Archives: Medical Student Finals

MSFinals-4094

An infant, born to a 25-year-old woman immigrant who did not receive prenatal care, is found to have a midline lesion on his lower back. Examination reveals a fluid-filled cystic mass that is continuous with the spinal canal.
With which one of the following could this anomaly have been prevented by supplementation?

MSFinals-4095

A 6-week-old baby boy is brought to the paediatric assessment unit with a 2-day history of frequent vomiting and a 5-hour history of no wet nappies. He appears lethargic and weak. However, his mother reports that he still seems hungry and is attempting to breastfeed in between bouts of vomiting. What diagnostic tool should be employed to determine the underlying cause of his symptoms?

MSFinals-4096

A 3-year-old girl presents to the emergency department with a 2 day history of intermittent vomiting. She has been generally unwell and has had episodes of inconsolable crying. Her parents have become concerned following a dirty nappy that contained both stool and blood. They have brought this nappy with them and on inspection there appears to be formed stool with streaks of jelly like blood.

On examination, the girl is quiet and pale. Her capillary refill time is 2-3 seconds peripherally. She has very mild increased work of breathing with normal heart sounds on auscultation. Her abdomen is tender on palpation with guarding centrally. You are unable to palpate any obvious masses.

Her observations are as follows-
Blood pressure 92/55 mmHg
Heart rate 140 bpm
Respiratory rate 30/min
Saturations 96% in air

After stabilizing the child, which investigation would be the most helpful in confirming a diagnosis for ongoing management?

MSFinals-4097

A 7-month-old infant is brought to the emergency department with symptoms of vomiting, blood in stools, and irritability. During the physical examination, the baby’s abdomen is found to be tense, and he draws his knees up in response to palpation.

What would be the most suitable course of action for this baby?

MSFinals-4062

A 3-year-old girl with meningococcal septicaemia has a cardiac arrest on the ward. You are the first responder. After confirming the arrest and following the paediatric BLS protocol, what is the appropriate rate for chest compressions?

MSFinals-4063

A 9-month-old baby has become unresponsive in the waiting area of the pediatrician’s office for an unknown cause. Basic life support for infants is started, and chest compressions are administered. What is the appropriate technique for performing chest compressions in this scenario?

MSFinals-4064

A 38-year-old woman has just found out that she has Huntington disease and is worried that she may have passed it on to her children. The father of the children does not have the disease. What is the probability that each of her children has inherited the condition?

MSFinals-4065

A 29-year-old woman undergoes antenatal haemoglobinopathy screening and is found to have sickle cell trait. The father of the child agrees to further screening and is found to have the HbAS genotype. What is the probability of their offspring having sickle cell disease?

MSFinals-4066

A 9-year-old girl comes to the GP with her father. She has been complaining of nausea for the past few days along with dysuria and increased frequency. Her father is worried that she might have a urinary tract infection. Upon examination, the girl seems healthy and her vital signs are stable. There are no notable findings during abdominal examination. A clean catch sample is collected and shows positive results for leucocytes and nitrites. What should be the next course of action in managing this case?