleed, mild small vessel disease... | True | True | neck; chest; back | null | severe | 92 | female | null | null |
8 | 11 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 64 year old woman develops an acutely painful right knee 3 weeks after a prosthetic right knee replacement.
Her temperature is 38.2°C and pulse 103 bpm. Her right knee is inflamed with serous fluid discharging from the lower end of the wound.
What is the most likely causative organism? | A 64 year old woman develops an acutely painful right knee 3 weeks after a prosthetic right knee replacement.
Her temperature is 38.2°C and pulse 103 bpm. Her right knee is inflamed with serous fluid discharging from the lower end of the wound.
What is the most likely causative organism? | True | True | right knee | acute | null | 64 | female | null | null |
9 | 12 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 52 year old man has 3 months of fatigue. He has ulcerative colitis and takes mesalazine. He drinks 20 units of alcohol per week.
His temperature is 36.8°C and pulse 80 bpm. He has 3 cm hepatomegaly.
Investigations:
Albumin 36 g/L (35–50)
ALT 65 IU/L (10–50)
ALP 580 IU/L (25–115)
Bilirubin 18 µmol/L (<17)
γGT 230 IU... | A 52 year old man has 3 months of fatigue. He has ulcerative colitis and takes mesalazine. He drinks 20 units of alcohol per week.
His temperature is 36.8°C and pulse 80 bpm. He has 3 cm hepatomegaly.
Investigations:
Albumin 36 g/L (35–50)
ALT 65 IU/L (10–50)
ALP 580 IU/L (25–115)
Bilirubin 18 µmol/L (<17)
γGT 230 IU... | False | False | null | null | null | 52 | male | null | null |
10 | 13 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 60 year old woman has 6 weeks cough productive of blood streaked sputum.
Investigations:
CT scan of chest: mass in left lower lobe.
Needle biopsy: nuclei that are enlarged, hyperchromatic and pleomorphic.
What is the most likely diagnosis? | A 60 year old woman has 6 weeks cough productive of blood streaked sputum.
Investigations:
CT scan of chest: mass in left lower lobe.
Needle biopsy: nuclei that are enlarged, hyperchromatic and pleomorphic.
What is the most likely diagnosis? | False | False | null | null | null | 60 | female | null | null |
11 | 14 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 65 year old woman has an infective exacerbation of COPD and has been treated with nebulised bronchodilators, antibiotics and steroids.
She is alert. Her temperature is 37.8°C, pulse 108 bpm, BP 100/75mmHg, respiratory rate 26 breaths per minute and oxygen saturation 88% breathing 15 L/minute oxygen via a non-rebreat... | A 65 year old woman has an infective exacerbation of COPD and has been treated with nebulised bronchodilators, antibiotics and steroids.
She is alert. Her temperature is 37.8°C, pulse 108 bpm, BP 100/75mmHg, respiratory rate 26 breaths per minute and oxygen saturation 88% breathing 15 L/minute oxygen via a non-rebreat... | False | False | null | null | null | 65 | female | null | null |
12 | 16 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 50 year old woman has acute onset of breathlessness. She underwent a laparoscopic cholecystectomy 10 days ago.
Her temperature is 37.4°C, pulse 104 bpm, BP 122/80 mmHg, respiratory rate 24 breaths per minute and oxygen saturation 94% breathing air. Her chest is clear. She has minimal tenderness over the right hypoch... | A 50 year old woman has acute onset of breathlessness. She underwent a laparoscopic cholecystectomy 10 days ago.
Her temperature is 37.4°C, pulse 104 bpm, BP 122/80 mmHg, respiratory rate 24 breaths per minute and oxygen saturation 94% breathing air. Her chest is clear. She has minimal tenderness over the right hypoch... | True | True | right hypochondrium | tenderness | mild | 50 | female | null | null |
13 | 17 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 39 year old man has had fever, chills and generalised weakness for 1 month. He has a systolic heart murmur. He is an intravenous drug user.
Investigations:
White cell count 15 × 10⁹/L (4.0–11.0)
C reactive protein 88 mg/L (< 5)
Blood culture results are awaited.
What further investigation will help to establish the... | A 39 year old man has had fever, chills and generalised weakness for 1 month. He has a systolic heart murmur. He is an intravenous drug user.
Investigations:
White cell count 15 × 10⁹/L (4.0–11.0)
C reactive protein 88 mg/L (< 5)
Blood culture results are awaited.
What further investigation will help to establish the... | False | False | null | null | null | 39 | male | null | intravenous drug user |
14 | 18 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 16 year old girl attends the emergency department after an episode of loss of consciousness following a fall. She had consumed an excessive amount of alcohol at a party before the fall.
She has a dirty scalp wound and cannot remember recent events. Her pulse is 68 bpm, BP 110/80 mmHg and oxygen saturation 98% breath... | A 16 year old girl attends the emergency department after an episode of loss of consciousness following a fall. She had consumed an excessive amount of alcohol at a party before the fall.
She has a dirty scalp wound and cannot remember recent events. Her pulse is 68 bpm, BP 110/80 mmHg and oxygen saturation 98% breath... | False | False | null | null | null | 16 | female | null | null |
15 | 19 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 47 year old woman has had 1 year of increased urinary frequency, urgency and nocturia. She leaks urine if she cannot get to the toilet promptly. She had three normal pregnancies with no complications.
The perineum appears normal and there is no uterine prolapse. Incontinence is not provoked by coughing or straining.... | A 47 year old woman has had 1 year of increased urinary frequency, urgency and nocturia. She leaks urine if she cannot get to the toilet promptly. She had three normal pregnancies with no complications.
The perineum appears normal and there is no uterine prolapse. Incontinence is not provoked by coughing or straining.... | False | False | null | null | null | 47 | female | null | null |
16 | 20 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 72 year old woman has 6 months of constipation.
Investigations:
Creatinine 70 µmol/L (60–120)
Calcium 2.90 mmol/L (2.2–2.6)
Phosphate 0.65 mmol/L (0.8–1.5)
24 h urinary calcium 7.0 mmol (2–6)
Parathyroid hormone 11.2 pmol/L (1.6–8.5)
Vitamin D 65 nmol/L (>60)
What is the most likely diagnosis? | A 72 year old woman has 6 months of constipation.
Investigations:
Creatinine 70 µmol/L (60–120)
Calcium 2.90 mmol/L (2.2–2.6)
Phosphate 0.65 mmol/L (0.8–1.5)
24 h urinary calcium 7.0 mmol (2–6)
Parathyroid hormone 11.2 pmol/L (1.6–8.5)
Vitamin D 65 nmol/L (>60)
What is the most likely diagnosis? | False | False | null | null | null | 72 | female | null | null |
17 | 21 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 52 year old man attends his GP for health screening. He is well with no previous medical history.
His pulse is 80 bpm and irregular, and BP 128/84 mmHg.
Investigations:
Sodium 136 mmol/L (135–146)
Potassium 3.9 mmol/L (3.5–5.3)
Urea 4.9 mmol/L (2.5–7.8)
Creatinine 80 μmol/L (60–120)
HbA1C 40 mmol/mol (20–42)
Thyroi... | A 52 year old man attends his GP for health screening. He is well with no previous medical history.
His pulse is 80 bpm and irregular, and BP 128/84 mmHg.
Investigations:
Sodium 136 mmol/L (135–146)
Potassium 3.9 mmol/L (3.5–5.3)
Urea 4.9 mmol/L (2.5–7.8)
Creatinine 80 μmol/L (60–120)
HbA1C 40 mmol/mol (20–42)
Thyroi... | False | False | null | null | null | 52 | male | null | null |
18 | 22 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | An 80 year old man attends the emergency department with 2 hours of epistaxis that has not stopped despite compression. He has hypertension.
A bleeding site is visible in the anterior nasal cavity. His BP is 160/95 mmHg.
What is the most appropriate initial management option? | An 80 year old man attends the emergency department with 2 hours of epistaxis that has not stopped despite compression. He has hypertension.
A bleeding site is visible in the anterior nasal cavity. His BP is 160/95 mmHg.
