MSFinals-2781
A 4-year-old is brought in with a fracture that affects the physis, metaphysis, and epiphysis of their left femur. What Salter-Harris classification does this fracture fall under?
Archives: Medical Student Finals
MSFinals-2782
A 22-year-old man presents with a 5-month history of low back pain and stiffness that lasts for 20 minutes in the morning. He reports that his pain improves with exercise and taking ibuprofen. He denies any gastrointestinal, genitourinary, or skin symptoms. During the examination, he exhibits limited lumbar flexion as determined by Schober’s test. An x-ray of his lumbar spine and sacroiliac joints has been ordered. What radiographic finding is likely to be observed?
MSFinals-2783
A 56-year-old woman presents to the clinic with a 6-month history of excessive thirst and abdominal pain. Her medical history is unremarkable, without previous vitamin D deficiency or chronic kidney disease. Upon examination, no other abnormalities were found. Blood tests reveal a hemoglobin level of 128 g/L, platelets at 168 * 109/L, and a white blood cell count of 6.2 * 109/L. Her sodium and potassium levels are within normal range, but her urea and creatinine levels are elevated at 8.8 mmol/L and 130 µmol/L, respectively. Additionally, her calcium level is high at 2.8 mmol/L, while her phosphate level is low at 0.7 mmol/L. Her parathyroid hormone level is also elevated at 10.2 pmol/L. What is the most likely diagnosis?
MSFinals-2784
A 50-year-old male patient complains of a painful swelling at the back of his elbow, without any history of injury. Upon examination, an erythematosus and tender swelling is observed. What is the probable diagnosis?
MSFinals-2785
A 56-year-old woman without significant medical history presents to the emergency department complaining of right-sided hip pain that has been bothering her for the past 2 weeks. Despite the pain, she is still able to walk, although with a slight limp. The pain is particularly worse at night when she rolls onto her right side, causing her to have difficulty sleeping.
Upon examination, there is tenderness over the lateral aspect of the right hip, and she experiences pain on internal and external rotation of the hip. Blood tests reveal the following results: Hb 142 g/L (Female: 115-160), WBC 9.8 * 109/L (4.0 – 11.0), and CRP 23 mg/L (< 5).
What is the most likely diagnosis?
MSFinals-2786
A 12-year-old boy is admitted to the paediatric ward due to recurrent episodes of arthralgia affecting multiple sites. During physical examination, swelling and tenderness are observed in the right ankle joint, while tenderness on motion and pain are present over the bilateral wrist and left sacroiliac joints. The patient had visited his GP two months ago with symptoms of vomiting, diarrhoea, and fever, for which he received supportive treatment. Synovial fluid analysis from the aspirated ankle joint reveals a high white cell count and no organisms present in the culture. What is the most likely diagnosis?
MSFinals-2787
A 50-year-old patient presents with polyarthralgia, cyclical fevers, and a salmon pink rash on her torso. She reports experiencing flares of this condition since her late twenties and has been admitted to ITU in the past for intravenous medications, although she cannot recall their names. Her current medications include paracetamol 1g PRN and naproxen 500 mg PRN. On examination, she exhibits tenderness in multiple joints, including her hips, knees, wrists, shoulders, and small joints of her hands. Her vital signs show a heart rate of 110/min, respiratory rate of 24/min, blood pressure of 96/65 mmHg, oxygen saturations of 98% on room air, and temperature of 39ºC. Laboratory results reveal elevated CRP and ferritin levels, as well as mild leukocytosis and anemia. What is the most likely diagnosis?
MSFinals-2788
A 38-year-old man comes to the emergency department complaining of worsening lower back pain over the past 3 months. He denies any history of trauma or prior fractures, does not smoke, consume excessive alcohol, and has never been treated with corticosteroids. Upon review, he reports experiencing reduced libido and delayed puberty for several years, as well as the absence of morning erections. Alongside routine investigations, what crucial test should be performed given the following DEXA scan results?
Lumbar vertebrae (L2-L4): -6.9
Femoral neck: -3.5
Total hip: -4
MSFinals-2789
A 27-year-old female patient complains of pain and swelling in her hand joints that have persisted for the past four months. She reports experiencing stiffness in her joints in the morning, which lasts for about an hour. The patient denies any pain or swelling in her elbows, ankles, or knees.
During the physical examination, the doctor observes swelling and tenderness in the second and third metacarpophalangeal (MCP) joints of both hands. Laboratory tests reveal an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels.
Which investigation has NICE recommended to be performed on all patients with similar symptoms?
MSFinals-2790
A 32-year-old female presents with stiff and swollen joints. She reports that the joints are especially stiff in the morning for the first few hours of the day. Her mother and sister have a history of rheumatoid arthritis (RA). On examination, she has symmetrical polyarthritis affecting the small joints of the hand. Rheumatoid factor antibody, anti-nuclear antibody, and anti-dsDNA are all negative.
Which of the following tests is the most suitable?