Archives: Medical Student Finals

MSFinals-4595

A 14-year-old boy comes to the GP complaining of left groin pain and a limp that has been gradually developing over the past 5 weeks. He has no medical or family history and his right leg is unaffected. Upon examination, there is a noticeable decrease in internal rotation of the left leg, but no swelling or warmth around the joints. The patient’s vital signs are normal, and his height is in the 50th percentile while his weight is in the 95th percentile. What is the most probable diagnosis?

MSFinals-4596

A mother brings her 12-year-old boy into the Emergency Department. She is concerned as he has started to limp over the last few days and is in pain. There is no history of trauma; he has no temperature and is otherwise well. You notice he is overweight for his age.
Which is the most likely diagnosis?

MSFinals-4597

A 9-year-old girl presents to the Emergency department with a three day history of limping. She has been experiencing illness recently. Upon examination, she has no fever and shows discomfort when moving her hip. What is the probable diagnosis?

MSFinals-4598

A 5-year-old girl is seen by the orthopaedic specialist after experiencing a worsening limp for 4 weeks. Her blood tests were normal, and x-rays revealed a hip joint effusion without any significant femoral head structural abnormalities. The doctor diagnosed her with Perthes’ disease. What would be the most suitable initial management plan for this child?

MSFinals-4599

A 4-week old baby is seen by the GP. The baby was born in breech position at 38+4 weeks gestation without any complications during delivery. However, two days after birth, the baby developed jaundice and was treated with phototherapy. The newborn physical examination was normal. The mother has a medical history of anaemia, asthma, and coeliac disease. The baby is currently thriving and is on the 45th centile. What investigations should the GP consider referring the baby for based on their medical history?

MSFinals-4600

A 3-day-old neonate born at term is presenting with tachypnoea, grunting, and cyanosis. The baby is unable to feed and has an oxygen saturation of 70% on room air. On auscultation, a loud S2 and systolic murmur are heard, which is loudest at the left sternal border. The doctors suspect transposition of the great arteries and have started the baby on intravenous fluids, antibiotics, and scheduled surgery. What additional medication should be given in the meantime?

MSFinals-4574

As a FY1 in the emergency department, you encounter a mother and her 5-year-old child who is complaining of a rapidly worsening sore throat, high fever, and excessive drooling from the sides of their mouth. The mother admits that the child has missed some vaccinations due to concerns about their negative effects, but is unsure which ones were omitted. Upon examination, the child is sitting on the examination couch, leaning forward and refusing to move. They are pyrexial (38.1C) with overt drooling from the sides of their mouth, and emitting a soft, high-pitched sound on inspiration. What is the most likely causative agent responsible for this child’s condition?

MSFinals-4575

A 9-month-old boy is brought to the emergency department by his father. His father reports that over the past 4 hours, his son has had episodes of shaking and is less responsive than usual.

On examination, the boy is drowsy and does not respond to voice. You note he has some bruising around his torso. You suspect that the baby may have been shaken.

Which triad of symptoms is consistent with this diagnosis?

MSFinals-4576

A teenager attends the GP with his mother who is concerned about his height. The GP charts the teenager’s height on a growth chart and finds him to be in the 5th percentile. At birth, he was in the 50th percentile. However, the teenager’s developmental milestones are normal, and he appears to be content with himself. What is the most appropriate next step in managing this teenager?

MSFinals-4577

A 4-year-old girl presents to the emergency department with a cough and noisy breathing after experiencing coryzal symptoms for 2 days. Upon examination, she has intercostal recession, a cough, and harsh vibrating noise during inspiration. Although she is afebrile, her symptoms are concerning. What is the probable causative organism?