Archives: Medical Student Finals

MSFinals-5212

Which diuretic inhibits the co-transport of Na+/K+/2Cl- in the thick ascending limb of the loop of Henle?

MSFinals-5213

You admit a 70-year-old patient who has severe hypercalcaemia, (3.5 mmol/l).
You are asked to commence her on a diuretic likely to promote calcium loss.
Which of the following is the most appropriate choice?

MSFinals-5214

A 55-year-old depressed male is prescribed ciclosporin following a liver transplant. After two weeks, he experiences flu-like symptoms, a fever of 39ºC, and decreased urine output. What substance is most likely responsible for his symptoms?

MSFinals-5186

A 42-year-old nurse takes an intentional overdose of paracetamol. A suicide note was discovered at the scene. Her only past health problem is long-standing, well-controlled epilepsy, for which she takes carbamazepine. She is believed to have taken approximately 30 tablets. When she reached hospital, blood samples were taken. From a collateral history, this is 6 h after ingestion.
Blood investigations:
Investigation Result Normal value
Haemoglobin 141 g/l 115–155 g/l
White cell count (WCC) 6.4 × 109/l 4–11 × 109/l
Platelets 321 × 109/l 150–400 × 109/l
Sodium (Na+) 134 mmol/l 135–145 mmol/l
Potassium (K+) 3.6 mmol/l 3.5–5.0 mmol/l
Urea 4.6 mmol/l 2.5–6.5 mmol/l
Creatinine 76 μmol/l 50–120 µmol/l
Bilirubin 12 μmol/l 2–17 µmol/l
Aspartate aminotransferase (AST) 45 IU/l 10–40 IU/l
Alanine aminotransferase (ALT) 86 IU/l 5–30 IU/l
GGT 74 IU/l 5–30 IU/l
Alkaline phosphatase 53 IU/l 30–130 IU/l
Paracetamol level 110 mg/l
What is the ideal treatment for this patient who is a 42-year-old nurse that has taken an intentional overdose of paracetamol?

MSFinals-5187

In the field of pharmacology, what is the term used to describe a ligand that binds to a receptor and results in a decrease or complete halt in receptor activity?

MSFinals-5188

Drug A activates an intracellular signalling pathway by binding to a receptor on liver cells. Drug B, on the other hand, cannot activate this pathway but has the ability to enhance the effect of drug A. This is achieved by binding to an alternative site on the same receptor.

What term can be used to describe the impact of drug B?

MSFinals-5189

A 40-year-old woman suffers a deep cut to her right hand while cleaning up broken glass. After being evaluated in the Emergency Department and determined to have no nerve damage, the wound is stitched up with the assistance of local anesthesia. What is the primary mode of action for local anesthetics?

MSFinals-5198

A 30-year-old woman reports experiencing recurring, distressing thoughts that have been invading her mind for the past six months. She believes that her hands are contaminated and frequently cleans them with disinfectants and alcohol to alleviate her anxiety. The doctor prescribes fluvoxamine as a treatment.

What is the primary mechanism of action and main side effect of fluvoxamine?

MSFinals-5199

A 60-year-old man comes in with a chronic cough. He reports having a productive cough for a few months now, with occasional mild haemoptysis. He has also experienced some weight loss and night sweats. He has traveled to India multiple times throughout the year. After a sputum sample comes back positive for acid-fast bacilli, what examination should be conducted before beginning treatment?