What is the most appropriate initial management option? | False | False | null | null | null | 80 | male | null | null |
19 | 23 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 65 year old man has abdominal distension and vomiting 48 hours after a sigmoid colectomy with primary anastomosis for bowel cancer. He has not passed any flatus for 24 hours. He is taking regular paracetamol and as required intravenous morphine.
His temperature is 37.6°C, pulse 96 bpm and BP 122/85 mmHg. His abdomen... | A 65 year old man has abdominal distension and vomiting 48 hours after a sigmoid colectomy with primary anastomosis for bowel cancer. He has not passed any flatus for 24 hours. He is taking regular paracetamol and as required intravenous morphine.
His temperature is 37.6°C, pulse 96 bpm and BP 122/85 mmHg. His abdomen... | True | True | abdomen | null | null | 65 | male | null | null |
20 | 24 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 23 year old man attends the sexual health clinic with a painful swelling in his groin and pain when opening his bowels. He had unprotected anal sex with a new male partner 4 weeks ago.
He has a perianal ulcer and tender inguinal lymphadenopathy.
What is the most likely diagnosis? | A 23 year old man attends the sexual health clinic with a painful swelling in his groin and pain when opening his bowels. He had unprotected anal sex with a new male partner 4 weeks ago.
He has a perianal ulcer and tender inguinal lymphadenopathy.
What is the most likely diagnosis? | True | True | groin | null | null | 23 | male | null | null |
21 | 26 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 25 year old man attends the emergency department after vomiting a large quantity of blood.
At endoscopy, there is a deep ulcer in the posterior wall at the junction of the first and second parts of the duodenum, with a bleeding vessel in its base.
From which artery is the bleeding most likely to be arising? | A 25 year old man attends the emergency department after vomiting a large quantity of blood.
At endoscopy, there is a deep ulcer in the posterior wall at the junction of the first and second parts of the duodenum, with a bleeding vessel in its base.
From which artery is the bleeding most likely to be arising? | False | False | null | null | null | 25 | male | null | null |
22 | 27 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 27 year old woman has a long history of irregular menstruation. She does not take any medication.
Her BMI is 29.4 kg/m².
Investigations:
LH (pre-menopausal female) 15 U/L (follicular) (1–11)
FSH 6 U/L (follicular) (2–8)
Testosterone 3.5 nmol/L (0.2–2.9)
Cortisol post 1 mg dexamethasone 40 nmol/L (<50)
Prolactin 425... | A 27 year old woman has a long history of irregular menstruation. She does not take any medication.
Her BMI is 29.4 kg/m².
Investigations:
LH (pre-menopausal female) 15 U/L (follicular) (1–11)
FSH 6 U/L (follicular) (2–8)
Testosterone 3.5 nmol/L (0.2–2.9)
Cortisol post 1 mg dexamethasone 40 nmol/L (<50)
Prolactin 425... | False | False | null | null | null | 27 | female | null | null |
23 | 28 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 30 year old woman attends her GP 3 months after a diagnosis of iron deficiency anaemia. She was advised to take oral iron supplements and has been taking these regularly. She has some looseness of her stools. Her periods are scanty on a combined oral contraceptive.
Investigations:
Haemoglobin 92 g/L (115–165)
MCV 70... | A 30 year old woman attends her GP 3 months after a diagnosis of iron deficiency anaemia. She was advised to take oral iron supplements and has been taking these regularly. She has some looseness of her stools. Her periods are scanty on a combined oral contraceptive.
Investigations:
Haemoglobin 92 g/L (115–165)
MCV 70... | False | False | null | null | null | 30 | female | null | null |
24 | 29 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 75 year old man is admitted with weakness in his legs. He has a squamous cell lung cancer treated by radiotherapy 18 months ago.
He is cachectic. He has 4 out of 5 strength in hip flexion and knee flexion bilaterally. Sensation and reflexes are normal, and sphincter function is preserved. His BMI is 17 kg/m².
MR sc... | A 75 year old man is admitted with weakness in his legs. He has a squamous cell lung cancer treated by radiotherapy 18 months ago.
He is cachectic. He has 4 out of 5 strength in hip flexion and knee flexion bilaterally. Sensation and reflexes are normal, and sphincter function is preserved. His BMI is 17 kg/m².
MR sc... | False | False | null | null | null | 75 | male | null | null |
25 | 30 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 34 year old woman has had headaches for 3 months. Her mother developed hypertension at the age of 38 years.
Her BP is 180/92 mmHg. Fundoscopy is normal.
Investigations:
Sodium 136 mmol/L (135–146)
Potassium 3.3 mmol/L (3.5–5.3)
Chloride 97 mmol/L (95–106)
Urea 4.0 mmol/L (2.5–7.8)
Creatinine 94 µmol/L (60–120)
Plas... | A 34 year old woman has had headaches for 3 months. Her mother developed hypertension at the age of 38 years.
Her BP is 180/92 mmHg. Fundoscopy is normal.
Investigations:
Sodium 136 mmol/L (135–146)
Potassium 3.3 mmol/L (3.5–5.3)
Chloride 97 mmol/L (95–106)
Urea 4.0 mmol/L (2.5–7.8)
Creatinine 94 µmol/L (60–120)
Plas... | True | True | head | null | null | 34 | female | null | null |
26 | 31 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 20 year old man has had 2 days of visible haematuria. Three days before the haematuria started, he developed tonsillitis and was treated with phenoxymethylpenicillin.
His BP is 112/54 mmHg.
Investigations:
Urea 3.2 mmol/L (2.5–7.8)
Creatinine 61 µmol/L (60–120)
Urinalysis: glucose negative, ketones negative, blood ... | A 20 year old man has had 2 days of visible haematuria. Three days before the haematuria started, he developed tonsillitis and was treated with phenoxymethylpenicillin.
His BP is 112/54 mmHg.
Investigations:
Urea 3.2 mmol/L (2.5–7.8)
Creatinine 61 µmol/L (60–120)
Urinalysis: glucose negative, ketones negative, blood ... | False | False | null | null | null | 20 | male | null | null |
27 | 32 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 38 year old man has had 2 months of epigastric pain that radiates into his back. It is worse at night and sometimes wakes him up. It is better after eating. He has been very busy at work. He occasionally misses lunch, which worsens the pain. He has not lost weight. He smokes 10 cigarettes per day and drinks two bottl... | A 38 year old man has had 2 months of epigastric pain that radiates into his back. It is worse at night and sometimes wakes him up. It is better after eating. He has been very busy at work. He occasionally misses lunch, which worsens the pain. He has not lost weight. He smokes 10 cigarettes per day and drinks two bottl... | True | True | epigastric; back | radiating | null | 38 | male | null | null |
28 | 33 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 26 year old woman has had 12 months of back pain, located in the low lumbosacral region. She has intermittent bilateral thigh pain. The back pain disturbs her sleep. It is improved by activity but not relieved by resting. She finds it difficult to bend down to pick things up from the floor.
Which clinical feature is... | A 26 year old woman has had 12 months of back pain, located in the low lumbosacral region. She has intermittent bilateral thigh pain. The back pain disturbs her sleep. It is improved by activity but not relieved by resting. She finds it difficult to bend down to pick things up from the floor.
Which clinical feature is... | True | True | low lumbosacral region; thigh | intermittent | null | 26 | female | null | null |
29 | 34 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 68 year old man has had a swollen tender knee for 3 days and cannot weight bear. He has had previous episodes of big toe swelling. He has chronic kidney disease stage 4.
Investigations:
Fluid analysis of knee aspirate:
White cell count 55 000/mL, 95% neutrophils
Gram stain negative
Copious 10 μm intracellular needle... | A 68 year old man has had a swollen tender knee for 3 days and cannot weight bear. He has had previous episodes of big toe swelling. He has chronic kidney disease stage 4.
Investigations:
Fluid analysis of knee aspirate:
White cell count 55 000/mL, 95% neutrophils
Gram stain negative
Copious 10 μm intracellular needle... | True | True | knee | null | null | 68 | male | null | null |
30 | 35 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | An 18 year old man is in the intensive care unit with septic shock as a result of a compound fracture of his leg. His urine output has been <30 mL for the past 2 hours.
