Archives: Medical Student Years 1-3

MS-0446

A 48-year-old man visits his local doctor complaining of chest pain that occurs during physical activity and subsides with rest. He first noticed it 10 months ago and feels that it has gradually worsened. He now experiences this pain while climbing a few stairs. Previously, he could walk down to the newsagent and back, a distance of 200 yards, without any discomfort. He has a medical history of hypertension and appendectomy.

His close friend had similar symptoms that were relieved by sublingual glyceryl nitrates. He asks the doctor to prescribe something similar.

What is the mechanism by which nitrates work?

MS-0427

Which one of the following vessels does not directly drain into the inferior vena cava?

MS-0428

A 32-year-old male is admitted for elective surgery for a lymph node biopsy in the supraclavicular region. Following the surgery, the patient experiences difficulty in shrugging his left shoulder. What could be the probable cause?

MS-0429

A 50-year-old man is having a lymph node biopsy taken from the posterior triangle of his neck. What structure creates the posterior boundary of this area?

MS-0430

A 68-year-old man presents to the emergency department after experiencing a syncopal episode. His ECG reveals a prolonged PR interval, with every other QRS complex being dropped. The QRS complex width is within normal limits.

From which area of the heart is the conduction delay most likely originating?

MS-0431

A 16-year-old competitive swimmer visits the paediatric clinic after experiencing palpitations during races or intense training. She has never had shortness of breath or chest pain, but one persistent episode led her to the emergency department where an ECG was taken. Based on the shortening of one of the ECG intervals, a provisional diagnosis of Wolff-Parkinson-White syndrome was made. What does this abnormal section of the ECG represent in terms of electrical activity?

MS-0432

A 32-year-old woman who is 34 weeks pregnant with her first baby is worried about the possibility of her child having a congenital heart defect. She was born with patent ductus arteriosus (PDA) herself and wants to know what treatment options are available for this condition.

What treatment will you recommend if her baby is diagnosed with PDA?

MS-0433

A 25-year-old man comes to the clinic complaining of shortness of breath during physical activity. He has no significant medical history but mentions that his mother passed away while playing netball at the age of 28. During the physical exam, the doctor detects an ejection systolic murmur when listening to his heart. The intensity of the murmur decreases when the patient squats. An echocardiogram is ordered to further investigate.

What findings may be observed on the echocardiogram of this patient?

MS-0434

A 7-year-old girl with Down Syndrome presents to her General Practitioner (GP) with complaints of getting tired easily while playing with her friends and experiencing shortness of breath. The mother informs the GP that the patient was born with an uncorrected cardiac defect. On examination, the GP observes clubbing and plethora.

What is the probable reason for the patient’s current symptoms?

MS-0435

A 35-year-old man comes to the clinic complaining of occasional palpitations and feeling lightheaded. He reports no chest pain, shortness of breath, or swelling in his legs. Upon examination, no abnormalities are found. An ECG reveals a shortened PR interval and the presence of delta waves. What is the underlying pathophysiology of the most likely diagnosis?