A 66-year-old man has an abdominal aortic aneurysm of 5.8 cm diameter found on his NHS screening ultrasound. He has no abdominal or back pain and is well. Pulse 72, blood pressure 136/80 mmHg. What is the most appropriate next step?
Question 2MLA content map: Intestinal obstruction and ileus
A 58-year-old woman who had a hysterectomy 10 years ago has 24 hours of colicky central abdominal pain, vomiting and distension, and has passed no flatus. CT shows small bowel obstruction from adhesions with no signs of ischaemia. She is not peritonitic. Pulse 92, blood pressure 130/80 mmHg, lactate normal. What is the most appropriate initial management?
Question 3MLA content map: Acute stress reaction
A 37-year-old woman is brought to the emergency department 2 hours after her car was hit at a junction. She is uninjured, GCS 15 and has no neurological signs. She seems dazed, keeps asking what happened, swings between tearfulness and calm, and says everything feels unreal. She has no psychiatric history. What is the most likely diagnosis?
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