His pulse is 125 bpm, BP 85/40 mmHg and JVP 4 cm above the sternal angle. There are basal crackles on auscultation of the chest.
Investigations:
ECG ... | An 18 year old man is in the intensive care unit with septic shock as a result of a compound fracture of his leg. His urine output has been <30 mL for the past 2 hours.
His pulse is 125 bpm, BP 85/40 mmHg and JVP 4 cm above the sternal angle. There are basal crackles on auscultation of the chest.
Investigations:
ECG ... | False | False | null | null | null | 18 | male | null | null |
31 | 36 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 34 year old man has had pain in his right shoulder and upper arm for 6 weeks that worsens when elevating his arm above his head. He does not recall any injury.
There is no deformity, tenderness or reduced range of movement. There is pain on abduction of the right shoulder that is worse with the arm in internal rotat... | A 34 year old man has had pain in his right shoulder and upper arm for 6 weeks that worsens when elevating his arm above his head. He does not recall any injury.
There is no deformity, tenderness or reduced range of movement. There is pain on abduction of the right shoulder that is worse with the arm in internal rotat... | True | True | right shoulder; upper arm | null | null | 34 | male | null | null |
32 | 37 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 65 year old woman has advanced carcinoma of the breast with cerebral and liver metastases, and is rapidly deteriorating. She is recognised to be dying.
She has become confused and agitated.
What is the most suitable initial treatment? | A 65 year old woman has advanced carcinoma of the breast with cerebral and liver metastases, and is rapidly deteriorating. She is recognised to be dying.
She has become confused and agitated.
What is the most suitable initial treatment? | False | False | null | null | null | 65 | female | null | null |
33 | 38 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 80 year old man has progressive memory loss over 2 years.
He scores 20/30 on the Montreal Cognitive Assessment.
The doctor suspects early Alzheimer disease and requests an MR scan of brain.
In which part of the brain are changes most likely? | A 80 year old man has progressive memory loss over 2 years.
He scores 20/30 on the Montreal Cognitive Assessment.
The doctor suspects early Alzheimer disease and requests an MR scan of brain.
In which part of the brain are changes most likely? | False | False | null | null | null | 80 | male | null | null |
34 | 39 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 43 year old woman is admitted to hospital with an overdose of amitriptyline taken 4 hours ago. She has a history of chronic headache.
Her pulse is 105 bpm and BP 95/40 mmHg. She is drowsy and her pupils are dilated.
ECG shows significant QRS prolongation.
What is the most appropriate immediate management? | A 43 year old woman is admitted to hospital with an overdose of amitriptyline taken 4 hours ago. She has a history of chronic headache.
Her pulse is 105 bpm and BP 95/40 mmHg. She is drowsy and her pupils are dilated.
ECG shows significant QRS prolongation.
What is the most appropriate immediate management? | True | abstain | head | null | null | 43 | female | null | null |
35 | 40 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 76 year old man undergoes an abdominoperineal resection for a low rectal carcinoma. He has severe COPD and hypertension.
What is the most appropriate method for providing analgesia during the early postoperative period? | A 76 year old man undergoes an abdominoperineal resection for a low rectal carcinoma. He has severe COPD and hypertension.
What is the most appropriate method for providing analgesia during the early postoperative period? | abstain | abstain | abdomen; perineum | null | null | 76 | male | null | null |
36 | 41 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 75 year old woman becomes breathless while receiving the third unit of a blood transfusion. She was admitted with melaena and her haemoglobin was 65 g/L (115–150). She has ischaemic heart disease and takes aspirin and lisinopril.
Her temperature is 37.3°C, pulse 96 bpm, BP 120/80 mmHg, respiratory rate 30 breaths pe... | A 75 year old woman becomes breathless while receiving the third unit of a blood transfusion. She was admitted with melaena and her haemoglobin was 65 g/L (115–150). She has ischaemic heart disease and takes aspirin and lisinopril.
Her temperature is 37.3°C, pulse 96 bpm, BP 120/80 mmHg, respiratory rate 30 breaths pe... | False | False | null | null | null | 75 | female | null | null |
37 | 42 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A researcher is seeking to examine whether long-term mobile phone use is linked to the risk of developing vestibular schwannoma (acoustic neuroma).
The information on mobile phone usage is collected from participants with vestibular schwannoma and a comparable group of participants without vestibular schwannoma, selec... | A researcher is seeking to examine whether long-term mobile phone use is linked to the risk of developing vestibular schwannoma (acoustic neuroma).
The information on mobile phone usage is collected from participants with vestibular schwannoma and a comparable group of participants without vestibular schwannoma, selec... | False | False | null | null | null | null | null | null | null |
38 | 43 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 56 year old woman has home blood pressure readings averaging 160/90 mmHg. She has type 1 diabetes mellitus.
Investigations:
Urinary albumin: creatinine ratio 42 mg/mmol (<3.5)
eGFR 43 mL/min/1.73 m² (>60)
Hypertension is confirmed on 24 hour ambulatory monitoring.
What class of antihypertensive drug is most appropr... | A 56 year old woman has home blood pressure readings averaging 160/90 mmHg. She has type 1 diabetes mellitus.
Investigations:
Urinary albumin: creatinine ratio 42 mg/mmol (<3.5)
eGFR 43 mL/min/1.73 m² (>60)
Hypertension is confirmed on 24 hour ambulatory monitoring.
What class of antihypertensive drug is most appropr... | False | False | null | null | null | 56 | female | null | null |
39 | 44 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 70 year old man has had a dry cough and breathlessness on exertion for 3 months. He has lost 4 kg in weight. He has ischaemic heart disease and atrial fibrillation. He takes apixaban, ramipril and amiodarone. He has never smoked cigarettes.
His temperature is 37.5°C, pulse 70 bpm, respiratory rate 18 breaths per min... | A 70 year old man has had a dry cough and breathlessness on exertion for 3 months. He has lost 4 kg in weight. He has ischaemic heart disease and atrial fibrillation. He takes apixaban, ramipril and amiodarone. He has never smoked cigarettes.
His temperature is 37.5°C, pulse 70 bpm, respiratory rate 18 breaths per min... | False | False | null | null | null | 70 | male | null | null |
40 | 45 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 31 year old woman is admitted with 24 hours of confusion. She is having visual hallucinations of snakes and mice on the floor. Her partner says that she often drinks 80 units of alcohol per week. He has not seen her for the past week. She has depression and takes fluoxetine.
Her temperature is 37.6°C, pulse 100 bpm ... | A 31 year old woman is admitted with 24 hours of confusion. She is having visual hallucinations of snakes and mice on the floor. Her partner says that she often drinks 80 units of alcohol per week. He has not seen her for the past week. She has depression and takes fluoxetine.
Her temperature is 37.6°C, pulse 100 bpm ... | False | False | null | null | null | 31 | female | null | null |
41 | 46 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 61 year old woman is admitted with 2 days of confusion. She has hypertension and takes nifedipine. She smokes 20 cigarettes per day.
She is confused but has no focal neurological deficit. Her pulse is 75 bpm, BP 139/87 mmHg and JVP 2 cm above the sternal angle.
Investigations:
Sodium 117 mmol/L (135–146)
Potassium ... | A 61 year old woman is admitted with 2 days of confusion. She has hypertension and takes nifedipine. She smokes 20 cigarettes per day.
She is confused but has no focal neurological deficit. Her pulse is 75 bpm, BP 139/87 mmHg and JVP 2 cm above the sternal angle.
Investigations:
Sodium 117 mmol/L (135–146)
Potassium ... | False | False | null | null | null | 61 | female | null | null |
42 | 47 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 43 year old woman has a sudden severe headache that started 24 hours ago. She has autosomal dominant polycystic kidney disease.
Her temperature is 36.8°C, pulse 92 bpm and BP 140/100 mmHg. Neurological examination is normal.
CT scan of head is normal.
What is the most appropriate next step in management? | A 43 year old woman has a sudden severe headache that started 24 hours ago. She has autosomal dominant polycystic kidney disease.
Her temperature is 36.8°C, pulse 92 bpm and BP 140/100 mmHg. Neurological examination is normal.
