MSFinals-2704
Perinuclear antineutrophil cytoplasmic antibodies (pANCA) are most commonly associated with which medical condition?
Archives: Medical Student Finals
MSFinals-2705
A 30-year-old female complains of pain on the radial side of her wrist and tenderness over the radial styloid process. During examination, she experiences pain when she abducts her thumb against resistance. Additionally, when she flexes her thumb across the palm of her hand, pain is reproduced by movement of the wrist into flexion and ulnar deviation. What condition is most likely causing these symptoms?
MSFinals-2706
A 65-year-old woman presents with gradual onset proximal shoulder and pelvic girdle muscular pains and stiffness. She is experiencing difficulty getting dressed in the morning and cannot raise her arms above the horizontal. She is currently taking atorvastatin 20 mg for primary prevention and recently completed a course of clarithromycin for a lower respiratory tract infection (penicillin-allergic). Blood tests were conducted, and the results are as follows:
Hb 128 g/L Male: (135-180) Female: (115 – 160)
WBC 12.8 * 109/L (4.0 – 11.0)
Platelets 380 * 109/L (150 – 400)
Na+ 142 mmol/L (135 – 145)
K+ 4.2 mmol/L (3.5 – 5.0)
Urea 6.1 mmol/L (2.0 – 7.0)
Creatinine 66 µmol/L (55 – 120)
Bilirubin 10 µmol/L (3 – 17)
ALP 64 u/L (30 – 100)
ALT 32 u/L (3 – 40)
γGT 55 u/L (8 – 60)
Albumin 37 g/L (35 – 50)
CRP 72 mg/L (< 5)
ESR 68 mg/L (< 30)
Creatine kinase 58 U/L (35 – 250)
What is the most probable underlying diagnosis?
MSFinals-2707
A 55-year-old male comes to the emergency department complaining of a one-sided headache on his left side and blurry vision in his left eye. The pain extends to his jaw, especially when he chews. He has been experiencing fatigue, muscle pain, and night sweats for the past few weeks. What medical conditions would you anticipate in his medical history?
MSFinals-2708
A 67-year-old woman presents with a 6-week history of bilateral muscle weakness in her shoulders and hips. She reports difficulty getting out of chairs without assistance and experiences breathlessness and fatigue. Her vital signs reveal a heart rate of 98 bpm and blood pressure of 130/75 mmHg. Proximal muscle strength is symmetrically 4/5, while distal strength is normal. No skin rashes or arthralgia are present. Laboratory results show Hb 116 g/L (115 – 160), WBC 7.5 * 109/L (4.0 – 11.0), Na+ 140 mmol/L (135 – 145), K+ 4.9 mmol/L (3.5 – 5.0), Creatine kinase 1250 U/L (35 – 250), Urea 6.7 mmol/L (2.0 – 7.0), Creatinine 115 µmol/L (55 – 120), and ESR 60 mm/hr (<40). What is the most likely diagnosis based on these features?
MSFinals-2709
A 55-year-old woman presents at the one-stop breast clinic for triple assessment following a suspicious lesion detected on a screening mammogram. You review recent blood tests from her GP and are asked to identify the most probable underlying cause of the abnormal result.
Hb 121 g/L Male: (135-180)
Female: (115 – 160)
Platelets 242 * 109/L (150 – 400)
WBC 10.0 * 109/L (4.0 – 11.0)
Calcium 2.6 mmol/L (2.1-2.6)
Phosphate 1.1 mmol/L (0.8-1.4)
Magnesium 0.8 mmol/L (0.7-1.0)
Thyroid stimulating hormone (TSH) 4.5 mU/L (0.5-5.5)
Free thyroxine (T4) 12 pmol/L (9.0 – 18)
Amylase 203 U/L (70 – 300)
Uric acid 0.46 mmol/L (0.18 – 0.48)
Creatine kinase 1200 U/L (35 – 250)
MSFinals-2710
A 58-year-old woman comes to her doctor complaining of bilateral hip pain that has been getting worse over the past 6 months. The pain is now preventing her from taking her usual evening walks and worsens throughout the day, especially during exercise. She is a lifelong non-smoker and drinks half a bottle of red wine every night. Her medical history includes recurrent gout and Sjogren syndrome. What is the probable diagnosis?
MSFinals-2711
An 80-year-old woman has been experiencing jaw pain and difficulty chewing for the past 2 months. She describes her jaw as feeling heavy, but there is no clicking or locking, and no changes to her vision or scalp tenderness. She has a history of well-controlled polymyalgia rheumatica and depression, and recalls a medical student mentioning that this could be a side effect of one of her medications. Her current medications include vitamin D and calcium supplements, prednisolone, alendronic acid, and sertraline. What is the most probable cause of her symptoms?
MSFinals-2712
A 42-year-old man presents to his GP with complaints of persistent flu-like symptoms. Upon further inquiry, he reports experiencing fever, nausea, vomiting, muscle aches, weakness, and an itchy sensation for the past two weeks. He also mentions having red urine on a few occasions. The patient denies having any respiratory symptoms such as cough or haemoptysis. During the examination, the GP observes slight scleral icterus and small palpable purpura on the patient’s lower legs and arms. Based on these findings, what is the most probable diagnosis?
MSFinals-2713
A 54-year-old man visits his GP with complaints of feeling weak all over. He has been experiencing difficulty standing up from his chair and climbing stairs for the past 6 months. He also reports feeling constantly tired and down, but denies any other symptoms. He has no significant medical history and is not taking any regular medications. During a routine blood test, the following results were obtained: Hb 146 g/L (Male: 135-180), Platelets 268 * 109/L (150 – 400), WBC 7.2 * 109/L (4.0 – 11.0), TSH 4.2 mU/L (0.5-5.5), Creatine kinase 428 U/L (35 – 250), eGFR 68 ml/min (<90), and ESR 42 mm/hr <(age / 2). What is the most probable diagnosis?