Archives: Medical Student Finals

MSFinals-3522

A 23-year-old asthmatic woman has been brought to the emergency department after experiencing seizures during her pregnancy. She is currently 35 weeks pregnant and has been diagnosed with gestational hypertension by her doctor. She is taking oral medication to manage her condition. Upon examination, her urine test shows proteinuria (3+) and her blood pressure is elevated at 170/115 mmHg. As a result, the baby is delivered and the patient’s seizures have ceased. What is the most appropriate treatment option for her seizures after delivery, given her probable diagnosis?

MSFinals-3501

A 32-year-old woman who is 32 weeks pregnant visits her local antenatal unit for a midwife check-up. She has been diagnosed with intrahepatic cholestasis of pregnancy and is taking ursodeoxycholic acid. Additionally, she is being treated with lamotrigine for epilepsy. This is her first pregnancy, and she has not experienced any previous miscarriages. During her appointment, she expresses concern about her step-sister’s recent stillbirth, as her step-sister has already had two prior stillbirths. Based on her medical history, which factor puts her at the highest risk for a similar outcome?

MSFinals-3502

A 29-year-old pregnant woman is in the labour ward and ready to deliver her second child. Her pregnancy has been uncomplicated thus far. However, her first child had to stay in neonatal intensive care shortly after birth due to an infection but is now healthy. The latest vaginal swabs indicate the presence of Streptococcus agalactiae. She has no other medical conditions and is in good health.
What is the best course of action for managing this situation?

MSFinals-3503

A 30-year-old woman is being seen on the postnatal ward 3 days after an uncomplicated, elective lower-segment caesarean section. This is her first child and she is eager to exclusively breastfeed. Her lochia is normal and she is able to move around independently. She is scheduled to be discharged later in the day and is interested in starting contraception right away. She has previously used both the combined oral contraceptive pill and an intrauterine device, both of which worked well for her. What options should be presented to her?

MSFinals-3500

A 30-year-old asymptomatic woman comes to the hospital for an oral glucose tolerance test (OGTT). She is currently 16 weeks pregnant with her second child. During her first pregnancy, she had gestational diabetes and foetal macrosomia. Despite having a body mass index of 34 kg/m2, she is in good health.

Her test results are as follows:
– Fasting glucose: 8.5 mmol/L (<5.6 mmol/L)
– 2 hour glucose: 12.8 mmol/L (<7.8 mmol/L) What is the recommended course of action for managing her condition?

MSFinals-3483

A 25-year-old woman who is 16 weeks pregnant comes to her GP with concerns of exposure to an infectious disease. Her neighbor’s son has a rash and a high temperature. She has no medical history and is unsure if she had chickenpox in childhood. What is the initial step to take?

MSFinals-3484

A 20-year-old woman presents for her first antenatal appointment following a positive pregnancy test. She has no significant medical or family history and reports no smoking or alcohol consumption. Her BMI is 30.9kg/m², blood pressure is within normal limits, and a urine dipstick is unremarkable. What tests should be offered to her?

MSFinals-3485

A 44-year-old pregnant refugee from Afghanistan visits her general practitioner for her first scan at 20 weeks. During the ultrasound, a ‘snow-storm’ appearance is observed without visible foetal parts. What is the probable diagnosis?

MSFinals-3486

You are requested to evaluate a 28-year-old patient in a joint medical/obstetric clinic who has recently been diagnosed with gestational diabetes. Her pregnancy has been complicated by a diagnosis of gestational diabetes through routine screening and she now takes metformin 500 mg three times a day.

She is currently 26 weeks pregnant and has just undergone a scan that revealed an estimated foetal weight of 900g (99th percentile). She reports feeling well and has been tolerating the metformin without any issues. A fasting blood glucose level is taken at the clinic and compared to her previous results:

6 weeks ago: 6.0mmol/L
4 weeks ago: 6.1 mmol/L
Today: 7.5mmol/L

Based on the above information, what changes would you make to the management of this patient?

MSFinals-3487

You are evaluating a 35-year-old gravida 2 para 1 woman who has presented for her initial prenatal visit. She is currently 12 weeks pregnant.
During her first pregnancy, she had gestational diabetes which was managed with insulin therapy. However, her blood glucose levels are currently within normal limits. She is presently taking 400 µcg folic acid supplements and has no other medication history.
At this clinic visit, a complete set of blood and urine samples are collected.
What alterations would you anticipate observing in a healthy pregnant patient compared to before pregnancy?