MSFinals-4742
What is the most suitable time to collect blood samples for therapeutic monitoring of phenytoin levels in pediatric patients?
Archives: Medical Student Finals
MSFinals-4743
A 23-year-old man who is currently living in student accommodation is brought in by ambulance. His flatmates returned from lectures and found him slumped over a chair with features of dizziness, headache and a reduced conscious level. He lives in student accommodation and his flatmates reveal there have had problems with the boiler but the landlord has not sorted these out. He denies any illicit drug use or relevant past medical or surgical history. The paramedics arrived and found him lying on the floor with cyanosis of his skin.
Examination findings:
Oxygen saturations on room air are 97%
Blood pressure is 120/80 mmHg
Heart rate 80 bpm
Respiratory rate 16 breaths per minute
Temperature 37.1 C
Heart sounds normal without added sounds
Chest clear without added sounds and vesicular in nature
pH 7.35
pO2 8.3 kPa
pCO2 5.8 kPa
Bicarbonate 24 mmol/l
What is the most appropriate target oxygen saturations to aim for, given the likely diagnosis?
MSFinals-4744
A 24-year-old student is brought into the emergency department by paramedics. He is unconscious.
Interpret the liver function tests and choose the most appropriate investigation to confirm the likely diagnosis:
Bilirubin 164 µmol/l
ALP 213 u/l
ALT 11641 u/l
AST 9465 u/l
Albumin 27 g/l
MSFinals-4745
What term is used to describe reactions that can render a drug inactive?
MSFinals-4746
A woman in her mid-thirties arrives at the haemodialysis clinic for her regular appointment. Before the session, a typical amount of unfractionated heparin is given. What is the drug’s mechanism of action?
MSFinals-4747
What is the most appropriate mechanism to describe the action of simvastatin?
MSFinals-4712
An 82-year-old woman with metastatic breast cancer is referred to the Palliative Care team for assessment and planning of further care.
Which of the following best describes the role of palliative care?
MSFinals-4713
A 70-year-old man is in hospice care and his family is concerned about his lack of food and water intake. They fear that this may cause him discomfort and pain.
What is the most crucial side-effect of dehydration due to poor oral intake that needs to be addressed in an actively dying patient?
MSFinals-4714
A 65-year-old lady with metastatic breast cancer is admitted to the hospice for ongoing care. She complains that, at night, strange men enter her room and move her belongings and that staff talk about her during the day. In addition, she sometimes sees a vision of her deceased sister in her room and this has caused her anxiety and distress.
Which of the following medications would be most appropriate to treat her symptoms?
MSFinals-4715
You are the out-of-hours General Practitioner (GP) on call. You receive a call from the relative of an 85-year-old woman with palliative breast cancer and a complete Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order. The relative believes she has passed away and is not sure what to do. You offer your condolences and arrange a home visit to confirm death.
Which of the following should be confirmed in order to diagnose death?