CT scan of head is normal.
What is the most appropriate next step in management? | True | True | head | null | severe | 43 | female | null | null |
43 | 48 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 74 year old man has progressively worsening muscle aches that are now causing him to struggle to get up from a chair or raise his arms above his head. He has oesophageal cancer, treated surgically, and ischaemic heart disease. He takes bisoprolol, clopidogrel, ramipril and simvastatin.
Investigations:
Haemoglobin 12... | A 74 year old man has progressively worsening muscle aches that are now causing him to struggle to get up from a chair or raise his arms above his head. He has oesophageal cancer, treated surgically, and ischaemic heart disease. He takes bisoprolol, clopidogrel, ramipril and simvastatin.
Investigations:
Haemoglobin 12... | True | True | muscles | ache | null | 74 | male | null | null |
44 | 49 | MLA_AKT_Practice_Paper_1_-_with_answers_and_justifications.pdf | A 59 year old woman has had 6 months of pain affecting her hips and lower back. She is from Libya and has lived in the UK for 10 years. She has chronic kidney disease stage 3 and hypertension. She takes lisinopril and simvastatin.
She has weakness of hip flexion bilaterally. There is no muscle or bony tenderness.
Inv... | A 59 year old woman has had 6 months of pain affecting her hips and lower back. She is from Libya and has lived in the UK for 10 years. She has chronic kidney disease stage 3 and hypertension. She takes lisinopril and simvastatin.
She has weakness of hip flexion bilaterally. There is no muscle or bony tenderness.
Inv... | True | True | hips; lower back | null | null | 59 | female | null | null |
45 | 1 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 73 year old man collapses on the surgical ward 24 hours after having a sigmoid volvulus reduced by sigmoidoscopy.
He has no pulse.
ECG shows asystole.
Chest compressions and ventilation are started. The cardiac arrest team are with the patient.
What is the most appropriate next step in management? | A 73 year old man collapses on the surgical ward 24 hours after having a sigmoid volvulus reduced by sigmoidoscopy.
He has no pulse.
ECG shows asystole.
Chest compressions and ventilation are started. The cardiac arrest team are with the patient.
What is the most appropriate next step in management? | False | False | null | null | null | 73 | male | null | null |
46 | 2 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 78 year old woman has pain in both shoulders, hips and thighs. She is very stiff on waking in the morning and takes 2–3 hours to loosen up. She finds getting dressed difficult.
Investigations:
Erythrocyte sedimentation rate 67 mm/hr (<20)
CRP 87 mg/L (<5)
What is the most appropriate initial treatment? | A 78 year old woman has pain in both shoulders, hips and thighs. She is very stiff on waking in the morning and takes 2–3 hours to loosen up. She finds getting dressed difficult.
Investigations:
Erythrocyte sedimentation rate 67 mm/hr (<20)
CRP 87 mg/L (<5)
What is the most appropriate initial treatment? | True | True | shoulders; hips; thighs | null | null | 78 | female | null | null |
47 | 3 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 36 year old man is rescued from a house fire. He is alert and talking but has a dull headache.
His pulse is 98 bpm, BP 139/86 mmHg, respiratory rate 22 breaths per minute and oxygen saturation 100% breathing 15 L/min oxygen via a non-rebreather mask.
What is the most appropriate investigation? | A 36 year old man is rescued from a house fire. He is alert and talking but has a dull headache.
His pulse is 98 bpm, BP 139/86 mmHg, respiratory rate 22 breaths per minute and oxygen saturation 100% breathing 15 L/min oxygen via a non-rebreather mask.
What is the most appropriate investigation? | True | True | head | dull | null | 36 | male | null | null |
48 | 4 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 60 year old man has 2 days of a swollen, painful right leg. He has hypertension and takes ramipril. He is otherwise well.
He has a swollen right leg. The remainder of the examination is normal.
Investigations:
Haemoglobin 140 g/L (130–175)
White cell count 8.0 × 10⁹/L (3.8–10.0)
Platelets 340 × 10⁹/L (150–400)
Crea... | A 60 year old man has 2 days of a swollen, painful right leg. He has hypertension and takes ramipril. He is otherwise well.
He has a swollen right leg. The remainder of the examination is normal.
Investigations:
Haemoglobin 140 g/L (130–175)
White cell count 8.0 × 10⁹/L (3.8–10.0)
Platelets 340 × 10⁹/L (150–400)
Crea... | True | True | right leg | null | null | 60 | male | null | null |
49 | 5 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 65 year old woman underwent mechanical aortic valve replacement and coronary revascularisation 3 days ago. She takes aspirin long term.
She is being treated with dalteparin sodium.
What is the most appropriate long-term management? | A 65 year old woman underwent mechanical aortic valve replacement and coronary revascularisation 3 days ago. She takes aspirin long term.
She is being treated with dalteparin sodium.
What is the most appropriate long-term management? | False | False | null | null | null | 65 | female | null | null |
50 | 6 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | In order to assess the association between maternal smoking during pregnancy and low birthweight, smoking histories can be obtained from pregnant women at the first prenatal visit and data analysed by measuring birthweight at delivery.
What is the best description of this type of study? | In order to assess the association between maternal smoking during pregnancy and low birthweight, smoking histories can be obtained from pregnant women at the first prenatal visit and data analysed by measuring birthweight at delivery.
What is the best description of this type of study? | False | False | null | null | null | null | female | null | null |
51 | 7 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | An 18 year old woman has had a chronic skin condition for several years. She describes having well-defined areas of scale formation at the sites of minor skin injuries, such as scratches or insect bites, typically when the injuries are healing. The scaling can persist for several weeks or months.
What is the most like... | An 18 year old woman has had a chronic skin condition for several years. She describes having well-defined areas of scale formation at the sites of minor skin injuries, such as scratches or insect bites, typically when the injuries are healing. The scaling can persist for several weeks or months.
What is the most like... | False | False | null | null | null | 18 | female | null | null |
52 | 8 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 64 year old man has vomiting and severe chest pain after eating a large meal.
His temperature is 37.6°C, pulse 130 bpm, BP 95/50 mmHg and respiratory rate 30 breaths per minute. There is palpable subcutaneous emphysema on the left side of his neck.
What is the most likely diagnosis? | A 64 year old man has vomiting and severe chest pain after eating a large meal.
His temperature is 37.6°C, pulse 130 bpm, BP 95/50 mmHg and respiratory rate 30 breaths per minute. There is palpable subcutaneous emphysema on the left side of his neck.
What is the most likely diagnosis? | True | True | chest | null | severe | 64 | male | null | null |
53 | 9 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 54 year old woman has polyuria and the feeling that she needs to drink continuously. She drinks at least 1 litre of water before bedtime and gets up three to four times during the night to pass urine. She has another glass of water each time that she gets up.
Investigations:
Sodium 140 mmol/L (135–146)
Potassium 4.1... | A 54 year old woman has polyuria and the feeling that she needs to drink continuously. She drinks at least 1 litre of water before bedtime and gets up three to four times during the night to pass urine. She has another glass of water each time that she gets up.
Investigations:
Sodium 140 mmol/L (135–146)
Potassium 4.1... | False | False | null | null | null | 54 | female | null | null |
54 | 10 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 30 year old woman has irregular periods, decreased libido and galactorrhoea.
Visual field examination is normal.
Investigations:
Prolactin 5000 mU/L (100–500)
Pregnancy test: negative
MR scan of pituitary shows a 4 mm mass in the sella turcica.
What is the most appropriate management? | A 30 year old woman has irregular periods, decreased libido and galactorrhoea.
Visual field examination is normal.
Investigations:
Prolactin 5000 mU/L (100–500)
Pregnancy test: negative
MR scan of pituitary shows a 4 mm mass in the sella turcica.
What is the most appropriate management? | False | False | null | null | null | 30 | female | null | null |
55 | 11 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 23 year old man is diagnosed with appendicitis. He is being prepared for theatre on the acute surgical ward. He has been vomiting intermittently all day, despite not having eaten for 24 hours.
The anaesthetist advises using an airway device to protect the lungs from regurgitated stomach contents.
