Archives: Medical Student Finals

MSFinals-4215

Sophie is a 16-year-old girl who is admitted with abdominal pain. An ultrasound scan report comes back with findings consistent with appendicitis. Her parents do not want her to undergo surgery.

Sophie appears to be a mature and intelligent young woman and is currently in a stable condition. After extensive discussions with her parents and the surgical team, Sophie expresses her desire to undergo surgery. However, her parents are unhappy with her decision and threaten to sue the hospital if she goes through with the operation.

What is the appropriate course of action in this situation?

MSFinals-4216

An infant is admitted to the neonatal intensive care unit with low Apgar scores at birth. During examination, the infant is found to have micrognathia, low set ears, overlapping fingers, and rocker-bottom feet. What is the most probable diagnosis?

MSFinals-4217

A 10-year-old boy with Down’s syndrome, asthma, reflux, and hyperthyroidism is brought to the GP by his mother due to concerns about his chronic snoring. What could be the potential cause of his snoring based on his medical history?

MSFinals-4218

A 14-year-old boy presents to the clinic for a routine check-up due to his recent development of poor near vision, without any history of eye trauma. He is tall, measuring at the 99th percentile for his age, and is performing well in school. During the medical history, he reports experiencing fatigue easily during physical activity. Upon examination, you observe that he has a high arched palate, pectus excavatum, and long arms. Additionally, you notice a bounding pulse and an early diastolic murmur at the left sternal edge during the cardiovascular exam. What is the most likely diagnosis?

MSFinals-4219

You are summoned to the delivery room for the forceps delivery of a baby of 37 week gestation who experienced fetal distress during labour. The attending obstetrician passes the baby to you for resuscitation. What is the initial step?

MSFinals-4220

A 4-month-old infant presents with jaundice and difficulty feeding. The baby was born via caesarean section at 38 weeks with an APGAR score of 8 and 9 at 1 and 5 minutes, respectively. There are no dysmorphic features or rashes on examination, and vital signs are within normal limits. The family history is significant for the father and older sibling having a condition that causes transient, asymptomatic episodes of jaundice. Laboratory results show a conjugated bilirubin level of 72 µmol/L (normal range: 3-17), unconjugated bilirubin level of 10 µmol/L (normal range: 3-17), ALP level of 134 u/L (normal range: 30-100), ALT level of 58 u/L (normal range: 3-40), and γGT level of 197 u/L (normal range: 8-60). What is the most likely diagnosis?

MSFinals-4221

You are working on the neonatal ward and are called to see a newborn who the nurses have noticed is persistently ‘floppy’. You assess the newborn and find no acute cause for concern and wonder whether there might be an underlying issue.
Which of the following is most likely to be the underlying cause of neonatal hypotonia in this case?

MSFinals-4222

Which one of the following statements regarding Perthes disease is incorrect?

MSFinals-4223

A mother takes her four-week-old daughter to visit her pediatrician. The baby has been throwing up white substance after feeds, particularly when laid down afterwards. The mother reports that the baby also frequently cries during breastfeeding. The baby was born at 36 weeks through vaginal delivery and has been meeting developmental milestones. There are no other siblings. There have been no instances of bloody stools or diarrhea. What is the probable diagnosis?

MSFinals-4224

A couple brings their 5 week old formula fed baby to the short stay paediatric ward due to persistent non-bilious vomiting and increasing lethargy. However, the baby’s appetite remains substantial. During examination, the baby appears pale and visible peristalsis is observed in the left upper quadrant. What is the probable diagnosis?