SHA exam questions by profession

Answer: B. Below the level of the bladder, off the floor

Keeping the bag below bladder level and off the floor allows drainage and prevents backflow of urine, which reduces infection risk. A bag above the bladder or on the floor increases infection risk.

Answer: A. 200 mL of 95% and 250 mL of 50%

Alligation gives 70 - 50 = 20 parts of 95% and 95 - 70 = 25 parts of 50%, a total of 45 parts, so 450 mL needs 200 mL of 95% and 250 mL of 50%. Check: 190 mL + 125 mL of ethanol = 315 mL in 450 mL, which is 70%. Reversing the parts is the classic error and produces about 75%.

Answer: D. The focused grid was placed upside down

An upside-down focused grid aligns only the central lead strips with the beam, causing severe grid cut-off at both edges while the centre remains exposed. Off-level and lateral decentring errors produce a uniform or one-sided loss of density across the image, and a low grid ratio causes more scatter fog rather than cut-off.

Answer: C. Digoxin-specific antibody fragments

Life-threatening arrhythmia and hyperkalaemia in digoxin toxicity are indications for digoxin-specific antibody fragments, which bind digoxin and reverse its effects within an hour. Digoxin has a large volume of distribution, so haemodialysis removes very little. Antiarrhythmics such as amiodarone do not address the cause and may worsen conduction.

Answer: B. Le Fort II fracture

A Le Fort II fracture is pyramidal, passing through the nasal bones, medial orbital walls, infraorbital rims and zygomaticomaxillary buttresses, so the nose and maxilla move together. A Le Fort I fracture separates only the tooth-bearing maxilla below the nose. A Le Fort III separates the whole midface including the zygomas from the cranial base.

Answer: C. Withhold the antipsychotic and escalate for urgent medical management

Fever, lead-pipe rigidity, altered consciousness, autonomic instability and raised CK after starting a dopamine antagonist indicate neuroleptic malignant syndrome, a medical emergency: the antipsychotic is stopped and the patient is cooled, hydrated and escalated. Serotonin syndrome is the tempting alternative, but it typically follows serotonergic drugs and presents with clonus and hyperreflexia rather than lead-pipe rigidity.