MSFinals-6463
For which disease does the use of a screening procedure result in an increase in overall survival?
Archives: Medical Student Finals
MSFinals-6464
A 67-year-old man is recovering on the ward, one day after a left-hemicolectomy for colorectal cancer. He complains of abdominal pain and nausea and has vomited 3 times in the last hour.
His heart rate is 105 bpm, blood pressure 100/83 mmHg, and temperature is 37.3ºC. There is abdominal distention with slight tenderness, his chest is clear, bowel sounds are absent, and there are no signs of wound infection or dehiscence. He has not opened his bowels or passed any wind since the operation.
Investigations are performed:
Na+ 130 mmol/L (135-145 mmol/L)
K+ 3.2 mmol/L (3.5 – 5.0 mmol/L)
CRP 145 mg/L (< 10 mg/L) What is the most likely diagnosis?
MSFinals-6465
A 65-year-old man visits his GP complaining of increased frequency of urination for the past 3 months, particularly at night. He also reports dribbling while urinating and a sensation of incomplete bladder emptying. He denies any weight loss. Upon examination, his abdomen is soft and non-tender. The digital rectal examination reveals a smooth unilateral enlargement of the lateral lobe of the prostate.
What is the initial management strategy that should be employed?
MSFinals-6466
A 35-year-old woman who is a heavy smoker presents with recurring infections in her right breast. During examination, an indurated area is found at the lateral aspect of the nipple areolar complex. Imaging reveals no mass lesions. What is the probable diagnosis?
MSFinals-6467
An 80-year-old male is admitted to the urology ward with acute urinary retention. He is catheterised successfully with a large retention volume of 1.5 litres and therefore kept on the ward for observation. Over the next 24 hours, the patient has a urine output of 200 ml/hour and develops increasing confusion. His blood results are as follows:
Hb 130 g/L Male: (135-180)
Platelets 280 * 109/L (150 – 400)
WBC 9 * 109/L (4.0 – 11.0)
Na+ 136 mmol/L (135 – 145)
K+ 4.5 mmol/L (3.5 – 5.0)
Urea 8 mmol/L (2.0 – 7.0)
Creatinine 130 µmol/L (55 – 120)
CRP 3 mg/L (< 5) What could be the possible reason for the patient’s confusion?
MSFinals-6468
Which one of the following scenarios is the most common presentation of testicular cancer?
MSFinals-6469
A 52-year-old man presents with haematuria, lethargy, and cough. He smokes 15 cigarettes/day and has COPD.
His heart rate is 89/min, his respiratory rate is 18/min, his blood pressure is 151/93 mmHg and his oxygen saturation is 88%. There is central adiposity with purple striae on the abdomen and a painless 8 cm mass in the left flank.
The blood results are as follows:
Hb 191 Men: 135-180 g/L Women: 115-160 g/L
Na+ 148 135-145 mmol/L
K+ 3.1 3.5 – 5.0 mmol/L
Calcium 3.2 2.1-2.6 mmol/L
The chest x-ray shows areas of low density and flattening of the diaphragm.
What is the most likely diagnosis and what is the definitive treatment?
MSFinals-6475
A 72-year-old man presents to the emergency department after being referred by his primary care physician due to experiencing abdominal distension and difficulty passing stool or flatus for the past four days. The patient denies any nausea or vomiting, but reports irregular bowel movements with occasional bleeding and recent weight loss. During the examination, tinkling bowel sounds are heard and a digital rectal exam reveals the presence of hard feces. The patient also mentions that his mother had a history of recurrent bowel adhesions requiring multiple surgeries. What is the most probable cause of the patient’s symptoms?
MSFinals-6476
A 6-month old boy is brought to his pediatrician by the parents. They request circumcision due to their religious beliefs. The doctor explains that this is not a service provided by the NHS unless there is a medical necessity, and it must be done at a private clinic. Before making a decision about performing the procedure, what should be ruled out?
MSFinals-6477
A 6-week-old boy is brought to his pediatrician by his parents to discuss referral to private healthcare for a circumcision, which they want performed for cultural reasons. They do not report any concerns regarding his health. On examination, he appears to be developing normally and the external genitalia appear normal.
What is a contraindication to performing a circumcision?