MSFinals-2872
You are considering commencing a patient in their 60s on cilazapril. In discussion with the patient you mention that this is an ACE inhibitor.
The patient asks you what ‘ACE’ is.
What is the primary function of ‘ACE’?
Archives: Medical Student Finals
MSFinals-2873
A 40-year-old male patient has been referred to the hypertension clinic by his general practitioner due to hypertension that has persisted for the past 18 months. His blood pressure readings have been consistently high, measuring around 210/140 mmHg. During the examination, a large ballotable mass is detected in the right flank. The patient’s blood test results reveal elevated levels of renin at 120 pmol/L (normal range: 10-60) and aldosterone at 1215 pmol/L (normal range: 100-800). Additionally, his hemoglobin levels are high at 205 g/L (normal range: 120-170). What is the most likely cause of hypertension in this case?
MSFinals-2874
In the treatment of autoimmunity and to prevent rejection following solid organ transplantation, various immunosuppressant drugs are used, each with its own mechanism of action and specific side effects. However, all of them carry the risk of increased susceptibility to infection and malignancy. At what age is new onset of diabetes after transplantation (NODAT) commonly associated with medication?
MSFinals-2875
A 26-year-old man with chronic renal failure received a renal transplant from a matched related donor. After being discharged with a functioning graft, he returned to the nephrology clinic a month later with a high fever and was admitted for further investigation. During his first evening in the hospital, his condition rapidly worsened, and he became dyspneic. A full blood count revealed significant leukopenia, and his liver function tests were severely abnormal. What is the probable cause of his illness?
MSFinals-2876
As a locum GP, you are seeing a 60-year-old patient who is known to be alcohol-dependent. He informs you that he has been staying at a hostel but has had very little to eat in the last week.
Which urinalysis results would you expect to see in this situation?
A. Haemoglobin: Negative
B. Urobilinogen: Negative
C. Bilirubin: Negative
D. Protein: +
E. Glucose: + + +
F. Nitrites: Negative ++ +++
G. Leucocytes: + ++ +++
H. Ketones: Negative +++ Negative +++ Negative
Please note that the urinalysis results may vary depending on the individual’s health condition and other factors.
MSFinals-2877
Dr. Patel is a nephrologist who has five patients attending his clinic. The patients’ results are as follows:
Adam Ahmed Bella Brownie Charlie Chen David Davis
Urine protein mg/24 hrs: 150 4000 3000 200 300
Haematuria: Present Absent Present Present Absent
Oedema: Absent Present Present Absent Absent
Serum albumin g/l: 24 18 26 17 32
Serum creatinine µmol/l: 430 110 280 560 120
Which patient is diagnosed with nephrotic syndrome?
MSFinals-2878
A patient in his 60s visits his GP clinic complaining of general malaise, severe itch, and breathlessness that have been progressively worsening for several months. Upon conducting blood tests, the following results were obtained: adjusted calcium of 2.0 mmol/L (normal range: 2.2-2.4), phosphate of 2.8 mmol/L (normal range: 0.7-1.0), PTH of 12.53 pmol/L (normal range: 1.05-6.83), urea of 32.8 mmol/L (normal range: 2.5-7.8), creatinine of 540 µmol/L (normal range: 60-120), 25 OH Vit D of 32 nmol/L (optimal level >75), and eGFR of 8 ml/min/1.73m2. What is the most effective treatment for this patient?
MSFinals-2879
What are the expected urinalysis results for a 23-year-old patient with abdominal pain, dehydration, anorexia, and marked hyperglycemia who may have a new diagnosis of type 1 diabetes?
A) Haemoglobin: Negative
Urobilinogen: Negative
Bilirubin: Negative
Protein: Positive
Glucose: Positive (+++)
Nitrites: Negative
Leucocytes: Positive
B) Haemoglobin: Negative
Urobilinogen: Negative
Bilirubin: Negative
Protein: Negative
Glucose: Positive
Nitrites: ++
Leucocytes: ++
C) Haemoglobin: Negative
Urobilinogen: Negative
Bilirubin: Negative
Protein: Negative
Glucose: +
Nitrites: +++
Leucocytes: +++
D) Haemoglobin: Negative
Urobilinogen: Negative
Bilirubin: Negative
Protein: Negative
Glucose: Negative
Nitrites: Negative
Leucocytes: Negative
E) Haemoglobin: +++
Urobilinogen: +
Bilirubin: +
Protein: Negative
Glucose: Negative
Nitrites: Negative
Leucocytes: Negative
MSFinals-2880
As a locum GP, you have a pregnant patient who denies symptoms or urinary tract infection. What urinalysis results might be expected for patients A, B, C, D, and E?
Patient A:
– Haemoglobin: Negative
– Urobilinogen: Negative
– Bilirubin: Negative
– Protein: Negative
– Glucose: +++
– Nitrites: Negative
– Leucocytes: +
Patient B:
– Haemoglobin: Negative
– Urobilinogen: Negative
– Bilirubin: Negative
– Protein: Negative
– Glucose: Negative
– Nitrites: ++
– Leucocytes: ++
Patient C:
– Haemoglobin: Negative
– Urobilinogen: Negative
– Bilirubin: Negative
– Protein: Negative
– Glucose: Negative
– Nitrites: +++
– Leucocytes: +++
Patient D:
– Haemoglobin: Negative
– Urobilinogen: Negative
– Bilirubin: Negative
– Protein: Negative
– Glucose: Negative
– Nitrites: Negative
– Leucocytes: Negative
Patient E:
– Haemoglobin: +++
– Urobilinogen: +
– Bilirubin: +
– Protein: Negative
– Glucose: Negative
– Nitrites: Negative
– Leucocytes: Negative
MSFinals-2851
A 63-year-old man presents to the Emergency department with severe abdominal pain and hypotension. A CT scan reveals a ruptured diverticular abscess, and he undergoes a Hartmann’s procedure and faecal peritonitis washout. postoperatively, he is transferred to HDU and given broad spectrum IV antibiotics. During surgery, he had poor urine output and low blood pressure, prompting the anaesthetist to administer fluids. The next day, the F1 for surgery notes that the patient had a urine output of 5 mls per hour for three hours and then complete anuria overnight. His blood pressure is 110/65 mmHg, and his CVP is 10 cm. What is the probable cause of his anuria?