Archives: Medical Student Finals

MSFinals-5276

A 7-year-old girl is brought to the Emergency Department after falling off her scooter and hitting her face. She had a brief episode of nosebleed which stopped on its own. However, her mother is worried about her breathing, which has become congested and noisy, and her right nostril is getting more swollen. Upon examination, there is an enlarged and red nasal septum on the right side, and a fluctuating swelling can be felt upon palpation. What is the best course of action for this likely diagnosis?

MSFinals-5277

A 75-year-old bedridden patient presents with a wound under their left heel. They complain of pain in the area and feel that the situation is getting worse. Apart from this, they are in good health and have no fever. On examination, you observe an erythematosus area measuring around 2 cm under the left heel, with partial-thickness skin loss affecting the epidermis. There is no necrotic tissue, discharge, or foul odor.
What is the most suitable course of action for this probable diagnosis?

MSFinals-5278

A 21-year-old man visits the Emergency Department after getting into a brawl at a bar, resulting in a cut on his left cheek. He is anxious about the wound leaving a scar as he works as a model, and scarring could affect his career opportunities. What is the most precise statement about wound healing by secondary intention?

MSFinals-5279

A 25-year-old university student comes to the Emergency Department following a fireworks injury. She reports experiencing intense pain in her forearm. Upon examination, her left forearm appears pale pink and is extremely sensitive, with visible blisters. You conduct a palpation of the affected area and find no loss of sensation throughout the region.
What is the probable diagnosis?

MSFinals-5280

A 6-year-old boy spills boiling water on his hand. The lesion is wet, pink, highly tender and blistered. How would you describe this burn?

MSFinals-5281

What is the definition of healing by secondary intention, which is the final stage of tissue response to injury involving regeneration and repair?

MSFinals-5282

As a core trainee on call in England, you are faced with a situation where a 35-year-old patient who is informally admitted and may be suffering from psychosis threatens to leave the hospital while being suicidal. What section of the Mental Health Act can be used to detain this patient?

MSFinals-5283

A 29-year-old man is admitted to a psychiatry ward from the emergency department. He was brought by a concerned family member who was worried by his recent behaviour. He had been engaging in large amounts of shopping, spending nearly every night at the mall and hardly sleeping. When asked if he understands the risks of overspending, he is convinced that nothing can go wrong. He struggles to focus on the topic and begins rambling about buying various different items that are sure to make him happy. A diagnosis of a manic episode is made and he is stabilised on treatment with quetiapine. Subsequently it is decided to initiate lithium to maintain his mood.
When should his serum lithium levels next be monitored?

MSFinals-5251

A 25-year-old male patient arrives at the emergency department with agitation, dry mouth, and blurred vision. He has a history of major depression and admits to taking an overdose of amitriptyline two hours ago in an attempt to end his life. Upon examination, his respiratory rate is 18 breaths/min, heart rate is 110 beats/min, and temperature is 37.7°C. What is the primary investigation that should be conducted based on the patient’s clinical presentation?

MSFinals-5252

An 80-year-old man is admitted following a head injury and presents with indications of elevated intracranial pressure. While awaiting a CT scan, the emergency department team decides to administer mannitol. What is the mechanism of action of mannitol?