Archives: Medical Student Finals

MSFinals-6544

A 78-year-old man presents to his primary care physician with bothersome urinary symptoms. He reports difficulty with urination, including a weak stream and the need to strain. These symptoms are causing increased pain in his abdominal incisional hernia. Additionally, he experiences significant post-void dribbling, requiring the use of incontinence pads.

Upon examination, the physician notes a significantly enlarged prostate that is smooth with a clear median sulcus. A urine dipstick test is unremarkable. The patient’s blood test reveals a prostate-specific antigen level of 1 ng/mL (normal range <4 ng/mL). What is the most appropriate course of treatment for this patient?

MSFinals-6545

A 62-year-old male comes to the clinic complaining of pain during bowel movements for the past 4 days. Upon examination, a tender, oedematous, and purple subcutaneous mass is found at the anal margin. What is the most appropriate course of action for this patient?

MSFinals-6546

A 70-year-old man visits his GP complaining of a burning sensation in his right leg while walking. The pain occurs only during physical activity and subsides with rest. He has a medical history of hypertension and has suffered two heart attacks in the past. He is currently taking ramipril, amlodipine, aspirin, and atorvastatin. He is a former smoker with a 20-pack-year history. An ECG reveals a normal sinus rhythm, and the ankle-brachial pressure index in his right leg is 0.67. What is the most appropriate initial recommendation for this patient, given the most likely diagnosis, after advising him to quit smoking and optimizing his hypertension management?

MSFinals-6547

A 28-year-old man visits his doctor complaining of pain during bowel movements for the past few days. He notices a small amount of fresh, bright-red blood on the toilet paper. He has been having one or two bowel movements per day, which is normal for him, but lately, he has been experiencing hard stools. He is concerned about the pain he will feel during his next bowel movement. He has no other symptoms, fever, or recent weight loss. He has no significant medical history and is not taking any regular medication. The doctor diagnoses him with an anal fissure. What would be an appropriate management option at this point?

MSFinals-6517

A 7-year-old girl is discovered unresponsive in the bathtub and is rushed to the emergency department in a state of paediatric cardiac arrest. Despite attempts to establish peripheral IV access, the medical team is unable to do so. The decision is made by the registrar to insert an intraosseous line. What is the most frequently used insertion site for this type of line?

MSFinals-6518

A 28-year-old man visits his doctor with a complaint of a painless lump he discovered on his right testicle while showering. He has no other symptoms or significant family history except for his father’s death from pancreatic cancer two years ago. During the examination, the doctor identifies a hard nodule on the right testicle that does not trans-illuminate. An ultrasound is performed, and the patient is eventually referred for an inguinal orchiectomy for a non-invasive stage 1 non-seminoma germ cell testicular tumor. Based on this information, which tumor marker would we anticipate to be elevated in this patient?

MSFinals-6519

A 40-year-old male visits his GP complaining of a painless lump in his testicle that has been present for a month. After an ultrasound, the GP refers him to the hospital for suspected testicular cancer. The patient undergoes an orchidectomy and is diagnosed with stage 1 seminoma. What is the most likely tumour marker to be elevated in this patient?

MSFinals-6526

A 38-year-old woman arrives at the emergency department complaining of intermittent pain in her right upper quadrant for the past 3 hours. She reports that the pain worsens after eating and spreads to her right shoulder blade. There are no signs of jaundice or fever.
What blood test results would be anticipated for a diagnosis of biliary colic?

MSFinals-6527

A 26-year-old female presents with an inflamed non-perforated appendix during surgery.

What is the most reliable indicator of appendicitis, whether it be a symptom, sign, or serological marker?

MSFinals-6530

A 68-year-old male presents for a follow-up appointment after undergoing an abdominal aorta ultrasound. The width of his aorta is measured at 4.9 cm, which is an increase from 3.5 cm during his previous free screening appointment a year ago. Despite being asymptomatic, what would be the recommended course of action for his management?