Archives: Medical Student Finals

MSFinals-4311

A 4-year-old girl presents with a 5-day history of fever, increasing irritability, and a rash. Her mother is concerned as she has been giving her paracetamol and ibuprofen but there has been no improvement. During examination, the child’s temperature is 39.1°C, respiratory rate is 32 breaths/min, and heart rate is 140 beats/min. Further examination reveals bilateral conjunctivitis without exudate, cervical lymphadenopathy, erythema of the oral mucosa, and a non-vesicular rash that is spreading from her hands and feet. What is the immediate treatment that should be administered?

MSFinals-4312

A 35-year-old woman presents at 16+4 weeks gestation for amniocentesis due to a high-risk combined screening test, which revealed trisomy 21. What is a potential late complication associated with this condition?

MSFinals-4313

A 2-year-old girl presents with bilious vomiting, abdominal distension and has been constipated since birth and did not pass meconium until she was 3 days old. Height and weight are at the fifth percentile. On examination, the abdomen is distended and a PR examination causes stool ejection. What is the probable diagnosis?

MSFinals-4314

A 2-day-old male is brought to the neonatal unit due to bilious vomiting and decreased feeding. He was delivered without complications at 32 weeks gestation. An abdominal X-ray reveals intramural gas, prompting the cessation of oral feeding and initiation of broad-spectrum antibiotics. What is the most probable diagnosis?

MSFinals-4315

A 5-year-old boy is seen in an acute paediatric clinic due to unexplained bruising and hepatosplenomegaly on examination. He has a past medical history of Down’s syndrome and was placed in foster care immediately after birth. His birth mother, who was 45 years old at delivery, smoked during pregnancy and has a history of osteosarcoma. After further investigations, including a full blood count and bone marrow aspirate, the diagnosis of acute lymphocytic leukaemia is suspected. What is the most significant risk factor associated with this condition?

MSFinals-4316

A 9-month-old baby is brought to the emergency room with a 4 day history of fever and a new onset rash on the arms, legs, and abdomen that started today. Despite the fever, the baby has been behaving normally and does not seem bothered by the rash. Upon closer examination, the rash appears red with small bumps that are merging together. None of the lesions have scabbed over. The rash is mostly on the limbs and there are no signs of scratching. The baby’s temperature is now normal at 36.9ºC. Based on the likely diagnosis, what is the probable causative organism?

MSFinals-4318

A 10-month-old infant is brought to the emergency department by her mother. She has had a barking cough for the past 2 days and her mother says she has been eating poorly for the past 3 days. During examination, the infant appears calm and is easily entertained by her toys. The barking cough is audible even at rest and there is slight sternal retraction. Vital signs are stable. The diagnosis is croup and treatment is initiated. What is the most appropriate initial treatment for this infant?

MSFinals-4319

A 4-year-old girl is brought to the GP by her father who is concerned about her growth. He reports that she is not keeping up with her peers in terms of height and weight. The girl has been experiencing smelly diarrhoea around 4-5 times per week and complains of stomach pain.
During the examination, the GP notes that the girl’s abdomen is distended and her buttocks appear wasted. Her growth chart shows a drop of 2 centile lines, now placing her on the 10th centile.
Which investigation is most likely to lead to a diagnosis?

MSFinals-4320

A mother brings her 3-year-old daughter to surgery. For the past three weeks, she has been complaining of an itchy bottom. She is otherwise well and clinical examination including that of the perianal area is unremarkable. What is the most appropriate management?