UKMLA 2
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Case Presentation: Unstable Angina
Patient: Adam Jones, 56-year-old male, presented to Manchester Royal General Practice.
Task: Talk to the patient and address his concerns
Results
Notes
Diagnosis: Unstable Angina
Explanation to the Patient: Our impression is that you have angina, which means chest pain due to limited blood supply to the heart muscles. We call it unstable because it occurs spontaneously, without stress or exercise. Unfortunately, unstable angina is often referred to as a minor heart attack because it is a warning sign that you might develop a heart attack.
Next Steps: We will arrange an ambulance to take you to the emergency department for further assessment and refer you to the rapid chest pain assessment clinic.
Main Investigations:
- ECG
- 2D Echo
- Cardiac Markers
- Chest X-ray
Routine Investigations:
- FBC, LFT, KFT, TFT, RBS, ESR, CRP
Main Treatment:
- Medications: Initial treatment (MONA)
- Morphine, Oxygen, Nitrates, Aspirin
- IV Diamorphine
- Oxygen therapy
- Nitrate spray under the tongue
- High-dose aspirin (300mg)
- Blood tests (routine, heart markers, ECG)
Definitive Treatment:
- Angiography and Angioplasty: If confirmed, referral to a cardiologist for coronary angiography to map out blocked vessels. If many vessels are blocked, a CABG (Coronary Artery Bypass Graft) may be necessary.
Advice:
- Recommendations on diet and exercise.
Notes
Diagnosis: Unstable Angina
Explanation to the Patient: Our impression is that you have angina, which means chest pain due to limited blood supply to the heart muscles. We call it unstable because it occurs spontaneously, without stress or exercise. Unfortunately, unstable angina is often referred to as a minor heart attack because it is a warning sign that you might develop a heart attack.
Next Steps: We will arrange an ambulance to take you to the emergency department for further assessment and refer you to the rapid chest pain assessment clinic.
Main Investigations:
- ECG
- 2D Echo
- Cardiac Markers
- Chest X-ray
Routine Investigations:
- FBC, LFT, KFT, TFT, RBS, ESR, CRP
Main Treatment:
- Medications: Initial treatment (MONA)
- Morphine, Oxygen, Nitrates, Aspirin
- IV Diamorphine
- Oxygen therapy
- Nitrate spray under the tongue
- High-dose aspirin (300mg)
- Blood tests (routine, heart markers, ECG)
Definitive Treatment:
- Angiography and Angioplasty: If confirmed, referral to a cardiologist for coronary angiography to map out blocked vessels. If many vessels are blocked, a CABG (Coronary Artery Bypass Graft) may be necessary.
Advice:
- Recommendations on diet and exercise.
#1. Upon further exploration, Mr. Jones informed you that he is experiencing chest pain. How would you explore his symptoms further?
#2. Mr jones informed you that he had central chest pain which is crushing in character. The pain is 5/10 and radiates to his neck, shoulder and jaw. Upon further questioning he revealed that he has had similar chest pain last week and it lasted 5 minutes.What is the next best question to ask the patient?
#3. What are the correct differential diagnoses for the case?
#4. Upon further questioning, the patient revealed a family history of myocardial infarction (MI) in his father, who died at 67 years old. Based on this information, which of the following is the most likely diagnosis?
#5. What is your next best step for Mr. Adam Jones?
#6. What are the main investigations that will be offered to Mr Adam Jones?
#7. The examiner informed you that Mr. Jones’s ECG shows NSTEMI. What is the best management combination for Mr. Adam Jones?
Familiarize yourself with UKMLA 2 cases
Begin your UKMLA 2 preparation with our extensive collection of MCQ questions presented in a
case format. Each section includes video lectures that explain how to navigate UKMLA 2
questions effectively. Understanding the management system is crucial for UKMLA 2 success.
Study the management of each case based on NICE and NHS guidelines.
Breakdown of the course
Over 600 UKMLA 2 cases
With over 600 UKMLA cases, you will have access to the largest question bank, preparing you for every scenario you may encounter in
the UKMLA 2 exam
Videos
Get expert explanations on each case from previous UKMLA exam instructors and a preview of NICE CKS guidelines for each
management
Zoom Practice
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takers and kickstart your medical career in the UK
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Detailed Explanations
Make your revision session super efficient by instantly displaying comprehensive
explanations for both correct and incorrect answers
Writing Prescription
With over 600 UKMLA cases, you will have access to the largest question bank, preparing you for every scenario you may encounter in
the UKMLA 2 exam
Click the link below to download prescription charts for Regular
Medications, Antibiotics, Syringe Drivers, and Adult and Pediatric
Fluid Prescriptions.
Dermatology Case:
You are an FY2 in Leeds Road Practice. Ms Emily Balmer, a 28-year-old patient came to your department with some concerns
Additional Information: You have the picture of a lesion in the cubicle
Task: Talk to Mrs Balmer and address her concerns.
About UKMLA 2
What is the UKMLA Part 2?
Starting in 2024, the UK Medical Licensing Assessment (UKMLA) has been introduced as a new examination. It is designed to evaluate the essential knowledge, skills, and behaviours necessary for safe medical practice in the United Kingdom.
UKMLA 2 Exam Format
The UKMLA 2 exam is a case-based assessment designed to evaluate whether a medical doctor is fit to practice in the United Kingdom. It tests various essential skills, including language, listening, rapport, management, diagnosis, examinations, findings, time management, issue resolution, and consultations
UKMLA 2 Revision
The UKMLA 2 revision should focus on:
Covering cases across different concepts such as LGBTQ+ cases, Developmental Milestones, Non-Accidental Injuries, Difficult Colleague Scenarios, Patient refusal of treatments, and Dealing with angry relatives.
Learning to write prescriptions
Breaking bad news
Taking history using approved formats (SOCRATES, FLAWS, PMAFTOSA)
Simman cases
Management using NICE and NHS guidelines
UKMLA 2 Exam Sittings
The UKMLA 2 exam consists of 18 stations, including 2 rest stations, leaving 16 cases with 8 minutes each. Each station involves an examiner and an actor (the patient). High-yield stations among the 16 scenarios include a prescription station, a teaching station, and a Talking Mannikin station (A&E scenario).