Archives: Medical Student Finals

MSFinals-6448

A 65-year-old man presents with a lump on his right groin that he is unsure of when it first appeared. He reports no changes in bowel habits or abdominal discomfort. The patient has a medical history of hypercholesterolemia and type 2 diabetes and is currently taking atorvastatin and metformin.

During examination, a mass is visible above and towards the middle of the pubic tubercle. The lump disappears when the patient is lying down and does not transilluminate. There is no abdominal tenderness or bruising. The patient’s heart rate is 85 bpm, and his blood pressure is 143/85 mmHg.

What is the most effective next step in the management of this patient, given the likely diagnosis?

MSFinals-6449

A 45-year-old patient presents to their GP with a 3-month history of worsening dyspepsia, epigastric pain, and drenching night sweats on a background of recurrent gastric ulcers. The GP urgently refers the patient for investigation. Following a gastroscopy with biopsies taken, a low grade gastric MALT lymphoma is diagnosed, and the presence of H. pylori was also noted on the biopsy report. The patient has no significant past medical history. What treatment plan is the doctor likely to recommend?

MSFinals-6450

A 29-year-old male presents to the Emergency Department following a head injury sustained during a soccer game. The patient reports a loss of consciousness for about 10 seconds at the time of injury. What would be a clear indication to perform a CT scan of the head?

MSFinals-6451

A 45-year-old man with a history of alcohol abuse presents to your clinic after being diagnosed with chronic pancreatitis. You inform him that this diagnosis increases his likelihood of developing diabetes mellitus. What tests should you suggest to assess his risk for this condition?

MSFinals-6455

A 50-year-old man presents to the emergency department with sudden onset pain in his loin-to-groin region. He reports having experienced similar pain in the past, but never to this extent. Upon arrival, the following observations are recorded:
– Blood pressure: 110/85 mmHg
– Heart rate: 119 bpm
– Temperature: 38.6ºC
– Oxygen saturation: 98% on air
– Respiratory rate: 22/min

What is the most likely diagnosis and what is the definitive management?

MSFinals-6456

A 67-year-old male is admitted to your surgical ward for an elective hemicolectomy tomorrow due to Duke’s B colonic cancer. During your admission assessment, you observe that his full blood count (FBC) indicates a microcytic anaemia with a haemoglobin level of 60 g/L. His previous FBC 4 months ago showed Hb 90 g/L. Haematinic blood tests reveal that the cause of the microcytosis is iron deficiency.
What would be the most suitable approach to manage his anaemia?

MSFinals-6457

A 39-year-old man arrives at the emergency department complaining of intense pain in his lower back. The pain comes in waves and spreads to his groin area. He is unable to stay still due to the severity of the pain and has vomited multiple times since arriving at the hospital. The patient has no fever and is still able to urinate normally. A urine dipstick test shows the presence of blood but no signs of white blood cells or nitrites.

What is the initial treatment that should be administered to this patient?

MSFinals-6458

A 68-year-old man presents to the emergency department with increasing pain in his right leg. He has had intermittent claudication for a few months but has had a sudden increase in pain since this morning. His past medical history is otherwise significant for 2 previous myocardial infarctions, for which he takes regular simvastatin, aspirin, ramipril and atenolol.

On examination, his right dorsalis pedis and tibialis anterior pulses are weak, and his right leg is pale and cold below the knee.

His pain is currently being managed with oramorph.

What should be included in the initial management plan for this likely diagnosis?

MSFinals-6442

A 75-year-old woman complains of mild lower back pain and tenderness around the L3 vertebra. Upon conducting tests, the following results were obtained: Hemoglobin levels of 80 g/L (120-160), ESR levels of 110 mm/hr (1-10), and an albumin/globulin ratio of 1:2 (2:1). What is the probable diagnosis?