DCAS exam questions by profession

Answer: A. Stop the oxytocin infusion and request an obstetric review

More than 5 contractions in 10 minutes is uterine tachysystole, which reduces placental perfusion; combined with late decelerations, oxytocin must be stopped and urgent review arranged, with tocolysis considered. Halving the rate may be acceptable for tachysystole with a normal CTG, but with a pathological trace it delays correcting the cause.

Answer: C. A 40-year-old with fever and blood in the stool

Bloody diarrhoea with fever suggests invasive bacterial infection or inflammatory bowel disease; antimotility agents such as loperamide are avoided and medical assessment is needed. Short-lived watery diarrhoea in otherwise well adults, including mild traveller's diarrhoea, can be managed with oral rehydration and, where appropriate, loperamide.

Answer: B. Graded activity scheduling of small, meaningful and achievable activities

Behavioural activation, using graded scheduling of meaningful and achievable activities, breaks the cycle of withdrawal and low mood, and success builds motivation and a sense of mastery. Waiting for mood to lift reinforces inactivity, while a full schedule at once is likely to fail and increase feelings of hopelessness.

Answer: A. Telogen effluvium

A physiological stress such as childbirth shifts many follicles into telogen, and diffuse shedding of club (telogen) hairs follows about 2 to 4 months later; postpartum shedding usually resolves within 6 to 12 months. Anagen effluvium occurs within days to weeks of chemotherapy and produces dystrophic, tapered hairs. Alopecia areata typically causes well-defined patches, and female pattern hair loss causes gradual central thinning rather than acute shedding.

Answer: D. Dentinogenesis imperfecta

Dentinogenesis imperfecta associated with osteogenesis imperfecta shows opalescent teeth, bulbous crowns and pulp obliteration. Amelogenesis imperfecta affects enamel and leaves pulp chambers normal.

Answer: A. Wait at least 15 minutes before measuring

Hot or cold drinks and smoking alter mouth temperature, so oral measurement should be delayed for about 15 to 30 minutes. Measuring immediately gives a falsely high result.