Archives: Medical Student Finals

MSFinals-5113

Mrs. Bowls is a 65-year-old patient who presents with her ankles ‘going into spasm’ when using the pedals of her car over the past couple of days. She also reports a slight tingling in her hands and feet. Apart from this, she has been well recently, without other new symptoms. Her past medical history includes type 2 diabetes and dyspepsia. Her regular medications include metformin, sitagliptin, omeprazole, atorvastatin, and she uses sodium alginate with potassium bicarbonate after meals and before bed as required. You arrange some urgent blood tests, suspecting an electrolyte disturbance. These come back showing hypomagnesaemia.

Which of her medications should you stop?

MSFinals-5114

A 21-year-old male is brought into resus by an ambulance after being found extremely drowsy by his roommate, who wasn’t able to bring him round. The patient is borderline unconscious, with widespread clonus, extreme diaphoresis and dilated pupils. His temperature was taken and it read at 41.6ºC. When asked, the roommate states he is not completely aware of the patient’s past medical history but knows he has suffered from depression. He has also been asked to buy strange medicine from the shops for him but he cannot remember the name.
What is the most likely diagnosis in this patient?

MSFinals-5115

A 50-year-old man has been experiencing a chronic productive cough for a few months along with some instances of mild haemoptysis. He has also been losing weight unexpectedly and having night sweats. Despite having no history of smoking, a sputum sample reveals the presence of acid-fast bacilli. As part of his initial treatment, he is prescribed pyridoxine to reduce the risk of what adverse drug effect?

MSFinals-5116

A 55-year-old woman is presenting with symptoms of menopause such as hot flashes and difficulty sleeping. She has irregular periods and has discussed with her doctor the possibility of starting hormone replacement therapy (HRT). However, she has a medical history of migraines, deep vein thrombosis, and high blood pressure. What is the most suitable course of action?

MSFinals-5094

A 72-year-old retired head teacher undergoes a right hemicolectomy for a colonic carcinoma. The neuromuscular blocking agent used during intubation and surgery acts by competitive inhibition at the receptor site. Which of the following drugs is a neuromuscular blocking agent that works through competitive inhibition?

MSFinals-5095

A 49 year old male patient with a history of type 2 diabetes mellitus, angina and atrial fibrillation comes for a regular check-up. He is worried about experiencing erectile dysfunction and inquires about the use of sildenafil. Which of his medications is an absolute contraindication for its use?

MSFinals-5096

Which drugs act on calcium channels to induce relaxation of smooth muscle?

MSFinals-5097

A 50-year-old man presents to the Emergency Department with progressively worsening shortness of breath on exertion and has recently been waking up at night feeling short of breath. He has a pansystolic murmur found on auscultation, as well as coarse bilateral basal crackles found on auscultation. His echocardiogram reveals a reduced left ventricular ejection fraction (LVEF) and severe mitral regurgitation. Cardiologists recommend that he commences certain medications to improve both his symptoms and long-term outcomes until he has definitive treatment of his valvular pathology.
Which one of the following medications has been shown to reduce mortality in patients with the described condition?

MSFinals-5098

A 50-year-old diabetic male patient arrives at the clinic with worries about his erectile dysfunction. Can you explain the mechanism of action of sildenafil?