Archives: Medical Student Years 1-3

MS-0404

A 67-year-old woman visits her GP for a check-up after suffering from a significant anterior ST-elevation myocardial infarction (STEMI) 3 months ago. She has been feeling constantly fatigued and unwell and is worried that her heart may be causing these symptoms. Additionally, she has been experiencing sharp chest pain that worsens when she lies down and feels slightly breathless.

During the examination, the GP observes that her blood pressure drops by approximately 10mmHg when she inhales.

What is the probable reason for her symptoms and examination results?

MS-0405

A 70-year-old male inpatient, three days post myocardial infarction, has a sudden onset of intense crushing chest pain.
What is the most effective cardiac enzyme to determine if this patient has experienced a recurrent heart attack?

MS-0406

A 35-year-old man arrives at the emergency department with bradycardia. Is it possible for cardiac muscle to stay in phase 4 of the cardiac action potential for an extended period of time?

What happens during phase 4 of the cardiac action potential?

MS-0407

Sarah, a 68-year-old woman, visits her doctor complaining of shortness of breath and swollen ankles that have been worsening for the past four months. During the consultation, the doctor observes that Sarah is using more pillows than usual. She has a medical history of hypertension, hypercholesterolemia, type 2 diabetes mellitus, and a previous myocardial infarction. The doctor also notices a raised jugular venous pressure (JVP) and suspects congestive heart failure. What would indicate a normal JVP?

MS-0408

A 65-year-old male with chronic cardiac failure visits his doctor and reports experiencing dyspnoea even with minimal physical exertion, and only feeling comfortable when at rest. What class of the New York Heart Association scale does he fall under?

MS-0409

An 80-year-old woman comes to the hospital complaining of chest pain, vomiting, and sweating for the past two hours. She has a medical history of hypertension and peripheral arterial disease. Despite using sublingual nitrate spray at home, the pain has not subsided. Upon admission, she is found to be tachycardic and tachypneic, but no other respiratory or cardiac abnormalities are detected. An ECG reveals ST segment elevation in leads II, III, and aVF, as well as ST segment depression in leads I and aVL. Which coronary artery is most likely affected?

MS-0410

A 48-year-old man with a history of hypertension and type 2 diabetes mellitus arrives at the emergency department with loss of vision on the right side.

Which artery disease could be responsible for his symptoms?

MS-0399

A 57-year-old man needs long term parenteral nutrition and a PICC line is chosen for long term venous access. The insertion site is the elbow region of the basilic vein. During catheter advancement, which venous structure is the catheter tip most likely to pass into from the basilic vein?

MS-0400

A 26-year-old man presents to the emergency department after experiencing a syncopal episode. He is currently stable and reports no warning signs prior to the episode. He has had a few similar episodes in the past but did not seek medical attention. Upon further investigation, it is discovered that his father and uncle both died suddenly from heart attacks at ages 45 and 42, respectively. An ECG reveals coved ST segment elevation in V1 and V2 leads, followed by a negative T wave. What is the definitive treatment for this patient’s condition?

MS-0397

A 50-year-old man with a history of rate-controlled atrial fibrillation (AF) presents with chest pain, palpitations, and dizziness. The patient has a past medical history of a transient ischemic episode and is taking warfarin to prevent further ischemic episodes. He also has a history of gout, low back pain, depression, and polymyalgia rheumatica.

Upon immediate ECG, the patient is found to have an irregularly irregular rhythm consistent with fast AF. You decide to perform electrical cardioversion and prescribe a course of amiodarone to prevent recurrence.

What drug interaction should you be cautious of in this patient?