Archives: Medical Student Finals

MSFinals-3404

A 36-year-old woman presents to you, her primary care physician, with complaints of feeling sad and low since giving birth to her daughter 2 weeks ago. She reports difficulty sleeping and believes that her baby does not like her and that they are not bonding, despite breastfeeding. She has a strong support system, including the baby’s father, and has no history of depression. She denies any thoughts of self-harm or substance abuse, and you do not believe the baby is in danger. What is the best course of action for management?

MSFinals-3405

A mother brings her 5-day old daughter to see you as she is worried about her daughter’s weight loss. The baby was born at term without any complications. She is exclusively breastfed and has had a normal amount of wet nappies today. The baby is not showing any signs of distress and all observations are within normal limits. However, her birth weight was 3200g and today she weighs 2900g. What would be the best course of action to manage this infant’s weight loss?

MSFinals-3406

A 35-year-old woman has been diagnosed with gestational diabetes during her second pregnancy. Despite progressing well, she has been experiencing persistent nausea and vomiting throughout her pregnancy. In her previous pregnancy, she tried taking metformin but it worsened her symptoms and caused frequent loose stools. As a result, she refuses to take metformin again. She has made changes to her diet and lifestyle for the past two weeks, but her blood results show little improvement. Her fasting plasma glucose levels are 6.8 mmol/L, which is still above the normal range of <5.3mmol/L. What should be the next step in managing her gestational diabetes?

MSFinals-3407

A 35-year-old woman presents with a two-week history of morning sickness. She is 10 weeks pregnant. She can keep down oral fluid but has vomited twice in the previous 24 hours. There are no acid reflux symptoms, abdominal pain, vaginal bleeding or urinary symptoms.

She takes folic acid and is not on any other medications.

On examination, her temperature is 36.8ºC. Blood pressure is 100/60 mmHg and heart rate is 80/min. Her abdomen is soft and non-tender. Urine B-HCG is positive and urine dipstick shows 1+ ketone only. There is no weight loss.

What is the most appropriate management option for this patient?

MSFinals-3388

A 32-year-old pregnant woman comes for a routine check at 28 weeks gestation. During the examination, her symphysis-fundal height measures 23 cm. What is the most crucial investigation to confirm these findings?

MSFinals-3389

A 23-year-old female, gravidity 1 and parity 0 at 12 weeks’ gestation is in a car accident where her abdomen hits the dashboard. The mother’s vital signs are stable, and there is no vaginal bleeding or uterine contractions. An ultrasound reveals an intact placenta. What is the most suitable course of action?

MSFinals-3390

A 29-year-old female attends the antenatal clinic for a booking appointment. What should be recognized as a risk factor for pre-eclampsia?

MSFinals-3391

A 25-year-old patient visits the antenatal clinic after her 20-week scan reveals a low-lying placenta. She is concerned about what this means and if any action needs to be taken. This is her first pregnancy, and she has not experienced any complications thus far. She has no known medical conditions and does not take any regular medications. The patient mentions that her mother had a placenta-related issue that resulted in significant bleeding, and she is worried that the same may happen to her. What steps would you take to assist this patient?

MSFinals-3392

A 36 year-old female patient visits her GP complaining of a grape-sized lump in her breast that she discovered during a bath a week ago. The lump is firm, painless, and has no skin changes around it. The patient is generally healthy, without fever, and no prior history of breast disease. She recently stopped breastfeeding a month ago. An ultrasound scan reveals a well-defined lesion, and aspiration of the lump produces white fluid. What is the probable diagnosis?

MSFinals-3393

Your next patient in an antenatal clinic is a woman who is 32 weeks pregnant. What examination findings would cause you to be concerned?