Archives: Medical Student Years 1-3

MS-0299

A 65-year-old man presents to the vascular clinic with bilateral buttock claudication that spreads down the thigh and erectile dysfunction. The vascular surgeon is unable to palpate his left femoral pulse and the right is weakly palpable. The patient is diagnosed with Leriche syndrome, which is caused by atherosclerotic occlusion of blood flow at the abdominal aortic bifurcation. He has been consented for aorto-iliac bypass surgery and is currently awaiting the procedure.

What is the vertebral level of the affected artery that requires bypassing?

MS-0300

A patient in their 60s develops complete heart block in hospital after experiencing a myocardial infarction. Their ECG displays a heart rate of 37 beats per minute and desynchronisation of atrial and ventricular contraction. What is the most probable coronary artery that is occluded in heart block during a myocardial infarction, indicating damage to the AV node?

MS-0287

A 56-year-old man visits his GP complaining of congestive heart failure, angina, and exertional syncope. During the examination, the doctor observes a forceful apex beat and a systolic ejection murmur at the upper right sternal border.

What condition is most likely causing these symptoms?

MS-0288

A 40-year-old male patient complains of shortness of breath, weight loss, and night sweats for the past six weeks. Despite being generally healthy, he is experiencing these symptoms. During the examination, the patient’s fingers show clubbing, and his temperature is 37.8°C. His pulse is 88 beats per minute, and his blood pressure is 128/80 mmHg. Upon listening to his heart, a pansystolic murmur is audible. What signs are likely to be found in this patient?

MS-0289

A 51-year-old woman has just had a right hemiarthroplasty and is now experiencing sudden onset of shortness of breath and sharp pleuritic pain on the right side of her chest. A chest x-ray is done as part of the initial evaluation, revealing a wedge-shaped opacification. What is the probable diagnosis?

MS-0290

A 57-year-old woman comes to see her GP to discuss the findings of her ABPM, which revealed a blood pressure reading of 145/90 mmHg, leading to a diagnosis of stage 1 hypertension. What is the most common symptom experienced by patients with this condition?

MS-0291

You are asked to evaluate a 5-day old cyanotic infant named Benjamin. Benjamin has had a chest x-ray which shows a heart appearance described as ‘egg-on-side’. What is the probable underlying diagnosis?

MS-0292

A 68-year-old man arrives at the emergency department complaining of intense abdominal pain that spreads to his back. His medical history shows that he has an abdominal aortic aneurysm. During a FAST scan, it is discovered that the abdominal aorta is widely dilated, with the most significant expansion occurring at the point where it divides into the iliac arteries. What vertebral level corresponds to the location of the most prominent dilation observed in the FAST scan?

MS-0293

A 57-year-old woman visits her doctor with complaints of flushing and warmth. She has been in good health lately, except for a stomach bug she had two weeks ago. Her medical history includes hyperlipidemia, hypertension, myocardial infarction, and type II diabetes mellitus. Although she used to smoke, she has quit and does not drink alcohol. She lives with her husband in a bungalow.

During the consultation, she reveals that her cardiologist recently prescribed niacin to her. Her recent lab results show an increase in total cholesterol.

Which of the following is responsible for the adverse effects observed in this patient?

Substance P
15%
Bradykinin
20%
Prostaglandins
48%
Serotonin
9%
Kallikreins
8%

The adverse effects of niacin, such as flushing, warmth, and itching, are caused by prostaglandins.