Archives: Medical Student Finals

MSFinals-2667

A 50-year-old man visits his GP complaining of gradual onset back pain that has been bothering him for the past 10 months. The pain worsens with activity and walking, causing bilateral pain and weakness in his calves. However, sitting or leaning forward provides relief. Despite a thorough examination, no neurological findings are present. The patient has no significant medical history, smokes socially, and drinks a glass of wine with dinner each night. He works as a builder and is worried that his back pain will affect his ability to work. What is the most probable diagnosis?

MSFinals-2668

A 20-year-old soldier has recently completed a long marching exercise and complains of sudden and intense pain in the forefoot. Upon examination, there is tenderness along the second metatarsal. X-rays are taken and show callus formation around the shaft of the second metatarsal. What is the probable diagnosis?

MSFinals-2669

A 15-year-old boy visits his GP complaining of dull, aching pain and swelling in the distal part of his right thigh that has been present for 4 months. He has a history of exercise-induced asthma and a family history of retinoblastoma. During the examination, a knee X-ray is performed, revealing a triangular area of new subperiosteal bone in the metaphyseal region of the femur with a ‘sunburst’ pattern. What is the most probable diagnosis?

MSFinals-2670

A 16-year-old male patient visits his GP complaining of a lump on the back of his right thigh that has been increasing in size for the past four months. The patient reports that the lump has become excruciatingly painful over the last two weeks. Upon ordering a radiograph, the results show a lytic lesion in the diaphysis of the right femur with an ‘onion skin’ appearance. What is the probable diagnosis?

MSFinals-2671

A 45-year-old woman presents to the rheumatology clinic with a 4-month history of myalgia and widespread bony tenderness. She reports increased fatigue and weakness when lifting heavy objects. Her medical history includes coeliac disease.

During the examination, tenderness is noted over the shoulder girdle and arms, but there is no associated joint stiffness. The patient has a waddling gait.

Blood tests are ordered and reveal the following results:
– Calcium: 1.9 mmol/L (normal range: 2.1 – 2.6)
– Phosphate: 0.8 mmol/L (normal range: 0.8 – 1.4)
– ALP: 176 u/L (normal range: 30 – 100)

What is the most likely diagnosis?

MSFinals-2672

A 55-year-old woman presents to her GP complaining of worsening fatigue, generalised weakness, and pelvic pain over the past year. She has noticed difficulty climbing stairs and walking long distances. Upon examination, she has a waddling gait and reduced power in hip flexion, hip extension, and hip abduction. The patient has no significant medical history and takes no regular medications. She moved to the UK with her husband from Riyadh three years ago and is a non-smoker and non-drinker. What potential diagnosis should be considered for this patient?

MSFinals-2673

A 25-year-old male is being evaluated by his GP due to gradually worsening lower back pain. The pain is more severe in the morning and after prolonged periods of inactivity. He has also experienced increasing fatigue over the past 6 months. The GP prescribed regular NSAIDs, which resulted in significant symptom improvement. An x-ray of the lumbar spine was conducted, revealing indications of ankylosing spondylitis.
What is the most probable finding on the patient’s x-ray?

MSFinals-2674

A 56-year-old woman who has had two Colles fractures in the past three years undergoes a DEXA scan:
T-score
L2-4 -1.4
Femoral neck -2.7
What is the interpretation of the scan results?

MSFinals-2675

An 80-year-old woman complains of deep pain in her leg bones that has been gradually worsening over the past 4 months. She has no significant medical history. Upon conducting blood tests, the following results were obtained:
– Calcium: 1.6 mmol/L (normal range: 2.1-2.6)
– Phosphate: 0.5 mmol/L (normal range: 0.8-1.4)
– ALP: 160 u/L (normal range: 30-100)
– Parathyroid hormone (PTH): 100 pg/mL (normal range: 14-65)
What is the most likely diagnosis?

MSFinals-2637

A 78-year-old male presents to the emergency department with severe pain in his left thigh. He has a history of recurrent UTIs and currently has a catheter in place. Upon examination, he is febrile and experiences significant tenderness in the left thigh, making it difficult to move his knee. Blood and bone cultures both come back positive, leading to a diagnosis of osteomyelitis. What organism is most likely responsible for this infection?