MSFinals-0856
A 65-year-old man with lung cancer was admitted to the Emergency department due to respiratory distress. Upon examination, his ECG revealed electrical alternans. What is the most probable diagnosis for this patient?
Med Student Finals Category: Emergency Medicine
MSFinals-0872
A 47-year-old man with HIV and a CD4 count of 46 is found to have ‘owl’s eye’ inclusion bodies on histological tissue staining. Which virus is this finding suggestive of?
MSFinals-0857
A 20-year-old male with sickle cell disease complains of severe abdominal pain. He has a blood pressure of 105/80 mmHg, heart rate of 110 bpm, and temperature of 38.0°C.
What would be your initial step?
MSFinals-0873
A known case of chronic obstructive pulmonary disease (COPD) presents to the Emergency department, distressed and cyanosed. Arterial blood gases reveal pH 7.2 (7.36-7.44), PaO2 8.3 kPa (11.3-12.6 kPa), PaCO2 10 kPa (4.7-6.0 kPa). The patient, who is in his 60s, is given high concentration oxygen together with a salbutamol nebuliser and intravenous hydrocortisone. Despite these interventions, the patient’s breathing effort worsens, although pulse oximetry showed SaO2 of 93%. What could be the reason for the patient’s deterioration?
MSFinals-0858
What virus is described as a picornavirus with a single stranded RNA genome, transmitted through faecal-oral route, and has no chronic sequelae?
MSFinals-0859
The following arterial blood gases (ABGs) were taken from an unconscious 50-year-old woman in the Emergency department on FiO2 of 21%:
pH 7.36 (7.36-7.44)
pO2 13.0 kPa (11.3-12.6)
pCO2 3.7 kPa (4.7-6.0)
HCO3− 15 mmol/L (20-28)
What is the correct interpretation of the ABG result?
MSFinals-0860
As the foundation year doctor in general surgery, you are called to assess a patient who has suddenly become unresponsive at 4 am. The patient is a 45-year-old female who has been admitted for an elective cholecystectomy scheduled for 8 am.
Upon examination, the patient appears sweaty and clammy and is hypoventilating. She is only responsive to painful stimuli.
The patient’s vital signs are as follows: heart rate of 115, blood pressure of 110/70 mmHg, respiratory rate of 8, oxygen saturation of 99%, and blood glucose level of 1.1.
What would be your next step in initiating drug therapy?
MSFinals-0845
A 78-year-old male is brought to the Emergency department by ambulance after experiencing a cardiac arrest. The ambulance crew is currently performing resuscitation attempts. Upon arrival, the patient has been intubated and connected to a defibrillator monitor, which shows a slow sinus rhythm (pulseless electrical activity) at a rate of 30 complexes per minute. The patient has been administered the full drugs protocol in accordance with the latest Adult Advanced Life Support guidelines. What do these guidelines recommend regarding the use of adrenaline during cardiac arrest?
MSFinals-0846
A 26-year-old man with a history of asthma is admitted to the hospital for a left lower lobe pneumonia. He is prescribed amoxicillin, but within two minutes of taking the antibiotic, he complains of feeling unwell. A rapidly developing, erythematosus, macular rash appears on his trunk and limbs, along with large wheals on his torso. He also experiences lip and tongue swelling and a harsh wheeze is heard when his chest is auscultated. His blood pressure is 84/39 mmHg, and his heart rate is 167 bpm, which is determined to be a sinus tachycardia when connected to cardiac monitoring. His oxygen saturation levels are at 90% on air, so he is put on high flow oxygen.
What is the most appropriate drug to administer next?
MSFinals-0847
As the foundation year doctor on ward cover, you are asked to assess a 75-year-old male who was admitted to the cardiac care unit five hours ago due to chest pain. The patient has been given morphine, aspirin, clopidogrel, enoxaparin, and metoprolol. However, he has recently experienced a sudden worsening of chest pain, and his heart rate has dropped to 30 beats per minute. His other vital signs are BP 140/85 mmHg, O2 98%, and RR 18. An ECG has been conducted, revealing complete heart block. What is the most probable cause of this sudden development?