Archives: Medical Student Finals

MSFinals-4357

A 9-month-old infant is presented to the emergency department by his parents due to several hours of profuse vomiting. The vomit is thick and green in colour, and the infant has not had any wet nappies in the past 24 hours. Upon examination, the infant appears distressed and is crying. An abdominal examination reveals a distended abdomen and absent bowel sounds. The infant has no significant medical history, and the pregnancy and delivery were uneventful. What is the most probable diagnosis?

MSFinals-4327

A 6-week-old girl is brought to the hospital and placed under the care of the paediatric surgeons due to her parents’ concern about her symptoms. She has been experiencing projectile vomiting, weight loss, and constant hunger. The doctors have made a preliminary diagnosis of pyloric stenosis. What is the probable biochemical abnormality associated with this condition?

MSFinals-4328

A one-month-old baby boy develops bluish skin and mucous membrane discoloration. The pregnancy and delivery were uncomplicated. The arterial oxygen saturation is 70%, and the arterial partial pressure of oxygen is 35 mmHg (normal range is 75-100 mmHg) after receiving 100% oxygen. There are no signs of respiratory distress or pulmonary edema upon examination. What is the probable reason for the infant’s discoloration?

MSFinals-4329

A father brings his 2-day-old son to the pediatrician for a routine check-up. During the examination, the pediatrician notices that the baby’s skin has a yellowish tint. The pediatrician suspects that the baby has jaundice and investigates further.
What is a possible reason for jaundice caused by reduced bilirubin conjugation?

MSFinals-4330

A 4-year-old girl is brought into resus in cardiac arrest. The patient was brought in by ambulance with her father. He is too distraught to give any history other than the child had been okay when he had left the room. She was found unconscious on his return so an ambulance was called.
Which of the reversible causes of cardiac arrest are most likely in this situation?

MSFinals-4331

A 7-year-old girl is brought to the emergency department by her mother. The mother reports that her daughter has been running a fever for the past 5 days and has been acting differently. Despite giving her paracetamol, the fever has not subsided.
During the examination, the girl presents with cracked, bright red lips, conjunctival injection, palpable lymph nodes in the cervical area, and redness on the palms of her hands and soles of her feet.
What medication should be given based on the probable diagnosis?

MSFinals-4332

A 7-year-old girl is brought to the clinic by her mother who reports that her daughter becomes breathless when climbing stairs at home. The mother is concerned as her daughter is unable to keep up with her peers. During the examination, multiple small bruises of varying ages are observed on both lower legs. The patient is afebrile and appears to be in good health. A soft systolic murmur is heard on the left sternal edge during cardiac examination. Palpation of the abdomen reveals a mass in both the left and right hypochondriac regions. What is the most likely diagnosis?

MSFinals-4333

A 9-year-old boy presents with colicky abdominal pain, nausea, vomiting, and diarrhoea over the past 3 days. The child’s mother reports that the diarrhoea is associated with passage of blood and mucous. He also had arthralgia of the knees, elbows, ankles, and wrists. On examination, there is an obvious palpable purpuric rash on his extremities. Investigations revealed:
Investigation Result Normal value
Haemoglobin 120 g/l 115–140 g/l
White cell count (WCC) 15 × 109/l 5.5–15.5 × 109/l
Platelet count 350 × 109/l 150-–400 × 109/l
BUN (blood urea nitrogen) 6.3 mmol/l 1.8–6.4 mmol/l
Serum creatinine 89.3 μmol/l 20–80 μmol/l
Urine analysis shows: Microscopic haematuria and proteinuria 1+
After a few days the child recovered completely without any treatment.
Which one of the following is the most likely diagnosis?

MSFinals-4334

A 1-day-old child is found to have absent femoral pulses and a systolic ejection murmur over the left side of their chest and back upon their routine examination. Their brachial pulses are strong. They appear pale and are tachypnoeic. They have not managed to eat much solid food, as they become distressed.

Which of the following statements about their condition is true?

MSFinals-4335

A 7-year-old boy presents to his GP with recurrent head lice. The GP notices that the child has had several attendances to the Emergency Department with asthma exacerbations, but has not attended an asthma review for several years and his inhalers have not been ordered for several months.
When would a social services referral be indicated in the first instance?