Archives: Medical Student Finals

MSFinals-5723

An 80-year-old known alcoholic is brought by ambulance after being found unconscious on the road on a Sunday afternoon. He has a superficial laceration in the right frontal region. He is admitted for observation over the bank holiday weekend. Admission chest X-ray is normal. Before discharge on Tuesday morning, he is noted to be febrile and dyspnoeic. Blood tests reveal neutrophilia and elevated C-reactive protein (CRP) levels. A chest X-ray demonstrates consolidation in the right lower zone of the lung.
What is the most likely diagnosis for this patient?

MSFinals-5724

A 65-year-old known alcoholic is brought by ambulance after being found unconscious on the road on a Sunday afternoon. He has a superficial laceration in the right frontal region. He is admitted for observation over the weekend. The admission chest X-ray is normal. Before discharge on Tuesday morning, he is noted to be febrile and dyspnoeic. Blood tests reveal a neutrophilia and elevated C-reactive protein (CRP). A chest X-ray demonstrates consolidation in the lower zone of the right lung.
What is the most likely diagnosis?

MSFinals-5725

A 40-year-old patient visits his GP complaining of a dry cough that has persisted for 3 months. He has been smoking 20 cigarettes daily for the past 12 years and has no other medical history. Upon examination, no abnormalities are found, and his vital signs, including pulse rate, respiratory rate, blood pressure, temperature, and oxygen saturation, are all normal. Spirometry results reveal a forced expiratory volume in 1 second (FEV1) of 3.6 litres (predicted = 3.55 litres) and a forced vital capacity of 4.8 litres (predicted 4.72 litres). What is the most probable diagnosis?

MSFinals-5726

A 54-year-old man who is a long-term cigarette smoker presents with nocturnal dry cough of 4 weeks’ duration. He has recently gone through a stressful life situation due to divorce and bankruptcy. He mentions a history of atopic diseases in his family. His symptom improves with omeprazole, one tablet daily taken in the morning.
What is the most likely diagnosis?

MSFinals-5727

The blood gases with pH 7.38, pO2 6.2 kPa, pCO2 9.2 kPa, and HCO3– 44 mmol/l are indicative of a respiratory condition. Which respiratory condition is most likely responsible for these blood gas values?

MSFinals-5728

A 65-year-old man presents to the Emergency Department with sudden breathlessness and haemoptysis. He had just returned from a trip to Thailand and had been complaining of pain in his left leg. His oxygen saturation is 88% on room air, blood pressure is 95/70 mmHg, and heart rate is 120 bpm. He has a history of hypertension managed with lifestyle measures only and used to work as a construction worker. While receiving initial management, the patient suddenly becomes unresponsive, stops breathing, and has no pulse. Despite prolonged resuscitation efforts, the patient is declared dead after 40 minutes. Which vessel is most likely to be affected, leading to this patient’s death?

MSFinals-5729

A 29-year-old woman comes to the Emergency Department complaining of right-sided chest pain. She reports experiencing fever and shortness of breath for the past week. Upon examination, there are reduced breath sounds on the right side, and a chest X-ray reveals a right pleural effusion without loculation. The patient consents to a thoracentesis to obtain a sample of the pleural fluid.
What is the optimal location for needle insertion?

MSFinals-5730

A 50-year-old man visits the Respiratory Outpatients Department complaining of a dry cough and increasing breathlessness. During the examination, the doctor observes finger clubbing, central cyanosis, and fine end-inspiratory crackles upon auscultation. The chest X-ray shows reticular shadows and peripheral honeycombing, while respiratory function tests indicate a restrictive pattern with reduced lung volumes but a normal forced expiratory volume in 1 second (FEV1): forced vital capacity (FVC) ratio. The patient’s pulmonary fibrosis is attributed to which of the following medications?

MSFinals-5731

A 20-year-old male presents to the Emergency department with left-sided chest pain and difficulty breathing that started during a football game.

Which diagnostic test is most likely to provide a conclusive diagnosis?

MSFinals-5732

What is the most effective method for diagnosing sleep apnoea syndrome?