Archives: Medical Student Finals

MSFinals-4761

A 68 year old woman has been admitted to the cardiology ward with worsening symptoms of congestive cardiac failure. She is breathless at rest and has pitting oedema bilaterally to the level of the shins. The cardiology consultant asks you to prescribe a furosemide infusion.
Which of the following mechanisms best describes the way that furosemide acts as a diuretic?

MSFinals-4762

A 65-year-old woman with mitral valve disease and atrial fibrillation is on warfarin therapy. Recently, her INR levels have decreased, leading to an increase in the dosage of warfarin. What new treatments could be responsible for this change?

MSFinals-4763

A 59-year-old man is admitted to the respiratory ward with a suspected pulmonary embolus. He presents with tachycardia, tachypnea, and saturations of 92% on 6L of oxygen. Suddenly, he becomes unresponsive and cardiopulmonary resuscitation is initiated. Despite the first cycle of chest compressions, the defibrillator displays sinus rhythm, but there are no detectable central pulses.

What is the immediate course of action for managing this patient?

MSFinals-4764

A 58-year-old man comes to the Emergency Department with confusion and tremors. He reports excessive sweating earlier in the day. During the examination, hyperreflexia is observed. The patient has a medical history of depression and is currently taking citalopram. Additionally, he has been experiencing back pain and has been prescribed tramadol. What is the probable reason for this man’s symptoms?

MSFinals-4765

You are assisting in receiving a priority call in the Emergency Department for a 27-year-old individual who attempted suicide by drinking insecticide. Which drug should be readily available for this patient upon arrival?

MSFinals-4766

A 57-year-old man presents to the Emergency department with sudden onset of chest pain, breathlessness, and palpitations. An admission ECG reveals ventricular tachycardia (VT) with a ventricular rate of 170 bpm. His blood pressure is 100/66 mmHg, and his oxygen saturations are 95% on air and 100% on high flow oxygen (15 L/min). His blood sugar level is 8.3 mmol/L. Despite his condition, he remains alert and able to communicate. The patient has a medical history of hypertension, type 2 diabetes, and asthma. The medical team administers intravenous amiodarone to attempt to stop the arrhythmia. What is the mandatory intervention while giving intravenous amiodarone?

MSFinals-4729

A 72-year-old man with ovarian cancer is currently taking morphine sulphate modified release (MST) tablets orally 30 mg twice a day. He is admitted under palliative care and his pain is not controlling well. Your consultant asked you to prescribe oral morphine for breakthrough pain.
What dose of Oramorph and frequency should you prescribed?

MSFinals-4730

A 28-year-old male is brought to the emergency department following a car accident that caused severe thoracic injuries. Upon arrival, the patient’s pulses cannot be detected and an ECG reveals asystole. CPR is initiated with a chest compression to rescue breath ratio of 30:2. What is the most appropriate next step in managing this patient?

MSFinals-4731

You are working in the oncology ward and you are called to see a patient with advanced lung cancer and bone metastases. The elderly patient informs you that she is experiencing pain. On looking at her drug kardex, you notice that she is prescribed 30mg of oral long-acting morphine sulfate twice daily and has already taken both doses today. Additionally, she takes regular paracetamol and ibuprofen. What is the appropriate breakthrough analgesia that you should prescribe?