Archives: Medical Student Finals

MSFinals-2938

A 47-year-old woman visits the renal clinic after six weeks of a triumphant renal transplant. She has some inquiries about her immunosuppression for the consultant. The doctor clarifies that the typical regimen for renal transplant patients involves the initial utilization of an induction agent, followed by a combination of a calcineurin inhibitor, antimetabolite, and steroids. This combination is intended to prevent rejection of the transplanted kidney. What is the name of the anti-lymphocyte monoclonal antibody used as an induction agent?

MSFinals-2939

A 60-year-old man visits the clinic with his 35-year-old son, who has been diagnosed with IgA nephropathy and is in CKD stage 5. The man wishes to be evaluated as a potential live kidney donor for his son. He has a history of mild hypertension that is managed with 2.5 mg of ramipril daily. He has never had any surgeries, does not smoke, and only drinks alcohol in moderation.

As part of the consent process for kidney donation, what advice should be provided to the patient?

MSFinals-2940

A 30-year-old woman who leads an active lifestyle visits her doctor for a routine work-related health check-up. During the check-up, her urinalysis shows a positive result for protein (+) and a 24-hour urine collection is ordered. The results reveal a urine protein level of 25 mg/24 hours. What recommendations should be provided to the patient?

MSFinals-2941

A 67-year-old man has been diagnosed with multiple myeloma. His serum protein electrophoresis reveals an IgA paraprotein of 60 g/l. Upon diagnosis, his urine shows protein levels of approximately 900 mg/24 hours. However, after undergoing chemotherapy, his urinary protein excretion returns to normal levels. What is the probable reason for his proteinuria?

MSFinals-2942

A 40-year-old man has just finished a round of chemotherapy for leukemia. During a routine check-up, he is discovered to have proteinuria with a level of 1000 mg/24 hours. Upon examination, there are no red cell casts present in his urine. What could be the probable reason for his proteinuria?

MSFinals-2943

As an Emergency department doctor, a 24-year-old man comes to the department with a complaint of blood in his urine that started yesterday. He is typically healthy but recently had a throat infection. Upon conducting a urinalysis, the results are as follows: Haemoglobin +++, Urobilinogen Negative, Bilirubin Negative, Protein +, Glucose Negative, Nitrites Negative, Leucocytes Negative, and Ketones +. What could be the probable reason for these findings?

MSFinals-2944

A 45-year-old patient presents to their GP with a general feeling of unwellness. They have previously been diagnosed with a condition by their former GP. The GP orders blood tests and the results are as follows:

Adjusted calcium 2.0 mmol/L (2.2-2.4)
Phosphate 2.8 mmol/L (0.7-1.0)
PTH 12.53 pmol/L (1.05-6.83)
Urea 22.8 mmol/L (2.5-7.8)
Creatinine 540 µmol/L (60-120)
25 OH Vit D 32 nmol/L (optimal >75)

What is the most likely diagnosis?

MSFinals-2945

A 68-year-old male comes to the clinic complaining of weakness and difficulty moving around. During the examination, it is observed that he has a slow gait with reduced arm movement and a tremor in his right arm. What is the usual frequency of the resting tremor in Parkinson’s disease?

MSFinals-2946

You are the pediatric doctor on call. The nurses ask you to come and review a patient, as she is acting ‘odd’. Her eyes are open spontaneously, she is withdrawing to pain and she is making incomprehensible sounds.
What is this patient’s Glasgow Coma Score (GCS)?

MSFinals-2947

A 60-year-old driver is admitted with a left-sided facial droop, dysphasia and dysarthria. His symptoms slowly improve and he is very keen to get back to work as he is self-employed.
Following a stroke, what is the minimum time that patients are advised not to drive a car for?