Archives: Medical Student Finals

MSFinals-3447

A Cardiotocogram (CTG) is performed on a 29-year-old female at 37 weeks gestation who has arrived at labour ward in spontaneous labour. The CTG shows a foetal heart rate of 120 bpm and variable decelerations and accelerations are present. There are no late decelerations. However, the midwife notices a 15 minute period where the foetal heart rate only varies by 2-3bpm. The mum is worried as she has not felt her baby move much for about 15 mins and would like to know what the likely cause is. She starts crying when she tells you that she took some paracetamol earlier as she was in so much pain from the contractions and is concerned this has harmed her baby. What is the most probable reason for this reduced variability?

MSFinals-3448

A 30-year-old woman attends her first antenatal appointment at 10 weeks gestation. She has not visited her GP in a long time and is not currently on any medication. There is no significant medical or family history of neural tube defects. During the examination, her BMI is 32 kg/m² and her blood pressure is 132/86 mmHg. What treatment options should be presented to her?

MSFinals-3449

A 32-year-old woman comes in with a positive urine pregnancy test. Lifestyle advice is given and blood tests are ordered. She has no notable medical history. During the examination, the following are observed:
– Heart rate: 92 beats per minute
– Blood pressure: 126/78 mmHg
– Oxygen saturation: 98% on room air
– Temperature: 36.6ºC
– Respiratory rate: 16 breaths per minute
– BMI: 30 kg/m²

What supplementation would you recommend for this patient?

MSFinals-3450

A 25-year-old female patient visits her GP seeking guidance on conceiving. She has a medical history of epilepsy and is currently taking lamotrigine. Her last seizure occurred 1 year ago. She is worried about the safety of epilepsy medications during pregnancy and wonders if there are any supplements she should take. What are the key counseling points to address her concerns?

MSFinals-3451

A 28-year-old primigravida 1+0 arrives at 35 weeks gestation with a blood pressure reading of 165/120 mmHg and 3+ proteinuria on dipstick testing. She had a stable blood pressure of approximately 115/75mmHg before becoming pregnant, and her only medical history is well-managed asthma. Which of the following statements is correct regarding her treatment?

MSFinals-3452

A 25-year-old first-time mother gave birth to a healthy baby girl with an APGAR score of 10 at 1, 5, and 10 minutes. However, during delivery, the mother experienced a perineal tear, and the midwife has called the doctor to suture it. Upon examination, it was found that the injury affected the superficial and deep transverse perineal muscles, but the anal sphincter remained intact. What is the degree of injury?

MSFinals-3453

A 36-year-old woman is admitted to the hospital for delivery. She has had two previous vaginal deliveries. After three hours, she gives birth to a healthy baby girl with APGAR scores of 9 at 1 minute and 10 at 5 and 10 minutes. However, the newborn appears to be macrosomic, and during delivery, the mother suffers a perineal tear. The midwife calls the doctor to suture the tear and upon examination, they discover an injury to the superficial and deep transverse perineal muscles, involving the external and internal anal sphincters, with mucosal sparing. What degree of injury does she have?

MSFinals-3454

A 28-year-old mother comes to see her GP. She had given birth to her child 8 weeks ago. She is feeling upset and tearful, explaining that motherhood is not what she expected. She is experiencing poor quality of sleep, loss of appetite, and feelings of guilt. She has not mentioned any thoughts of suicide. What screening tool should be used for this patient?

MSFinals-3455

A 27-year-old G4P3 woman presents with a lump in the breast, having ceased breastfeeding her youngest child two weeks prior. Her past medical history is significant for previous episodes of mastitis when breastfeeding her older children. On examination the lump is in the right breast at the six o’clock position, 3 cm from the nipple. The lump is non-tender and the overlying skin seems unaffected. Her observations are as follows:

Heart rate: 90,
Respiratory rate: 14,
Blood pressure: 112/72 mmHg,
Oxygen saturation: 99%,
Temperature: 37.5 Cº.

What is the probable diagnosis, and what is the most appropriate next step in investigation?

MSFinals-3456

A 25-year-old woman had blood tests taken at her 12-week booking appointment with the midwife. This is her first pregnancy and she has no significant medical history. The results of her full blood count (FBC) are as follows:
– Hb: 110 g/L (normal range for females: 115-160 g/L)
– Platelets: 340 x 10^9/L (normal range: 150-400 x 10^9/L)
– WBC: 7.2 x 10^9/L (normal range: 4.0-11.0 x 10^9/L)

What would be the most appropriate course of action based on these results?