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?
MSFinals-4977
Which of the following drugs is the most suitable to prescribe during the initial trimester of pregnancy for the given indication?
MSFinals-4948
What is the most frequent negative outcome of nicotinic acid therapy in the management of dyslipidemia patients?
MSFinals-4949
A 29-year-old man arrives at the emergency department with confusion and involuntary leg muscle jerks. He is too agitated to provide his medical history. Upon examination, his heart rate is 150/min, respiratory rate 20/min, blood pressure 147/92 mmHg, and temperature 37.9 ºC. He appears sweaty, clammy, and has a resting tremor. Cardiovascular examination is normal, and a neurological examination reveals hyperreflexia. What is the probable diagnosis?
MSFinals-4956
A young adult is a frequent attendee at hospital with recurrent attacks of drowsiness, sweating, and palpitations. The blood glucose level during one of the episodes is 2.9 mmol/l. Recovery occurs in response to intravenous 10% dextrose. C-peptide levels are measured and are found to be below the normal range. Which of the following is the most likely diagnosis?
MSFinals-4957
A 28-year-old female patient presents at the clinic for follow-up. She has been diagnosed with PCOS and is experiencing irregular and heavy menstrual cycles, excessive hair growth on her face and torso, and acne. Currently, she is taking the combined oral contraceptive pill but intends to switch to Dianette. What is the primary mechanism of action of Dianette?
MSFinals-4958
A 75-year-old male is recovering on the ward after being admitted with a community acquired pneumonia. He has completed a course of antibiotics and his latest chest radiograph is clear. He is currently waiting for social services input before discharge. During the morning ward round, the patient reports new symptoms of muscle pain, weakness, and fatigue. He feels nauseous and has vomited once this morning. He has a medical history of osteoarthritis, gout, type 2 diabetes, hypercholesterolemia, atrial fibrillation, and an appendectomy as a child. He is currently taking regular paracetamol, allopurinol, metformin, simvastatin, bisoprolol, and warfarin.
Upon examination, his respiratory rate is 25/min, blood pressure is 131/85 mmHg, heart rate is 95 bpm, and temperature is 36.4ºC. Recent blood tests show: – Na+ 140 mmol/l – K+ 4.8 mmol/l – Urea 12 mmol/l – Creatinine 190 µmol/l – eGFR 26 ml/min – Creatine kinase 174 iu/l (normal range 25-195 iu/l) – CRP 12 mg/l
What is the most likely cause of these symptoms and investigation results?
MSFinals-4959
A 36-year-old woman with a history of Von Willebrand disease underwent a left knee arthroscopy and screw removal with epidural anesthesia. The epidural space was identified at L3-L4 and local anesthetic was administered. During the operation, the patient experienced sensory block to temperature up to the T10 dermatome. After the procedure, the patient was comfortable and the block resolved completely after 2 hours. However, 2 hours later, the patient complained of severe back pain and exhibited 3/5 power in all muscle groups of the right leg, absent right patellar reflex, and reduced sensation to light touch in the right leg.
What complication of epidural anesthesia is likely to be demonstrated in this case?