Archives: Medical Student Finals

MSFinals-4966

A 23-year-old man is brought to the emergency department by ambulance after being found shouting at shoppers in a corner of a supermarket. He claims that the shoppers were trying to kill him and he sees coloured halos around the shop shelves. He has no past medical history. His vital signs are as follows: heart rate of 120 bpm, respiratory rate of 20/min, blood pressure of 130/90 mmHg, and temperature of 38°C. He is agitated, clammy to touch, and has dilated pupils despite adequate lighting. Both hands show a fine tremor. What drug overdose is responsible for his symptoms?

MSFinals-4967

A 16-year-old patient is brought into the emergency department by her friends at 2 am, following a night out. Her friends are worried as she is sweating excessively and is extremely disoriented. They also mention she has become jerky and rigid over the last 30 minutes. Upon further questioning, they reveal that the patient has used recreational drugs.

During the examination, the patient’s temperature is found to be 38.4ºC and she remains disorientated. Her medical history includes depression and hypothyroidism, for which she takes fluoxetine and levothyroxine. Based on the symptoms, what is the likely cause of this presentation?

MSFinals-4968

Your next patient is a 23-year-old woman who presents with symptoms of depression. She reports being allergic to all selective serotonin reuptake inhibitors and requests dothiepin and temazepam. Upon examination, you observe that she appears thin and disheveled. Additionally, she exhibits rhinorrhea, watery eyes, and frequent yawning. What is the probable underlying issue?

MSFinals-4970

A 45-year-old woman visits her doctor with a complaint of skin wheals. These wheels are often linked to migraines that she experiences occasionally before her menstrual cycle. She has a clean medical history, takes the progesterone-only pill, an over-the-counter multivitamin, and aspirin for pain relief as needed. She has no known allergies. What is the probable reason for her urticaria?

MSFinals-4971

Linda is a 51-year-old woman who is currently perimenopausal and visits your GP clinic seeking advice on how to manage her night sweats, hot flashes, and mood swings. She has heard about hormone replacement therapy (HRT) and is interested in trying it to alleviate her symptoms. She has a medical history of hypothyroidism and experienced a deep vein thrombosis (DVT) a decade ago.

What are the HRT choices you would suggest to her?

MSFinals-4972

A 49-year-old woman comes to the clinic complaining of irregular periods, hot flashes, and night sweats. She has had two uncomplicated pregnancies in the past and has been using a Mirena coil for the last five years. She is interested in exploring hormone replacement therapy (HRT) as a treatment option. Her mother had a history of DVT in her 40s. Based on her medical history, what would be the most suitable course of action?

MSFinals-4973

A 42-year-old man presents with a one-month history of tingling sensation in his fingers, toes and around the mouth. Initially, the symptom only affected his fingers but has since spread and gradually worsened. He had a similar symptom a couple of years ago and was diagnosed with low calcium levels. The patient reports no muscle weakness, tremors or other neurological symptoms. He is currently taking esomeprazole for reflux symptoms. His recent blood test showed a calcium level of 2.2 mmol/L (2.1-2.6). What electrolyte abnormality could be causing this patient’s presenting symptoms?

MSFinals-4974

A 55-year-old woman visits her General Practitioner (GP) with complaints of feeling down for some time. She reports experiencing episodes lasting approximately three minutes where she suddenly becomes very anxious and hyperventilates. Upon further inquiry, the GP discovers that this has been progressively worsening over the past two months. The patient is interested in knowing if there are any medications that could assist her.
What is the mode of action of monoamine oxidase inhibitors?

MSFinals-4975

A 75-year-old patient is admitted to the hospital for an elective total hip replacement. Thromboprophylaxis with dalteparin is administered before the surgery. After eight days, the patient complains of pleuritic chest pain and shortness of breath. The full blood count results reveal a pulmonary embolism. The following are the patient’s blood count results: Hb 124 g/L (Female: 115-160; Male: 135-180), Platelets 76 * 109/L (150-400), and WBC 6 * 109/L (4.0-11.0). What is the most probable cause of the pulmonary embolism?

MSFinals-4976

A 72-year-old retired teacher is prescribed donepezil for mild Alzheimer’s dementia. What side-effects should she be warned about before starting the medication?