Archives: Medical Student Finals

MSFinals-5224

A 57-year-old man is recovering on the medical ward after suffering from a pulmonary embolism. He has stage-5 chronic kidney disease and was considered a high bleeding risk, so unfractionated heparin was chosen as the safest anticoagulant. After 6 days of treatment, he developed a rash on his right arm that looks like a bruise, is red, and appears swollen. He also complains of itchiness. The diagnosis is heparin-induced thrombocytopenia (HIT). What is the most appropriate management option for this patient’s anticoagulation?

MSFinals-5225

A 29-year-old woman is brought to the emergency department by her sister. The patient is unresponsive, but the sister reports that the patient had an argument with her partner 4 hours ago and has since ingested at least 7 full packets of aspirin, with the intention of ending her life. The patient has a history of suicidal ideation. Along with other tests, a venous blood gas is taken upon arrival and again after 12 hours. What acid-base abnormalities would be present in this patient at t=0 and t=12?

MSFinals-5226

Which one of the following pairs of features would be expected to occur following administration of an anticholinesterase (acetylcholinesterase inhibitor)?

MSFinals-5227

An 80-year-old man has been diagnosed with osteoporosis after suffering a vertebral fracture. You plan to prescribe alendronate as part of his treatment regimen, alongside his current pain medication. What advice should you provide to ensure he can take the alendronate safely and efficiently?

MSFinals-5228

A 54-year-old woman comes to the Outpatient Clinic with involuntary movements in her lower and upper limbs that began 2 weeks ago. She has a history of schizophrenia and has been taking her medication regularly for the past 4 months, including haloperidol. During the examination, her temperature is 37.6 °C, blood pressure is 122/83 mmHg, and pulse is 96 bpm.

What is the probable diagnosis for this patient?

MSFinals-5229

A 23-year-old female student visits the dentist complaining of a painful mouth and is given a prescription for an antibiotic to treat a dental abscess. The dentist advises her to avoid consuming any alcohol during the course of the treatment due to the possibility of experiencing severe hangovers. What is the name of the antibiotic prescribed to her?

MSFinals-5230

A 25-year-old man has been diagnosed with Wolff-Parkinson-White syndrome and is being treated by the cardiology department. He has declined catheter ablation therapy and has opted for medical therapy. The cardiologist has decided to initiate treatment with amiodarone. The patient has undergone baseline investigations and has been informed about the potential side effects and monitoring requirements of amiodarone. What are the six-monthly investigations that need to be performed in this individual?

MSFinals-5231

A 70-year-old man is prescribed amiodarone for atrial fibrillation. What set of tests should the GP conduct on this patient as a baseline?

MSFinals-5232

A 25-year-old man is diagnosed with schizophrenia and medical management is initiated by the Community Psychiatry team. Two days later, he presents to the Emergency Department with a temperature and severe muscle rigidity. The patient’s mother notes that he has been confused, and at times seems to be drowsy. He has also developed a tremor and seems to be having difficulty walking. Following assessment, a diagnosis of neuroleptic malignant syndrome (NMS) is made.
NMS is a serious side-effect of neuroleptic drugs.
Which of the following is true regarding NMS?

MSFinals-5233

A new medication is being tested on healthy participants. It is only distributed in the vascular space and has limited hepatic metabolism. At 10:00 am, an intramuscular injection of the medication is administered, and a peak plasma concentration is achieved by 11:00 am. The drug concentrations in the blood plasma at different time points are provided below:

Time Drug concentration
11:00 70 mg/L
13:00 50 mg/L
15:00 30 mg/L
17:00 10 mg/L
19:00 0.1 mg/L

What conclusion can be drawn about the clearance of this medication?