Archives: Medical Student Finals

MSFinals-2799

A 65-year-old retired farmer contacts his GP seeking advice on preventing gout. Despite making dietary changes and limiting alcohol consumption, he has experienced four flares in the past year. The patient has a BMI of 28 kg/m² and is attempting to lower it through lifestyle modifications. He has a controlled hiatus hernia with omeprazole and no other underlying health issues or medications. His most recent gout attack occurred six weeks ago, and recent blood tests revealed a urate level of 498 micromol/L. What is the most appropriate treatment option?

MSFinals-2800

A 16-year-old boy comes to the emergency department with a painful knee that started 3 days ago. Upon examination, the patient is stable but has a fever of 38.5ºC. The left knee is red and has limited range of motion. The patient also reports having a severe sore throat 3 weeks ago, which was treated with antibiotics. There are no other symptoms reported. What is the next best course of action for managing this patient?

MSFinals-2773

A 55-year-old man presents with significant pain in the right first metatarsophalangeal joint that started quickly overnight. He has tried taking paracetamol but this failed to reduce the pain sufficiently. On closer inspection, there appears to be much effusion around the joint, which is also tender to palpation. The patient is at the end of his third month of being treated for tuberculosis.

The patient’s pulse is 89 bpm, respiratory rate is 14/min, temperature is 37.1oC, and blood pressure is 130/82 mmHg. A joint aspirate sample is taken.

What is the likely result of inspecting the joint aspirate?

MSFinals-2774

During a home visit to a 58-year-old patient with a lower respiratory tract infection, who is housebound due to motor neurone disease, you review her medications. What new regular medication/s should you contemplate starting?

MSFinals-2775

A 35-year-old woman presents to the rheumatology clinic for evaluation of her systemic lupus erythematosus (SLE). The rheumatologist recommends initiating hydroxychloroquine therapy due to her frequent complaints of wrist and hand pain flares.
What counseling points should be emphasized to the patient?

MSFinals-2776

A 25-year-old male presents to the clinic with ongoing lower back pain. He reports that his pain seems to improve with physical activity, despite his demanding job in construction. Additionally, he has been experiencing discomfort in both hands and knees. During the examination, you observe restricted movement in his lumbar spine and decide to order X-rays of his spine, hands, and knees. What are the most probable findings you expect to see?

MSFinals-2777

A 26-year-old man presents to the emergency department after injuring his knee while playing basketball. He reports hearing a loud ‘pop’ and experiencing severe pain in his right knee, causing him to fall to the ground. He is unable to bear weight on the affected knee and feels like it may give out. Upon examination, the knee is visibly swollen. What is the probable diagnosis?

MSFinals-2778

A 30-year-old runner complains of heel pain. During examination, there is widespread tenderness that is more severe on the medial side of the heel. Despite taking a break from running for the past week, the pain is exacerbated by standing on their feet all day at work. Walking on their toes intensifies the pain. What is the probable diagnosis?

MSFinals-2779

A 5-year-old boy came in with a painful left shoulder after a fall. An X-ray of his left humerus reveals no visible fracture line. Upon clinical examination, the pediatric orthopedic surgeon suggests that there may be a transverse fracture across the growth plate of his left humerus, and not involving any other structures. The prognosis is positive. What kind of fracture is this?

MSFinals-2780

A 6-year-old boy came to the clinic with a painful left little finger following a door being shut on it. Upon examination, an X-ray revealed a fracture line that passes through the metaphysis, growth plate, and epiphysis. What classification of fracture is this?