Which airway devic... | A 23 year old man is diagnosed with appendicitis. He is being prepared for theatre on the acute surgical ward. He has been vomiting intermittently all day, despite not having eaten for 24 hours.
The anaesthetist advises using an airway device to protect the lungs from regurgitated stomach contents.
Which airway devic... | abstain | False | null | null | null | 23 | male | null | null |
56 | 12 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 32 year old man is referred to a gastroenterology clinic with hepatomegaly. He has type 2 diabetes that is diet controlled. He takes no regular medication. He does not smoke. He drinks 16 units of alcohol per week.
Cardiovascular and respiratory examinations are normal. His abdomen is soft, with a 3 cm palpable live... | A 32 year old man is referred to a gastroenterology clinic with hepatomegaly. He has type 2 diabetes that is diet controlled. He takes no regular medication. He does not smoke. He drinks 16 units of alcohol per week.
Cardiovascular and respiratory examinations are normal. His abdomen is soft, with a 3 cm palpable live... | False | False | null | null | null | 32 | male | null | null |
57 | 13 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 30 year old woman has severe headache 24 hours after a spinal anaesthetic.
Her temperature is 37.1°C, pulse 90 bpm and BP 120/80 mmHg.
What is the most likely diagnosis? | A 30 year old woman has severe headache 24 hours after a spinal anaesthetic.
Her temperature is 37.1°C, pulse 90 bpm and BP 120/80 mmHg.
What is the most likely diagnosis? | True | True | head | null | severe | 30 | female | null | null |
58 | 14 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 27 year old man develops a dry cough and left-sided chest pain of sudden onset. The pain is worse on taking a deep breath and coughing.
His temperature is 36.8°C, pulse 126 bpm, BP 108/60 mmHg, respiratory rate 28 breaths per minute and oxygen saturation 94% breathing air.
Investigations: ECG: sinus tachycardia
Wh... | A 27 year old man develops a dry cough and left-sided chest pain of sudden onset. The pain is worse on taking a deep breath and coughing.
His temperature is 36.8°C, pulse 126 bpm, BP 108/60 mmHg, respiratory rate 28 breaths per minute and oxygen saturation 94% breathing air.
Investigations: ECG: sinus tachycardia
Wh... | True | True | left chest | sharp | null | 27 | male | null | null |
59 | 15 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 23 year old man is scheduled to undergo an elective arthroscopy of his knee. He is to have a general anaesthetic for the operation.
The pre-operative assessment nurse advises him how long he needs to fast beforehand.
What fasting times for clear liquids and solids are most likely advised? | A 23 year old man is scheduled to undergo an elective arthroscopy of his knee. He is to have a general anaesthetic for the operation.
The pre-operative assessment nurse advises him how long he needs to fast beforehand.
What fasting times for clear liquids and solids are most likely advised? | False | False | null | null | null | 23 | male | null | null |
60 | 16 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 28 year old woman has a lump that she noticed incidentally when rubbing her neck.
There is a smooth, non-tender 1.5 cm mobile lump within the thyroid gland.
Investigations:
TSH 2.3 mU/L (0.3–4.2)
Free T4 17 pmol/L (9–25)
What is the most appropriate next investigation? | A 28 year old woman has a lump that she noticed incidentally when rubbing her neck.
There is a smooth, non-tender 1.5 cm mobile lump within the thyroid gland.
Investigations:
TSH 2.3 mU/L (0.3–4.2)
Free T4 17 pmol/L (9–25)
What is the most appropriate next investigation? | True | False | null | null | null | 28 | female | null | null |
61 | 17 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 78 year old man has type 2 diabetes. His clinician does not invite him to join an internet-based self-monitoring programme because they consider him to be too old to engage with it effectively.
What is the most appropriate description of the clinician's approach? | A 78 year old man has type 2 diabetes. His clinician does not invite him to join an internet-based self-monitoring programme because they consider him to be too old to engage with it effectively.
What is the most appropriate description of the clinician's approach? | False | False | null | null | null | 78 | male | null | null |
62 | 18 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 47 year old man with well controlled hypertension for many years attends for annual review. He takes ramipril (10 mg once daily).
His BP is 138/78 mmHg.
Investigations:
Sodium 139 mmol/L (135–146)
Potassium 6.2 mmol/L (3.5–5.3)
Urea 5.0 mmol/L (2.5–7.8)
Creatinine 90 µmol/L (60–120)
Which is the most appropriate i... | A 47 year old man with well controlled hypertension for many years attends for annual review. He takes ramipril (10 mg once daily).
His BP is 138/78 mmHg.
Investigations:
Sodium 139 mmol/L (135–146)
Potassium 6.2 mmol/L (3.5–5.3)
Urea 5.0 mmol/L (2.5–7.8)
Creatinine 90 µmol/L (60–120)
Which is the most appropriate i... | False | False | null | null | null | 47 | male | null | null |
63 | 19 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 33 year old woman has 4 months of joint pain and stiffness, predominantly affecting her feet. This is worst in the morning and gradually improves through the day. She feels tired all the time but reports no other health problems.
What investigation would confirm the most likely diagnosis? | A 33 year old woman has 4 months of joint pain and stiffness, predominantly affecting her feet. This is worst in the morning and gradually improves through the day. She feels tired all the time but reports no other health problems.
What investigation would confirm the most likely diagnosis? | True | True | feet | stiffness; aching | null | 33 | female | null | null |
64 | 20 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 27 year old man has severe central chest pain. He admits to using cocaine shortly before the onset of the chest pain, but says that he had used it on only two previous occasions.
He is distressed and sweating. His pulse is 115 bpm and BP 118/68 mmHg.
An ECG shows sinus tachycardia with ST elevation in the lateral l... | A 27 year old man has severe central chest pain. He admits to using cocaine shortly before the onset of the chest pain, but says that he had used it on only two previous occasions.
He is distressed and sweating. His pulse is 115 bpm and BP 118/68 mmHg.
An ECG shows sinus tachycardia with ST elevation in the lateral l... | True | True | chest | null | severe | 27 | male | null | null |
65 | 21 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | An 18 year old man, who was born in the UK, develops drowsiness and confusion 2 days after returning from visiting his grandparents in Malawi. Over the past week he has had recurrent episodes of high fever.
Investigations:
Haemoglobin 92 g/L (130–175)
White cell count 3.2 × 10⁹/L (4.0–11.0)
Platelets 184 × 10⁹/L (150–... | An 18 year old man, who was born in the UK, develops drowsiness and confusion 2 days after returning from visiting his grandparents in Malawi. Over the past week he has had recurrent episodes of high fever.
Investigations:
Haemoglobin 92 g/L (130–175)
White cell count 3.2 × 10⁹/L (4.0–11.0)
Platelets 184 × 10⁹/L (150–... | False | False | null | null | null | 18 | male | null | null |
66 | 22 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 31 year old man has a painless lump in his scrotum.
There is a well-defined, non-tender spherical 1 cm mass on the right side of the scrotum. It is superior to the testis and transilluminates.
What is the most likely diagnosis? | A 31 year old man has a painless lump in his scrotum.
There is a well-defined, non-tender spherical 1 cm mass on the right side of the scrotum. It is superior to the testis and transilluminates.
What is the most likely diagnosis? | True | False | null | null | null | 31 | male | null | null |
67 | 23 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 68 year old man has 3 days of worsening vomiting and abdominal pain. He has not passed any stool for 3 days. Six months ago he underwent a right hemicolectomy for Dukes' A (T1, N0) bowel cancer.
He is dehydrated and his abdomen is distended.
What is the most likely diagnosis? | A 68 year old man has 3 days of worsening vomiting and abdominal pain. He has not passed any stool for 3 days. Six months ago he underwent a right hemicolectomy for Dukes' A (T1, N0) bowel cancer.
He is dehydrated and his abdomen is distended.
What is the most likely diagnosis? | True | True | abdomen | null | null | 68 | male | null | null |
68 | 24 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 78 year old man is admitted with chronic oropharyngeal dysphagia. He has left ventricular systolic dysfunction (HFrEF). He is breathless on exertion, particularly when climbing stairs.
