Archives: Medical Student Finals

MSFinals-4387

A six-year-old boy is brought to the doctor by his mother due to some unusual nighttime activity. For the past year, he has been making grunting and gurgling sounds while asleep. Upon entering the room, the doctor notices that the boy’s eyes are wide open, and his mouth is pulled to one side with excessive drooling onto the pillow. The mother is concerned because the boy was found shaking on the floor last night, which lasted for about 30 seconds. After the episode, he was weak and confused for hours. The boy’s older brother has been diagnosed with epilepsy. What is the most probable diagnosis?

MSFinals-4388

A doctor is performing a routine check on a 6-month-old baby and finds that the hips are positive for Barlow and Ortolani tests. What is the most probable situation for this child?

MSFinals-4358

A mother brings her 9-month-old son Henry to the Emergency Department (ED) at 0700 h. She is very concerned. She reports that he has been crying all night. She has two older children: a 4-year-old daughter Allison and a 2-year-old son James, who are both well. Henry was born at 40+1 weeks by normal vaginal delivery. She developed gestational diabetes, but there were no other complications during the pregnancy or birth. Henry has had all his vaccinations. He was breastfed until 6 months old, then bottle-fed. Mother reports that he has been crying non-stop since 0400 h this morning. She tried to feed him, but he vomited twice, minutes after the feed. The first vomit contained food only, the second time it was greenish. Mom has not noticed a change in faeces or urine, except that she has not had to change his nappies since last night. On examination: crying, warm and well perfused, heart rate 150 beats per minute (bpm), abdomen appears distended with tinkling bowel sounds. When you look in his nappies, you notice his stools look like redcurrant jelly.

What is the most likely diagnosis?

MSFinals-4359

A 9-month-old baby is presented to the emergency department due to vomiting and diarrhoea that has been going on for 2 days. The vomit and stools are unremarkable, but the father reports that the baby has been lethargic and unsettled for the past 3 days. Additionally, the baby has had 6 episodes of uncontrollable crying where he draws his legs up to his chest for a few minutes at a time. The baby has no fever. During the examination, the baby appears pale and lethargic, and a small mass is palpated in the right upper quadrant. To investigate further, a plain abdominal x-ray is performed, which shows no signs of obstruction, and an ultrasound scan reveals a target sign. What is the most probable diagnosis?

MSFinals-4360

A 12-year-old girl who plays soccer starts to feel discomfort during games. She visits her doctor and is diagnosed with Osgood-Schlatter disease.

Which bony prominence is affected by the inflammation that causes this condition?

MSFinals-4362

A 25-year-old pregnant woman is worried about her fetus after a routine ultrasound showed a large patent ductus arteriosus. She has read about indomethacin as a treatment option and wants to know more about the drug. What information will you provide her regarding the administration of indomethacin?

MSFinals-4363

You are a healthcare professional at the paediatric oncology unit and you have been summoned to speak with the parents of a 6-year-old boy who has recently been diagnosed with acute lymphoblastic leukaemia (ALL). The parents are anxious about their older daughter and are wondering if she is also at a higher risk of developing ALL. Can you provide them with information on the epidemiology of acute lymphoblastic leukaemia?

MSFinals-4364

A 5-year-old boy is brought to see GP by his mom with a seal-like barking cough. His mom is worried as he seems to be struggling with his breathing, especially at night.

On examination, he is alert and engaging, although has mild sternal indrawing and appears tired. His observations are as follows:

Heart rate: 90 bpm
Blood pressure: 110/70 mmHg
Oxygen saturation: 98% on air
Respiratory rate: 20 breaths/min
Temperature: 37.2 C°

You suspect croup. What statement best fits this diagnosis?

MSFinals-4365

A 3-month-old boy is brought to the emergency department by his mother. She reports a 3 hour history of a non-blanching rash all over his body. She also mentions that he has been more fussy than usual and has been refusing to eat.
Upon examination, the baby has a temperature of 38.9ºC and a non-blanching petechial rash with overall hypotonia. The anterior fontanelle is also bulging.
Based on the likely diagnosis and appropriate investigation, what would be the most suitable initial management option?