Archives: Medical Student Finals

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?

MSFinals-5100

A 30-year-old woman is receiving treatment for a severe exacerbation of ulcerative colitis on a general medical ward. She is currently on IV steroids for the past 4 days. During the morning ward round, her bloods are taken to assess her illness. The results are as follows:

Na+ 136 mmol/L (135 – 145)
K+ 3.5 mmol/L (3.5 – 5.0)
Bicarbonate 25 mmol/L (22 – 29)
Urea 6.5 mmol/L (2.0 – 7.0)
Creatinine 112 µmol/L (55 – 120)
Magnesium 0.38 mmol/L (0.8 – 1.1)
CRP 32 (<5) What would be the most appropriate next step in managing this patient’s illness?

MSFinals-5080

A 70-year-old hypertensive man has been prescribed six medications but still has uncontrolled hypertension. You suspect that he is not adherent to his medications.
Which screening tool is the best to use to determine his adherence to his medications?

MSFinals-5084

A 36-year-old male intravenous drug user presented to the emergency department with fever, shortness of breath and headache. During examination, a pansystolic murmur was detected. His temperature was 39.5ºC and his heart rate was 130/min. Blood tests conducted in the emergency department showed elevated levels of WBC and CRP. He was admitted to the ward and started on empirical antibiotic treatment. However, on the second day of admission, he became anuric and a blood sample revealed abnormal levels of Na+, K+, urea, and creatinine. Which medication administered during this admission is most likely responsible for the patient’s deterioration on day 2?

MSFinals-5085

A 25-year-old male contacts emergency services claiming to have ingested insecticide in a suicide attempt. He is a final year student studying agriculture and is experiencing mental health difficulties. During the assessment, he appears lethargic and uncommunicative. His eyes are constantly watering, and he is drooling saliva. Additionally, he seems to have experienced urinary and fecal incontinence.

What physical signs would you anticipate discovering during the examination?

MSFinals-5086

What is the most frequent side effect of simvastatin therapy in the management of dyslipidemia in patients?

MSFinals-5087

A 45-year-old woman has been diagnosed with ovarian carcinoma and is scheduled to start chemotherapy. The first line chemotherapy for ovarian cancer in her area is based on paclitaxel. What is the most appropriate description of paclitaxel for this patient?

MSFinals-5088

Sarah, a 54-year-old patient, has recently received a renal transplant and has been prescribed a medication called ciclosporin to prevent transplant rejection. She is feeling anxious and wants to know about any potential side effects of this medication.
What are the possible side effects of ciclosporin?

MSFinals-5089

A 53-year-old man is brought to the ED by ambulance after his daughter found him acting strangely in the basement. During transport, he experienced a seizure lasting for 2 minutes. According to the daughter, she found an empty bottle of insecticide near him, and he had been feeling down for the past few months after his divorce.

What would be the best initial approach to managing this patient?