Archives: Medical Student Finals

MSFinals-3983

An 80-year-old man is admitted to the hospital with increasing pains in his left hip, lumbar spine, and ribs, more recently associated with confusion, weakness, and falls. Routine investigations reveal low hemoglobin, high mean corpuscular volume, low white cell count, low platelets, high sodium, high urea, high creatinine, high corrected calcium, low PO42-, high alkaline phosphatase, and high erythrocyte sedimentation rate. Based on this presentation and blood results, what is the most likely diagnosis?

MSFinals-3984

A 26-year-old man presents following a basketball game where he landed awkwardly and twisted his leg. As a result, he is experiencing difficulty in extending his knee and it is locked in 30 degree flexion. Upon examination, his knee is swollen and painful.
What is the most probable diagnosis?

MSFinals-3985

A 28-year-old man presents to the Emergency Department after he notices that his right foot is ‘dropping’ as he walks. Upon examination, you observe that he is unable to dorsiflex his foot, although plantar flexion is normal. Additionally, he exhibits weakness of ankle eversion and some loss of sensation over the lateral aspect of his calf. After conducting a full systemic examination, you find no other abnormalities. The patient has no significant past medical history, except for a distal tibial fracture, which was in a plaster cast until 3 days ago. He works as a builder and consumes approximately 40 units of alcohol per week. What is the most probable diagnosis?

MSFinals-3986

A 62-year-old woman presents with weak, painful hands. The pain is worse when she types and at night. On examination, there is significant wasting of the thenar eminence muscles.
This sign is most likely to be caused by:

MSFinals-3987

A 26-year-old man presents to an Orthopaedic Outpatient Clinic with a knee injury sustained during a football game. He cannot recall the exact cause of the injury. During the examination, you note a positive McMurray’s’s test and tenderness on palpation of the lateral aspect of the joint line. What imaging modality would be the most beneficial for this patient?

MSFinals-3988

An older man tries to lift a heavy shopping bag but experiences sudden pain in his shoulder. As a result, he feels soreness in the area of the greater tuberosity of the humerus. He notices that he cannot initiate abduction when he tries to move his shoulder, but can continue to abduct once the arm is lifted away from his side. The shoulder flexion and extension can be performed normally, and the humerus medial and lateral rotation is also unaffected. What is the most probable diagnosis for the tendon injury?

MSFinals-3989

A 55-year-old accountant complains of chronic pain on the lateral aspect of his right elbow that worsens during tennis, particularly when executing a backhand. Upon examination, it is observed that the pain is triggered by resisted wrist extension while the elbow is fully extended.
Which muscle attachment is likely to be affected?

MSFinals-3990

Which muscle tendon was most likely entrapped by the displaced sustentaculum tali in a 24-year-old professional off-road motorcyclist who suffered a complete fracture during a race?

MSFinals-3991

A 38-year-old teacher and mother of two presents with back pain. This started after lifting some heavy boxes during a move. The pain was initially limited to her lower back but now she has shooting pains radiating down the back of her thigh, the lateral aspect of her leg and into the lateral border of her left foot. The pain can wake her at night if she moves suddenly but does not otherwise disturb her sleep. She is well, without past medical history of note. She reports no lower limb weakness, disturbance of sphincter function, nor any saddle symptoms. Examination reveals a tender lumbar spine, numbness to the lateral border of the left foot and pain on straight leg raise at 40 degrees on the left. There is no limb weakness.
What is the most appropriate management plan?

MSFinals-3992

A 21-year-old woman involved in a motorbike accident is brought to the Emergency Department at 10 pm. Her airway is patent; the respiratory rate is 20/minute with normal pulse oximetry and a clear chest; she is slightly tachycardic but is well perfused with a normal blood pressure. She is found to have a tibial fracture on the right side. The broken bone is visible through a break in the skin.
Which of the following is most appropriate?