MSFinals-4176
Which condition is frequently associated with plethoric lung fields on radiological imaging?
Archives: Medical Student Finals
MSFinals-4177
A 2-year-old child is brought in for a routine check-up, with concerns from the parents that the child is smaller than expected for their age. The parents mention that the child has difficulty with eating and mainly consumes milk and soft foods. The child appears healthy upon examination, but is found to be on the 3rd percentile for weight. During a cardiac examination, a systolic murmur is detected in the pulmonary area and a fixed splitting to the second heart sound is heard. All pulses are palpable and within normal range. What is the most likely diagnosis?
MSFinals-4178
A 4-year-old child is brought to your office by their mother, complaining of diarrhoea that has been ongoing for a few months. The mother reports that the diarrhoea does not have a foul smell but sometimes contains undigested food. The child does not experience any abdominal pain or bloating. Upon measuring their height and weight, it is found to be appropriate for their age. What is the most probable diagnosis?
MSFinals-4179
As an FY2 doctor in the Paediatric Emergency Department, you encounter an 8-month-old girl who has been brought in after experiencing rectal bleeding. According to her parents, she has been suffering from abdominal pain since this morning, drawing her legs up into the fetal position, and has had little appetite, which is unusual for her. She vomited three times and then passed bloody stools, which were described as jelly-like red and slimy. The child has been weaned for the past 2 months and only given baby food. Upon examination, you notice right lower abdominal tenderness, dehydrated mucous membranes, and a vague mass in her right lower abdomen. What is the most probable diagnosis?
MSFinals-4180
A 10-day-old preterm neonate is having difficulty tolerating cow’s milk feeds administered by the nurses in the special care baby unit. During the most recent feed, the neonate vomited and the nurse observed bile in the vomit. Although the stools are of normal consistency, the last stool contained fresh red blood. Upon examination, the neonate appears to be well hydrated, but the abdomen is significantly distended. An urgent abdominal x-ray is ordered, which reveals distended loops of bowel with thickening of the bowel wall. What is the next course of action in managing this situation?
MSFinals-4181
A baby born to a 28-year-old woman has ambiguous genitalia on examination; the rest of the physical examination is normal. Genotype is determined to be XY. The testes are retained within the abdominal cavity, and the internal reproductive tracts exhibit the normal male phenotype.
What could be the possible cause of this abnormal development?
MSFinals-4182
A 13-year-old girl presented with cystic hygroma and significant oedema. At the age of 27, she had a short stature, a webbed neck and a broad, shield-like chest. She did not develop secondary sexual characteristics at the appropriate age. What is the most probable diagnosis?
MSFinals-4183
A paediatrician is called to assess a 3-day-old neonate born at 37+2 weeks gestation due to concerns in the newborn physical examination. The neonate has absent fundal reflexes bilaterally and a loud machinery murmur is heard on auscultation. Automated otoacoustic emission suggests sensorineural deafness. The mother recently arrived from overseas where she was unable to access antenatal care. In the first trimester, she had an exanthematous rash on her trunk, but the pregnancy was otherwise unremarkable. What is the likely diagnosis for this neonate?
MSFinals-4184
A 23-year-old woman with a history of bipolar disorder gives birth to a baby girl at home. She received no prenatal care, but when she found out she was pregnant, she started taking prenatal vitamins that she got from the pharmacist. Her only medication is valproic acid. It is 2 days since the birth, and the mother has brought her baby to the Emergency Department because she has become impossible to arouse. On examination, the baby is estimated to have been born at 35 weeks’ gestation. The baby is afebrile, with stable vital signs. A head ultrasound through the fontanelle shows an intracerebral haemorrhage in the germinal matrix. There are no calcifications. Retinal examination does not show petechial haemorrhages. A full skeletal survey is negative.
What is the most likely pathophysiologic mechanism underlying this baby’s haemorrhage?
MSFinals-4149
As a healthcare professional in a bustling emergency department, a concerned mother rushes in with her 4-year-old son. The child has been crying excessively for the past 12 hours and has experienced bilious vomiting multiple times. Additionally, he passed a stool containing small amounts of blood about 2 hours ago. What initial investigation would you conduct to determine the probable diagnosis?