Archives: Medical Student Years 1-3

MS-0358

A 78-year-old patient is having an upper gastrointestinal endoscopy to investigate gastro-oesophageal reflux disease. While the procedure is ongoing, the patient experiences several coughing episodes.

Which two cranial nerves are responsible for this reflex action?

MS-0359

A 32-year-old woman arrives at the emergency department with a sudden and severe headache, describing it as the worst she has ever experienced. She has a medical history of hypertension and polycystic kidney disease (PKD). The emergency physician diagnoses a subarachnoid hemorrhage, which is a common complication of her PKD.

What is the gold standard investigation for intracranial vascular disease?

MS-0337

A 14-year-old girl presents to the general practitioner with fever, malaise, involuntary movements of the neck and arms and erythema marginatum. She was previously unwell with tonsillitis six weeks ago. She is taken to the hospital and after a series of investigations is diagnosed with rheumatic fever.

What is the underlying pathology of this condition?

MS-0338

A 54-year-old man is undergoing the insertion of a long venous line through the femoral vein into the right atrium to measure CVP. The catheter is being passed through the IVC. At what level does this vessel enter the thorax?

MS-0339

A 55-year-old man is having a radical gastrectomy for stomach cancer. What structure must be divided to access the coeliac axis during the procedure?

MS-0340

A 4-year-old boy is observed by his mother to turn blue around the lips abruptly after crying. This has occurred several times before and the child promptly assumes the squatting position to alleviate his symptoms. During previous check-ups, the child was found to have various heart issues, including a boot-shaped heart on his chest x-ray.

What is the probable diagnosis for his condition and what is the underlying cause?

MS-0341

A 50-year-old man visits the diabetic foot clinic and has his foot pulses checked. During the examination, the healthcare provider palpates the posterior tibial pulse and the dorsalis pedis pulse. What artery does the dorsalis pedis artery continue from?

MS-0342

A 67-year-old man comes to the emergency department with concerns of pain in his right foot. Upon examination, you observe a slow capillary refill and a cold right foot. The patient is unable to move his toes, and the foot is tender. You can detect a pulse behind his medial malleolus and in his popliteal fossa, but there are no pulses in his foot. Which artery is likely affected in this patient’s condition?

MS-0343

As a curious fourth-year medical student, you observe the birth of a full-term baby delivered vaginally to a mother who has given birth once before. The infant’s Apgar score is 9 at 1 minute and 10 at 10 minutes, and the delivery is uncomplicated. However, a postnatal examination reveals that the ductus arteriosus has not closed properly. Can you explain the process by which this structure normally closes?