Archives: Medical Student Finals

MSFinals-4377

A 6-hour-old neonate born at 38 weeks gestation is being evaluated on the postnatal ward. The midwives have observed that the baby is jittery and has irregular breathing. The mother had gestational diabetes. At 6 hours old, a heel prick blood glucose measurement was taken and showed the following result:
Glucose 1.2 mmol/L (1.5 – 6)
Apart from these symptoms, the baby appears to be healthy without other complications. What is the most appropriate course of action for managing this newborn?

MSFinals-4378

A toddler with macrosomia has had a difficult delivery, owing to shoulder dystocia. The obstetrician pulled the child’s head downwards towards the floor to disengage the anterior shoulder from below the pubic bones. When the child is having a check-up prior to discharge, the paediatrician notes that the left upper limb is adducted and medially rotated, with extension at the elbow joint. When questioned, the mother admits that the child has not been moving it.
What is the most likely diagnosis?

MSFinals-4379

A 5-year-old girl presents to you with her parents. She has been experiencing chronic diarrhoea for the past eight months, with five to seven loose stools per day. Her parents report that the stools appear to contain undigested food from previous meals, such as carrots, peas, and sweet corn. Despite this, she has been growing well and remains stable on the 75th percentile for weight, height, and head circumference. She has not experienced any other symptoms or abdominal pain, and her examination is unremarkable. What is the most likely diagnosis from the options below?

MSFinals-4380

A 9-year-old patient comes in with a history of increasing polyuria and polydipsia over the past eight months, along with diffuse bone pain. During the examination, the patient displays exophthalmos, seborrhoeic dermatitis, and indications of mastoiditis. What is the probable diagnosis?

MSFinals-4381

A 2-day-old baby girl is presented to the emergency department by her parents with complaints of decreased oral intake and fussiness. The parents also report that the baby has been vomiting green liquid and has not had a bowel movement since passing meconium, although she has had wet diapers. The baby was born vaginally at 39 weeks without any complications during pregnancy or delivery. An upper gastrointestinal contrast study revealed intestinal malrotation. What is the most appropriate definitive treatment option?

MSFinals-4382

A 20-days-old infant is brought to the emergency department by his parents due to a distended abdomen and lethargy. The parents report a decrease in feeding over the past three days and repeated vomiting, with bilious vomit. The infant also had bloody stools this morning but no fever. He was born prematurely at 35 weeks due to premature rupture of membranes but is currently in good health. Based on the probable diagnosis, which investigation should be conducted?

MSFinals-4383

A 3-month-old infant is presented to the emergency department with abdominal distension and tenderness. The parents report observing a small amount of blood in the diaper and some bilious vomit. They have also noticed reduced movement and difficulty feeding over the past few days. The infant was born prematurely at 29 weeks after premature rupture of membranes. What investigation is most likely to provide a diagnosis?

MSFinals-4384

A 6-day-old infant has been experiencing noisy breathing since birth. A perceptive resident physician identifies that the sound occurs during inhalation. What is the primary reason for stridor in a newborn?

MSFinals-4385

A 15-year-old girl comes to your clinic with concerns about not having started her menstrual cycle yet. As her physician, you decide to investigate the reason for this delay. During the physical examination, you observe that she has low set ears and a short stature. What type of murmur are you likely to detect upon auscultation?

MSFinals-4386

A 3-month-old infant with Down’s syndrome is presented to the GP by his parents due to their worry about his occasional episodes of turning blue and rapid breathing, especially when he is upset or in pain. These episodes have caused him to faint twice. The parents also mention that he has a congenital heart defect. What is the likely diagnosis based on this history?