Archives: Medical Student Finals

MSFinals-6523

A 44-year-old man is recovering on the ward several weeks after being treated for acute pancreatitis caused by excessive alcohol consumption. Despite being clinically stable, he continues to experience pain in the epigastric region. Routine blood tests and an abdominal ultrasound scan are performed, revealing the following results:

– Bilirubin: 28 µmol/l
– Albumin: 38 g/l
– ALT: 39 u/l
– γGT: 68 u/l
– CRP: 11.2 mg/l
– Amylase: 541 u/l

The abdominal ultrasound scan shows normal kidney and liver appearances, as well as a normal aortic diameter. However, a cystic lesion measuring 53 mm x 61 mm is present in the head of the pancreas. What is the most appropriate initial management strategy for this patient’s pancreatic lesion?

MSFinals-6524

A 55-year-old woman has been diagnosed with breast cancer and is receiving trastuzumab as part of her treatment. What is the rationale for using trastuzumab in breast cancer therapy?

MSFinals-6525

To which bone does Sever’s disease refer, and at what age is it commonly diagnosed?

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-6528

A 70-year-old female presents with sudden onset pain in her left leg. The leg appears pale and cold, with reduced sensation and muscle strength. She has no prior history of leg pain.

The patient has a medical history of COPD and atrial fibrillation. She has been taking ramipril and bisoprolol for a long time and completed a short course of prednisolone and clarithromycin for a respiratory tract infection 2 months ago. She is an ex-smoker with a 30-year pack history.

What factor from the patient’s background and medical history is most likely to contribute to her current presentation of acute limb ischaemia, which required an emergency operation 3 hours after admission?

MSFinals-6529

A 22-year-old man is struck on the left side of his face while playing rugby. He reports experiencing double vision when both eyes are open and finds it painful to open his mouth.
What is the likely explanation for his symptoms?

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?

MSFinals-6531

A 4-week-old male infant is presented to the GP for his routine check-up. During the examination, the GP observes that one side of his scrotum appears larger than the other. Upon palpation, a soft and smooth swelling is detected below and anterior to the testis, which transilluminates. The mother of the baby reports that it has been like that since birth, and there are no signs of infection or redness. The baby appears comfortable and healthy.
What would be the most suitable course of action for managing the probable diagnosis?

MSFinals-6502

You are summoned to assess a febrile 28-year-old female patient in the postoperative recovery area following her appendectomy. The patient denies experiencing any symptoms other than feeling unwell due to the fever. The nurse reports that her temperature is 39.1ºC and verifies that she had a urinary catheter inserted during the surgery. According to the operation notes, the appendectomy was carried out 20 hours ago.

What is the probable reason for the patient’s fever?