Archives: Medical Student Finals

MSFinals-4126

A father brings his 5-year-old child for a routine general practice (GP) appointment. During the consultation, the father mentions that the child recently started playing soccer and has been enjoying it. You observe that the child has a short stature, upslanting palpebral fissures, a flat occiput and a single palmar crease.

What should be the GP’s primary concern for this 5-year-old child with short stature, upslanting palpebral fissures, a flat occiput, and a single palmar crease who recently started playing soccer?

MSFinals-4127

A 6-year-old boy is discovered to have an incidental murmur. He is healthy and progressing normally. The first heart sound is regular, but the second heart sound appears to be broadly split, and this splitting is unchanging regardless of inhalation or exhalation. A faint mid-systolic murmur is heard over the pulmonary region. The electrocardiogram (ECG) reveals an rSr’ pattern in V1 and prominent P waves. What is the probable diagnosis?

MSFinals-4128

A 6-year-old boy is brought to the Emergency Department with episodes of cyanosis during physical activity. He was born at term via normal vaginal delivery, without complications during pregnancy. The child has been healthy, but recently started experiencing bluish skin during physical activity.
After examination, the child is diagnosed with Fallot’s tetralogy.
What is a common association with a patient diagnosed with Fallot’s tetralogy?

MSFinals-4129

A 15-year-old girl presents to your clinic with worries about delayed menarche. Upon taking her medical history, you find no developmental issues. She is currently at the 65th percentile for weight and 5th percentile for height. During the physical examination, you observe a short webbed neck and broad chest. After conducting a karyotype analysis, you discover an abnormality. What is the most prevalent heart condition linked to this clinical presentation?

MSFinals-4130

Should all infants undergo hearing screening by their health visitor as part of the ‘Infant Hearing Screening Programme’? And if the results are abnormal, what is the next hearing test they will have?

MSFinals-4131

A 7-year-old girl is brought to the GP by her parents due to concerns about her weight loss. She has been experiencing abdominal pain, diarrhoea, and a poor appetite. She denies having polyuria and her urinalysis results are normal. Upon examination, she is found to be below the 0.4th centile for both height and weight, having previously been on the 9th centile. What series of investigations would be most helpful in confirming a diagnosis?

MSFinals-4132

A 33-year-old woman comes to see her GP to talk about her pregnancy. She has a history of asthma and is concerned about the possibility of her child developing asthma as well. She has been a smoker since she was 16 years old but has reduced her smoking to ten cigarettes a day since becoming pregnant.

What steps can she take to minimize the risk of her baby developing asthma?

MSFinals-4133

A child is admitted to the hospital and during a neonatal examination, a systolic heart murmur is detected. Upon further testing with an echocardiogram, it is revealed that the right atrium is hypertrophied and the septal and posterior leaflets of the tricuspid valve are attached to the right ventricle. What is the commonly used name for this condition?

MSFinals-4101

A 6-year-old boy is brought to the GP surgery by his mother. He has a two-year history of asthma which has previously been controlled with a salbutamol inhaler twice daily and beclomethasone 50 micrograms bd. He has an audible wheeze that has been gradually worsening over the last few weeks and has not responded to additional doses of salbutamol. His mother also reports that he has a night-time cough for the past 6 weeks.

What is the most appropriate next step in management?

MSFinals-4102

A 2-year-old girl is brought to the pediatrician by her father due to concerns about her breathing. The father reports that she has had a fever, cough, and runny nose for the past three days, and has been wheezing for the past 24 hours. On examination, the child has a temperature of 37.9ºC, a heart rate of 126/min, a respiratory rate of 42/min, and bilateral expiratory wheezing is noted. The pediatrician prescribes a salbutamol inhaler with a spacer. However, two days later, the father returns with the child, stating that the inhaler has not improved her wheezing. The child’s clinical findings are similar, but her temperature is now 37.4ºC. What is the most appropriate next step in management?