Archives: Medical Student Finals

MSFinals-3428

A 27-year-old woman presents to the Emergency Department with a 5-day history of vomiting. She has vomited 6 times a day for the past 5 days. When asked about pregnancy, she states her periods are irregular. On examination, her chest is clear, heart sounds are normal and she has a non-tender but distended abdomen. Her temperature is 37ºC, oxygen saturation 98% on air, heart rate 110 beats per minute, respiratory rate 20 breaths per minute, and blood pressure 110/70 mmHg. Blood results: Hb 118 g/L Male: (135-180) Female: (115 – 160) Platelets 160 * 109/L (150 – 400) WBC 5.6 * 109/L (4.0 – 11.0) CRP 4 mg/L (< 5) βhCG 453,000 mIU/ml. What is the most likely diagnosis?

MSFinals-3429

A 32-year-old woman comes to the antenatal clinic at 14 weeks pregnant. She was surprised to discover her pregnancy just last week, as it was unexpected. This is her fourth pregnancy, but she has had three miscarriages in the past. The midwife suggests a quadruple test due to the late discovery of her pregnancy, which reveals the following results:

– Alpha-fetoprotein (AFP) is low
– Unconjugated oestriol (uE3) is low
– Total human chorionic gonadotrophin (hCG) is low
– Inhibin-A is normal

What is the most likely diagnosis?

MSFinals-3430

A 28-year-old woman presents at 34 weeks gestation with preterm labour. During examination, her blood pressure is found to be 175/105 mmHg and urinalysis reveals 3+ proteinuria. Treatment with magnesium sulphate and labetalol is initiated. However, the patient reports reduced foetal movements and a cardiotocogram shows late decelerations with a foetal heart rate of 90 beats/minute.

What is the recommended next step in management?

MSFinals-3431

A 35-year-old pregnant woman presents for her 41 week check-up with consistently high blood pressure readings of 140/90 mmHg for the past 2 weeks. Her initial blood pressure at booking was 110/70 mmHg. Labetalol is administered to manage the hypertension. What is the recommended next step in her management?

MSFinals-3432

A 29-year-old female comes to the emergency department complaining of vaginal bleeding and right lower quadrant abdominal pain. The pain worsens with movement and extends to her right shoulder. She has no gastrointestinal symptoms and her last menstrual period was 6 weeks ago. A pregnancy test confirms she is pregnant. What is a potential risk factor for this presentation?

MSFinals-3433

A 31-year-old woman arrives at 36 weeks gestation in her first pregnancy. She is admitted after experiencing a seizure following a 2 day period of intense abdominal pain, nausea, vomiting, and visual disturbance. Her family has a history of epilepsy. During the examination, hyperreflexia is observed. What is the probable diagnosis?

MSFinals-3434

As a junior doctor in the neonatal unit, you receive a call from a nurse regarding a delivery where the baby’s head has been delivered, but the shoulders are not descending with normal downward traction. What is your initial step in managing this situation?

MSFinals-3435

A 6-month-old infant is brought in for a check-up. The baby was born at 38 weeks gestation and weighed 4.5kg at birth. During the examination, the doctor observes adduction and internal rotation of the right arm. What is the probable diagnosis?

MSFinals-3436

A woman who is 38 weeks pregnant has arrived at the hospital in labor. The midwife observes that she has a temperature of 38.5ºC and recommends that the woman receive antibiotic treatment. The woman has had a regular and uncomplicated pregnancy thus far and has no known drug allergies. What type of Group B Streptococcus prophylaxis should the woman receive?

MSFinals-3437

A 32-year-old woman has given birth to her second child at 38 weeks gestation. She experienced a natural third stage of labor without any medication. Suddenly, 5 minutes after delivery, she had a massive blood loss of around 750 mL. Despite this, her vital signs remain stable. What is the initial management plan for her?