He weighs 70 kg. His pulse is 72 bpm and BP 132/80 mmHg.
He is being prepared for a percutaneous endoscopic gastrostomy feeding tub... | A 78 year old man is admitted with chronic oropharyngeal dysphagia. He has left ventricular systolic dysfunction (HFrEF). He is breathless on exertion, particularly when climbing stairs.
He weighs 70 kg. His pulse is 72 bpm and BP 132/80 mmHg.
He is being prepared for a percutaneous endoscopic gastrostomy feeding tub... | False | False | null | null | null | 78 | male | null | null |
69 | 25 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 75 year old woman is reviewed 4 days after a fractured neck of femur repair. She has been agitated and upset, particularly at night. She has punched nurses and keeps trying to leave the ward. She has seen strange men in black capes entering the ward and believes that they are controlling the hospital. When she was se... | A 75 year old woman is reviewed 4 days after a fractured neck of femur repair. She has been agitated and upset, particularly at night. She has punched nurses and keeps trying to leave the ward. She has seen strange men in black capes entering the ward and believes that they are controlling the hospital. When she was se... | False | False | null | null | null | 75 | female | null | null |
70 | 26 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 72 year old woman has 6 months of increasing pain at the base of her right thumb. She is having difficulty opening jars and sewing. She is otherwise well. No other joints are painful. She is taking regular analgesia.
The first carpometacarpal joint is swollen and tender, with reduced opposition of the thumb.
What i... | A 72 year old woman has 6 months of increasing pain at the base of her right thumb. She is having difficulty opening jars and sewing. She is otherwise well. No other joints are painful. She is taking regular analgesia.
The first carpometacarpal joint is swollen and tender, with reduced opposition of the thumb.
What i... | True | True | abstain | null | null | 72 | female | null | null |
71 | 27 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 62 year old man has acute breathlessness with a weak cough, following a recent viral upper respiratory infection. Over the past 4 months, he has had double vision, limb weakness and slurred speech when tired.
His respiratory rate is 18 breaths per minute and oxygen saturation 96% breathing air. He is sweating and us... | A 62 year old man has acute breathlessness with a weak cough, following a recent viral upper respiratory infection. Over the past 4 months, he has had double vision, limb weakness and slurred speech when tired.
His respiratory rate is 18 breaths per minute and oxygen saturation 96% breathing air. He is sweating and us... | False | False | null | null | null | 62 | male | null | null |
72 | 28 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 40 year old man has 4 days of left flank pain associated with fever, nausea and vomiting.
His temperature is 39.6°C, pulse 118 bpm and BP 90/40 mmHg.
Imaging shows an obstructing proximal left ureteric stone with severe hydronephrosis.
He is treated with intravenous antibiotics and intravenous fluids.
What is the... | A 40 year old man has 4 days of left flank pain associated with fever, nausea and vomiting.
His temperature is 39.6°C, pulse 118 bpm and BP 90/40 mmHg.
Imaging shows an obstructing proximal left ureteric stone with severe hydronephrosis.
He is treated with intravenous antibiotics and intravenous fluids.
What is the... | True | True | left flank | null | null | 40 | male | null | null |
73 | 30 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | An 80 year old woman attends the emergency department after being found collapsed at home. She has central chest pain.
Her pulse is 30 bpm, BP 70/40 mmHg and respiratory rate 26 breaths per minute.
Her 12-lead ECG shows sinus bradycardia with no evidence of myocardial ischaemia.
What is the most appropriate initial ... | An 80 year old woman attends the emergency department after being found collapsed at home. She has central chest pain.
Her pulse is 30 bpm, BP 70/40 mmHg and respiratory rate 26 breaths per minute.
Her 12-lead ECG shows sinus bradycardia with no evidence of myocardial ischaemia.
What is the most appropriate initial ... | True | True | chest | null | null | 80 | female | null | null |
74 | 31 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 62 year old man develops acute pain, redness, swelling and warmth of his right first metatarsophalangeal joint. He has gout and hypertension. His medications are allopurinol, amlodipine and ramipril.
His eGFR is >60 mL/min/1.73 m²(>60).
What is the most appropriate next step in his management? | A 62 year old man develops acute pain, redness, swelling and warmth of his right first metatarsophalangeal joint. He has gout and hypertension. His medications are allopurinol, amlodipine and ramipril.
His eGFR is >60 mL/min/1.73 m²(>60).
What is the most appropriate next step in his management? | True | True | right first metatarsophalangeal joint | acute | null | 62 | male | null | null |
75 | 32 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 10 year old boy has deafness of new onset. He has had a recent respiratory tract infection.
When the tuning fork is placed in the middle of his forehead he hears the tone loudest in his right ear. When the tuning fork is placed on the bone behind the right ear the sound is louder than when it is held in front of his... | A 10 year old boy has deafness of new onset. He has had a recent respiratory tract infection.
When the tuning fork is placed in the middle of his forehead he hears the tone loudest in his right ear. When the tuning fork is placed on the bone behind the right ear the sound is louder than when it is held in front of his... | False | False | null | null | null | 10 | male | null | null |
76 | 33 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 55 year old man has had painful red swelling of his left lower leg for 2 days. He has type 2 diabetes mellitus and takes metformin.
His temperature is 37.6°C. He has a tender erythematous area extending from the ankle to the proximal calf.
What is the most likely causative organism? | A 55 year old man has had painful red swelling of his left lower leg for 2 days. He has type 2 diabetes mellitus and takes metformin.
His temperature is 37.6°C. He has a tender erythematous area extending from the ankle to the proximal calf.
What is the most likely causative organism? | True | True | left lower leg | tender | null | 55 | male | null | null |
77 | 34 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 64 year old woman is due to undergo an arthroscopy of her knee. She has type 2 diabetes and takes metformin (500 mg twice daily) and gliclazide (80 mg each morning).
Her glycated haemoglobin (HbA1c) is 54 mmol/mol (20–42).
She is scheduled first on tomorrow morning's day case list and is asked to fast from midnight... | A 64 year old woman is due to undergo an arthroscopy of her knee. She has type 2 diabetes and takes metformin (500 mg twice daily) and gliclazide (80 mg each morning).
Her glycated haemoglobin (HbA1c) is 54 mmol/mol (20–42).
She is scheduled first on tomorrow morning's day case list and is asked to fast from midnight... | False | False | null | null | null | 64 | female | null | null |
78 | 35 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 67 year old man has difficulty walking. He states that he has to raise his left leg higher in the air than normal to avoid scraping his toes on the ground when he walks.
When he raises the left foot from the floor, the ankle assumes a plantar-flexed position with the toes directed towards the floor.
Which nerve is ... | A 67 year old man has difficulty walking. He states that he has to raise his left leg higher in the air than normal to avoid scraping his toes on the ground when he walks.
When he raises the left foot from the floor, the ankle assumes a plantar-flexed position with the toes directed towards the floor.
Which nerve is ... | False | False | null | null | null | 67 | male | null | null |
79 | 36 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 35 year old woman has 6 months of cyclical pain in both breasts. She has recently noticed a lump in the right breast.
There is diffuse nodularity of the axillary tails of both breasts with a discrete 20 mm mass in the upper outer quadrant of the right breast.
Fine needle aspiration is performed and 5 mL of brown fl... | A 35 year old woman has 6 months of cyclical pain in both breasts. She has recently noticed a lump in the right breast.
There is diffuse nodularity of the axillary tails of both breasts with a discrete 20 mm mass in the upper outer quadrant of the right breast.
Fine needle aspiration is performed and 5 mL of brown fl... | True | True | both breasts | null | null | 35 | female | null | null |
80 | 37 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 70 year old man has a brief episode of twitching that starts in his left hand and spreads up the arm over 2 minutes, then stops. His arm feels weak for an hour afterwards. He had an ischaemic stroke affecting his left side 6 months ago with good functional recovery. He has type 2 diabetes mellitus and is taking clopi... | A 70 year old man has a brief episode of twitching that starts in his left hand and spreads up the arm over 2 minutes, then stops. His arm feels weak for an hour afterwards. He had an ischaemic stroke affecting his left side 6 months ago with good functional recovery. He has type 2 diabetes mellitus and is taking clopi... | False | False | null | null | null | 70 | male | null | null |
81 | 38 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 63 year old woman has 4 months of abdominal bloating, fatigue and nausea.
