Archives: Medical Student Finals

MSFinals-5660

What ultrasound marker is most strongly linked to an elevated risk of trisomy 21 in the developing fetus?

MSFinals-5663

A 62-year-old woman with a history of type II diabetes comes in for her yearly check-up. Her most recent early morning urinary albumin : creatinine ratio (ACR) is 4 mg/mmol (normal for women: < 3.5 mg/mmol). What should be the target blood pressure for managing her diabetic nephropathy?

MSFinals-5664

A 70-year-old woman with type II diabetes mellitus presents to the Emergency Department. She was found to be confused at home by her son. According to her son, the patient is independent and able to take care of herself. On examination she has a temperature of 38.1 °C. Her blood pressure is 136/74 mmHg, and her heart rate is 110 bpm. She is disorientated and not able to provide any history. Physical examination is unremarkable except for tenderness elicited at the right lower back.
Urine dipstick results are shown below:
Investigation Result Normal value
Colour Turbid Clear
pH 6.7 7.35–7.45
Glucose 2+ Negative
Bilirubin Negative Negative
Ketone 1+ Negative
Nitrite 2+ Negative
Leukocytes 3+ Negative
Blood 1+ Negative
Which of the following is the most likely diagnosis?

MSFinals-5665

A 4-year-old child is brought to their General Practitioner (GP) with failure to thrive. His parents complain that he drinks a lot of water and urinates frequently and is not growing very well. The GP does blood and urine tests and diagnoses Fanconi syndrome.
Which of the following features would you most likely see in Fanconi syndrome?

MSFinals-5666

A 35-year-old woman with haematuria underwent a kidney biopsy, but light microscopy results were inconclusive. As a result, the specimen was sent for electron microscopy. Which renal disease requires electron microscopy for diagnosis?

MSFinals-5667

A 43-year-old man is suspected of having a renal calculus. He has some investigations carried out by the general practitioner to monitor the effects of his medication. The following results are obtained:
Plasma
Na+ 138 mmol/l (135–145 mmol/l)
K+ 3.1 mmol/l (3.5–5 mmol/l)
24-hour urine sample:
Ca2+ 40 mg/day (100–300 mg/day)
Given the results above, which one of the following is the patient most likely taking?

MSFinals-5668

A 54-year-old woman presents with back and flank pain affecting both sides. She has been diagnosed some years ago with antiphospholipid antibody syndrome and has suffered from a previous deep vein thrombosis. On assessment, temperature is 36.7oC, heart rate is 76 bpm, blood pressure 128/80 mmHg and she is still passing urine.
Investigations:
Investigation Result Normal value
Sodium (Na+) 141 mmol/l 135–145 mmol/l
Potassium (K+) 6.3 mmol/l 3.5–5.0 mmol/l
Urea 17.3 mmol/l 2.5–6.5 mmol/l
Creatinine 325 μmol/l 50–120 µmol/l
Urine proteinuria +++
Which of the following diagnoses fits best with this clinical scenario?

MSFinals-5669

A 27-year-old woman presents to you with bilateral palpable flank masses and headaches. Her blood pressure is 170/100 mmHg and creatinine is 176.8 μmol/l. She has no past medical history of this, but her family history is significant for renal disease requiring transplant in her mother, brother and maternal grandmother.
On which chromosome would genetic analysis most likely find an abnormality?