Archives: Medical Student Finals

MSFinals-4462

A 4-year-old girl is brought to the emergency department by her father with bruising after a fall. During assessment, it is noted that she has a global developmental delay. She walks with difficulty, has some fine motor skills, and is playing with toys during the consultation. There are bruises on her back, right elbow, and right thigh, at different stages of healing.
Her father reports that these bruises are from her being clumsy for the past few months and he himself once had bruising which required oral steroids and thinks she has developed the same condition.
What would be the most appropriate next step in her management?

MSFinals-4463

A ten-year-old boy with a history of asthma and eczema visits the urgent GP clinic due to a cough. Upon entering the room, he appears to be in good health and is able to speak in complete sentences. His oxygen saturation level is 97% in air, peak expiratory flow is 60% of expected, heart rate is 115/min, and respiratory rate is 28/min. During chest examination, widespread wheezing is observed. What is the appropriate course of action for this patient?

MSFinals-4464

A 4-month-old boy is being seen by his GP for an undescended testi. During the NIPE at birth, his right testi was found to be undescended. On examination today, only one testi is palpated in the scrotum. The patient is referred to the surgeons for further evaluation.

What potential complication is this patient at an elevated risk of experiencing if the undescended testi is not addressed?

MSFinals-4465

A 6-week-old baby and their mum come to the hospital for their postnatal baby check. The infant has an asymmetrical skinfold around their hips. The skin folds under the buttocks and on the thighs are not aligning properly.
What is the most suitable test to confirm the diagnosis?

MSFinals-4466

A 16-year-old girl visits her GP complaining of bilateral knee pain that has been bothering her for the past 2 months, particularly in the mornings. She has also been feeling generally fatigued, but denies experiencing any fevers, weight loss, or rashes. Her mother has a history of systemic lupus erythematosus (SLE), but otherwise, her family history is unremarkable. Upon examination, the patient’s vital signs are within normal limits. There is mild oedema in both knees and ankles, and passive movement of the knee joints elicits tenderness. What is the most likely diagnosis?

MSFinals-4432

A 6-year-old girl arrives at the emergency department with intense pain in her left hip and an inability to bear weight. Her parents are worried about the potential for an infection. She had a cold a week ago, but has since recovered. She seems to be in good health. There has been no hip trauma. Blood tests show normal WBC and ESR levels. An ultrasound of the hip reveals a slight effusion in the joint capsule. What is the best course of action now?

MSFinals-4433

A 5-month-old baby girl is admitted under the paediatric team with a suspicion of possible neglect and non-accidental injury. Both parents have a history of intravenous (IV) drug misuse, and the baby’s older sibling had been taken into care two years previously. The baby girl and her parents have been under regular review by Social Services. When the social worker visited today, she was concerned that the child seemed unkempt and distressed. She also noted some bruising on the child’s arms and left thigh and decided to act on her concerns by calling an ambulance.
Which of the conditions below would be most likely to lead to a suspicion of non-accidental injury?

MSFinals-4434

A 7-year-old boy comes to the clinic complaining of severe pain in his right testicle that started four hours ago. There was no history of injury or any other medical condition. Upon examination, the right testicle was found to be retracted and lying horizontally, but it was too tender to palpate completely. The left hemiscrotum appeared normal. What is the probable diagnosis?

MSFinals-4435

A 5-year-old boy visited his doctor last week due to recurring nosebleeds and bruises on his sides. Upon examination, his clotting was found to be prolonged. The following are his test results, along with the normal ranges for a 5-year-old:
– Hemoglobin: 80g/l (115-135)
– Platelets: 100 * 109/l (150-450)
– White blood cells: 10.0 * 109/l (5.0-17.0)
– Neutrophils: 1.0 * 109/l (1.5-8.5)
What is the most probable diagnosis?

MSFinals-4436

A toddler girl is brought to the emergency room with her abdominal contents protruding from the abdominal cavity. The contents are lined by the peritoneum. Her parents did not seek any prenatal scans during pregnancy.

What is the most probable diagnosis?