She is found to have ovarian cancer.
Staging CT is performed to look for lymphatic spread and metastatic disease.
Where is her tumour most likely to spread initially? | A 63 year old woman has 4 months of abdominal bloating, fatigue and nausea.
She is found to have ovarian cancer.
Staging CT is performed to look for lymphatic spread and metastatic disease.
Where is her tumour most likely to spread initially? | False | False | null | null | null | 63 | female | null | null |
82 | 39 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 52 year old woman has had three episodes of severe epigastric pain associated with vomiting over the past 3 months. The episodes occurred following eating and lasted for about 1 hour. She has type 2 diabetes mellitus and takes metformin.
Abdominal examination is normal. Her BMI is 35 kg/m²(18–25).
Investigations:
A... | A 52 year old woman has had three episodes of severe epigastric pain associated with vomiting over the past 3 months. The episodes occurred following eating and lasted for about 1 hour. She has type 2 diabetes mellitus and takes metformin.
Abdominal examination is normal. Her BMI is 35 kg/m²(18–25).
Investigations:
A... | True | abstain | epigastric | null | severe | 52 | female | null | null |
83 | 40 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 56 year old woman develops vertigo, nausea, vomiting and intense occipital headache of sudden onset. She is unable to walk without falling. She has hypertension and takes ramipril.
Her temperature is 37.4°C, pulse 94 bpm, BP 146/92 mmHg, respiratory rate 12 breaths per minute and oxygen saturation 96% breathing air.... | A 56 year old woman develops vertigo, nausea, vomiting and intense occipital headache of sudden onset. She is unable to walk without falling. She has hypertension and takes ramipril.
Her temperature is 37.4°C, pulse 94 bpm, BP 146/92 mmHg, respiratory rate 12 breaths per minute and oxygen saturation 96% breathing air.... | True | True | occipital | abstain | severe | 56 | female | null | null |
84 | 41 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 79 year old woman has 3 months of a left leg venous ulcer that is slowly healing.
Ankle–brachial pressure indices are 0.9 on the left side and 1.1 on the right side (0.8–1.2).
What is the most appropriate management? | A 79 year old woman has 3 months of a left leg venous ulcer that is slowly healing.
Ankle–brachial pressure indices are 0.9 on the left side and 1.1 on the right side (0.8–1.2).
What is the most appropriate management? | False | False | null | null | null | 79 | female | null | null |
85 | 42 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 26 year old woman sustains a head injury in a motorcycle accident.
Her eyes are closed, but she opens them when asked. She is confused about what happened and where she is, but attempts to talk about it. She repeatedly attempts to remove the cannula from her wrist.
What is her Glasgow Coma Score? | A 26 year old woman sustains a head injury in a motorcycle accident.
Her eyes are closed, but she opens them when asked. She is confused about what happened and where she is, but attempts to talk about it. She repeatedly attempts to remove the cannula from her wrist.
What is her Glasgow Coma Score? | False | False | null | null | null | 26 | female | null | null |
86 | 43 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 65 year old man has sudden pain and redness in his right eye. He also has a headache and nausea.
Visual acuity is 6/60 in the right eye. The eye is congested, with a hazy cornea and mid-dilated pupil.
What is the most likely diagnosis? | A 65 year old man has sudden pain and redness in his right eye. He also has a headache and nausea.
Visual acuity is 6/60 in the right eye. The eye is congested, with a hazy cornea and mid-dilated pupil.
What is the most likely diagnosis? | True | True | right eye; head | null | null | 65 | male | null | null |
87 | 44 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 68 year old man collapses when rising from a chair and is seen in the emergency department 45 minutes later. He has COPD and hypertension. He smokes 10 cigarettes per day.
He is conscious but has reduced strength in his left arm (3/5) and leg (4/5) and slurring of speech. He has bilateral scattered wheeze and bilate... | A 68 year old man collapses when rising from a chair and is seen in the emergency department 45 minutes later. He has COPD and hypertension. He smokes 10 cigarettes per day.
He is conscious but has reduced strength in his left arm (3/5) and leg (4/5) and slurring of speech. He has bilateral scattered wheeze and bilate... | False | False | null | null | null | 68 | male | null | null |
88 | 45 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 25 year old man sustains 40% full-thickness burns in a house fire. Despite intensive treatment, he becomes breathless and hypotensive. He develops a petechial rash.
His temperature is 38°C, pulse 110 bpm, BP 80/50 mmHg and oxygen saturation 96% breathing 40% oxygen.
Investigations:
Haemoglobin 110 g/L (130–175)
Whi... | A 25 year old man sustains 40% full-thickness burns in a house fire. Despite intensive treatment, he becomes breathless and hypotensive. He develops a petechial rash.
His temperature is 38°C, pulse 110 bpm, BP 80/50 mmHg and oxygen saturation 96% breathing 40% oxygen.
Investigations:
Haemoglobin 110 g/L (130–175)
Whi... | False | False | null | null | null | 25 | male | null | null |
89 | 46 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 65 year old woman with newly diagnosed advanced lung cancer has 1 day of breathlessness and 1 week of progressive headache.
Her pulse is 88 bpm, respiratory rate 20 breaths per minute and oxygen saturation 95% breathing 4 L/min oxygen via nasal prongs. She has a swollen face and neck with distended veins on her ches... | A 65 year old woman with newly diagnosed advanced lung cancer has 1 day of breathlessness and 1 week of progressive headache.
Her pulse is 88 bpm, respiratory rate 20 breaths per minute and oxygen saturation 95% breathing 4 L/min oxygen via nasal prongs. She has a swollen face and neck with distended veins on her ches... | True | True | head | null | null | 65 | female | null | null |
90 | 47 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 65 year old man has 3 weeks of progressive ankle oedema. He has a lifelong history of heavy smoking and drinks 12 units of alcohol per week.
His BP is 125/85 mmHg and oxygen saturation 98% breathing air. He has marked bilateral pitting ankle oedema.
Investigations:
Creatinine 85 µmol/L (60–120)
Urinary protein: cre... | A 65 year old man has 3 weeks of progressive ankle oedema. He has a lifelong history of heavy smoking and drinks 12 units of alcohol per week.
His BP is 125/85 mmHg and oxygen saturation 98% breathing air. He has marked bilateral pitting ankle oedema.
Investigations:
Creatinine 85 µmol/L (60–120)
Urinary protein: cre... | False | False | null | null | null | 65 | male | null | null |
91 | 48 | MLA_AKT_Practice_Paper_2_-_with_answers_and_justifications.pdf | A 55 year old woman has a tender, erythematous, swollen hard cord in the long saphenous vein distribution in her calf. The pain persists despite paracetamol. She has longstanding bilateral varicose veins.
An ultrasound scan shows superficial thrombophlebitis without deep vein thrombosis.
What is the most appropriate ... | A 55 year old woman has a tender, erythematous, swollen hard cord in the long saphenous vein distribution in her calf. The pain persists despite paracetamol. She has longstanding bilateral varicose veins.
An ultrasound scan shows superficial thrombophlebitis without deep vein thrombosis.
