MSFinals-5191
A 56-year-old man with stage 4 chronic kidney disease comes in for evaluation. What is the most crucial medication to steer clear of?
Archives: Medical Student Finals
MSFinals-5192
A 31-year-old man visits his GP clinic with complaints of sexual dysfunction. He reports experiencing reduced libido and impaired arousal for the past few months, along with difficulty in achieving and maintaining an erection, even upon waking. Additionally, he has noticed moderate breast development and occasional nipple discharge, which he finds embarrassing. He expresses a desire to start a family with his wife soon.
The patient has a medical history significant for depression, bipolar disorder, hypertension, and type 1 diabetes since he was 14 years old. He takes several medications regularly, including fluoxetine 20 mg once daily, risperidone 2 mg once daily, insulin Levemir 14 units once daily, ramipril 5 mg once daily, and bendroflumethiazide 5 mg once daily.
Which of his regular medications could be responsible for his current symptoms?
MSFinals-5193
A 30-year-old man presents to his GP with a fungal nail infection. He has a history of asthma since childhood, which is well-controlled with inhalers. He recently sustained a meniscal injury while playing soccer and has been taking 1 g paracetamol every six hours for the past week. The GP plans to start him on fluconazole 50 mg daily for the fungal nail infection. Before initiating treatment, the GP orders a routine blood panel:
Haemoglobin: 141 g/L (130-180)
Mean cell volume: 80.1 fL (80-96)
White cell count: 5.3 ×109/L (4-11)
Platelets: 350 ×109/L (150-400)
Prothrombin time: 11.3 sec (11.5-15.5)
APTT: 29.9 sec –
Urea: 4.4 mmol/L (3-7)
Creatinine: 89 μmol/ (50-100)
Sodium: 141 mmol/L (137-144)
Potassium: 4.8 mmol/L (3.5-4.9)
Total bilirubin: 56 μmol/L (1-22)
Conjugated bilirubin: 7 μmol/L (0-3.4)
Unconjugated bilirubin: 48 μmol/L –
ALP: 90 U/L (40-125)
ALT: 34 U/L (0-35)
Gamma GT: 16 U/L (10-85)
Albumin: 44 g/L (37-49)
Which medication, if any, will require a dose adjustment based on the results of these blood tests?
MSFinals-5194
A 48-year-old male with bipolar disorder has been on lithium therapy for 10 years without any issues. He arrives at the emergency department with symptoms of diarrhoea, vomiting, muscle twitching, and ataxia. The blood test reveals a lithium level of 1.6 mmol/l. Which medication is the most probable cause of this presentation?
MSFinals-5195
Each one of the following is a feature of organophosphate poisoning, except for which one?
MSFinals-5196
A 27-year-old female patient presents with painful red lesions on her shins bilaterally, which have been present for three weeks. She had a similar episode two years ago, which resolved on its own. However, this time the lesions are larger and more painful. She denies any issues with her eyes or other joints, and there is no dyspnea or cough. She has not experienced any weight loss or night sweats recently. The patient is sexually active with a regular partner and takes the combined contraceptive pill. She traveled to Tenerife one year ago, and her chest x-ray is normal. What is the probable cause of her symptoms?
MSFinals-5197
A pharmaceutical company is attempting to create a new medication for Parkinson’s disease. They evaluate numerous potential molecules to determine the most encouraging chemicals for further research.
What is the name of this procedure?
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?
MSFinals-5200
A 61-year-old man with metastatic colorectal cancer is admitted to the hospice for end-of-life care. The patient is prescribed ondansetron for management of his nausea symptoms.
Ondansetron acts on which of the following receptors as an antiemetic?