What is the most appropriate ... | True | True | calf | tender | null | 55 | female | null | null |
92 | 1 | MLA AKT Practice Paper 3 - with answers and justifications.pdf | An 88 year old woman has recurrent falls. She says that she cannot feel where her feet are. There is reduced pinprick sensation up to the level of her mid calf and joint position sense is impaired in the feet. Knee reflexes are brisk, but ankle reflexes are absent. Investigations: Haemoglobin 91 g/L (115–150) White c... | An 88 year old woman has recurrent falls. She says that she cannot feel where her feet are. There is reduced pinprick sensation up to the level of her mid calf and joint position sense is impaired in the feet. Knee reflexes are brisk, but ankle reflexes are absent. Investigations: Haemoglobin 91 g/L (115–150) White c... | False | False | null | null | null | 88 | female | null | null |
93 | 2 | MLA AKT Practice Paper 3 - with answers and justifications.pdf | A 55 year old man has had lower back pain and fatigue for 3 months. Investigations: Haemoglobin 110 g/L (130–175) White cell count 5.8 × 109/L (3.8–10.0) Platelets 120 × 109/L (150–400) Corrected calcium 2.90 mmol/L (2.2–2.6) Albumin 29 g/L (35–50) Serum electrophoresis: monoclonal Ig kappa peak Bone marrow... | A 55 year old man has had lower back pain and fatigue for 3 months. Investigations: Haemoglobin 110 g/L (130–175) White cell count 5.8 × 109/L (3.8–10.0) Platelets 120 × 109/L (150–400) Corrected calcium 2.90 mmol/L (2.2–2.6) Albumin 29 g/L (35–50) Serum electrophoresis: monoclonal Ig kappa peak Bone marrow... | True | True | lower back | null | null | 55 | male | null | null |
94 | 3 | MLA AKT Practice Paper 3 - with answers and justifications.pdf | A 54 year old woman has reduced urine output 24 hours after admission with right lower lobe consolidation due to community acquired pneumonia. She has been treated with intravenous amoxicillin and clarithromycin, but remains breathless. Her creatinine was 82 μmol/L (60–120) on admission. Her temperature is 38.0°C, ... | A 54 year old woman has reduced urine output 24 hours after admission with right lower lobe consolidation due to community acquired pneumonia. She has been treated with intravenous amoxicillin and clarithromycin, but remains breathless. Her creatinine was 82 μmol/L (60–120) on admission. Her temperature is 38.0°C, ... | False | False | null | null | null | 54 | female | null | null |
95 | 4 | MLA AKT Practice Paper 3 - with answers and justifications.pdf | A 70 year old woman has an ulcer above the left medial malleolus. She has type 2 diabetes mellitus. She smokes 10 cigarettes per day. Her BMI is 34. The ulcer is 10 × 5 cm and superficial. She has brown discolouration of both lower legs. The skin has a thickened, waxy feel. Which ulcer type is the most likely? | A 70 year old woman has an ulcer above the left medial malleolus. She has type 2 diabetes mellitus. She smokes 10 cigarettes per day. Her BMI is 34. The ulcer is 10 × 5 cm and superficial. She has brown discolouration of both lower legs. The skin has a thickened, waxy feel. Which ulcer type is the most likely? | False | False | null | null | null | 70 | female | null | null |
96 | 5 | MLA AKT Practice Paper 3 - with answers and justifications.pdf | A 67 year old man has 3 weeks of worsening ankle oedema. He has hypertension and takes amlodipine. He is a lifelong heavy smoker and drinks 12 units of alcohol per week. His BP is 125/85 mmHg and oxygen saturation 98% breathing air. His JVP is 4 cm above the sternal angle. He has marked bilateral pitting ankle oedema. ... | A 67 year old man has 3 weeks of worsening ankle oedema. He has hypertension and takes amlodipine. He is a lifelong heavy smoker and drinks 12 units of alcohol per week. His BP is 125/85 mmHg and oxygen saturation 98% breathing air. His JVP is 4 cm above the sternal angle. He has marked bilateral pitting ankle oedema. ... | False | False | null | null | null | 67 | male | null | null |
97 | 6 | MLA AKT Practice Paper 3 - with answers and justifications.pdf | A 68 year old man has eight weeks of back pain. It sometimes wakes him at night, and he is feeling increasingly tired. He has no history of back problems or recent trauma. He has tenderness over L3 and L4 vertebrae. Investigations: Haemoglobin 137 g/L (130–175) Erythrocyte sedimentation rate 55 mm/hr (< 20) Creatinin... | A 68 year old man has eight weeks of back pain. It sometimes wakes him at night, and he is feeling increasingly tired. He has no history of back problems or recent trauma. He has tenderness over L3 and L4 vertebrae. Investigations: Haemoglobin 137 g/L (130–175) Erythrocyte sedimentation rate 55 mm/hr (< 20) Creatinin... | True | True | back; l3 and l4 vertebrae | tenderness | null | 68 | male | null | null |
98 | 7 | MLA AKT Practice Paper 3 - with answers and justifications.pdf | A 17 year old girl has a florid skin rash for 24 hours. She has been feeling unwell for the past week with intermittent abdominal pain. She has a palpable, purpuric rash on her lower limbs and buttocks. Her temperature is 37.2°C, pulse rate 70 bpm and BP 122/80 mmHg. Her urinalysis has blood 3+, protein 2+, nitrites n... | A 17 year old girl has a florid skin rash for 24 hours. She has been feeling unwell for the past week with intermittent abdominal pain. She has a palpable, purpuric rash on her lower limbs and buttocks. Her temperature is 37.2°C, pulse rate 70 bpm and BP 122/80 mmHg. Her urinalysis has blood 3+, protein 2+, nitrites n... | True | True | abdomen | intermittent | null | 17 | female | null | null |
99 | 8 | MLA AKT Practice Paper 3 - with answers and justifications.pdf | A 67 year old woman becomes unwell whilst attending the diabetes foot clinic. She is anxious and noticeably tremulous as she drinks from her water bottle. She is sweaty but apyrexial. Her pulse rate is 98 bpm, BP 128/76 mmHg and oxygen saturation 96% breathing air. Her capillary blood glucose is 2.1 mmol/L. What is the... | A 67 year old woman becomes unwell whilst attending the diabetes foot clinic. She is anxious and noticeably tremulous as she drinks from her water bottle. She is sweaty but apyrexial. Her pulse rate is 98 bpm, BP 128/76 mmHg and oxygen saturation 96% breathing air. Her capillary blood glucose is 2.1 mmol/L. What is the... | False | False | null | null | null | 67 | female | null | null |
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WorldMedQA-Pain
Pain and demographic labels for 2,963 medical licensing examination items in four languages, the exam half of PAINT (paper, code). Labels come from a three-model open-weight ensemble (Gemma-4-E4B, Qwen3-8B, DeepSeek-R1-Distill-Qwen-32B) and were validated by clinicians in each language.
Files
| File | Partition | Language | Items |
|---|---|---|---|
UK.csv |
UK PLAB | en | 268 |
Spain.csv |
Spain MIR | es | 1,049 |
Japan.csv |
Japan NLE | ja | 742 |
Brazil.csv |
Brazil REVALIDA | pt | 904 |
from datasets import load_dataset
ds = load_dataset("tinaboya/WorldMedQA-Pain") # splits: uk, spain, japan, brazil
One row per exam item. Items and English translations are from WorldMedQA; only the item text was given to the models.
Fields
| Column | Content |
|---|---|
row_index |
0-based row position; the join key to the per-model outputs and the clinician sheets in the code repository |
Question_ID, file_name |
identifiers from the WorldMedQA source (Question_ID repeats across exam files; the pair is unique) |
Question |
exam item text in the source language |
Question_EN |
English translation (for UK, identical to Question) |
ensemble_pain_related, ensemble_pain_presence |
True / False when the three models agree, otherwise abstain |
ensemble_location, ensemble_pain_type |
lists merged item by item (kept when at least two models list an item), ; -separated, source language |
ensemble_severity |
mild / moderate / severe, 2-of-3 majority |
ensemble_age, ensemble_gender, ensemble_ethnicity, ensemble_occupation |
2-of-3 majority over non-null predictions; age in years, gender male / female, ethnicity and occupation free text |
For the majority fields an empty cell means that no model extracted the field and abstain
means that the models disagreed without a majority.
Validation and limitations
Pain relevance, pain presence, age, gender and occupation were checked by clinicians (see the paper); location, descriptors, severity and ethnicity are ensemble outputs that were not clinician-validated. Demographic values are model extractions, not verified facts about a person, and ethnicity categories are not comparable across countries. Label distributions describe each examination corpus and are not prevalence estimates. The items are public exam questions and contain no patient-identifiable information.
License and citation
Labels are released under the MIT license, with the items as distributed by WorldMedQA. Please cite PAINT (arXiv:2610.18269; BibTeX in the code repository) and WorldMedQA.
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