Archives: Medical Student Finals

MSFinals-2615

A 57-year-old motorcyclist is involved in a road traffic accident and suffers a displaced femoral shaft fracture. There are no other injuries detected during the primary or secondary surveys. The fracture is treated with closed, antegrade intramedullary nailing. The next day, the patient becomes increasingly confused and agitated. Upon examination, he is pyrexial, hypoxic with SaO2 at 90% on 6 litres O2, tachycardic, and normotensive. A non-blanching petechial rash is observed over the torso during systemic examination. What is the most probable explanation for this?

MSFinals-2616

An 80-year old male arrives at the emergency department following a head-on collision. He reports experiencing intense pain in his left knee. During a lower limb examination, you observe that the tibia moves backward when a force is applied. What is the probable diagnosis?

MSFinals-2617

A 32-year-old woman comes to see her doctor complaining of a burning sensation on the outside of her left thigh. The pain is particularly bothersome when she moves, especially when she’s standing at work. She reports no prior experience with this type of pain and has no significant medical history. Her records show a recent blood pressure reading of 130/90 mmHg and a BMI of 40 kg/m². What is the probable diagnosis in this scenario?

MSFinals-2618

A 65-year-old woman comes to the clinic complaining of gradual onset discomfort on her right lateral hip for the past two weeks. She denies any history of trauma and is able to bear weight fully. However, she experiences the worst discomfort at night, which sometimes wakes her up when lying on her right side. What is the probable underlying diagnosis?

MSFinals-2587

An 80-year-old man visits his GP with a complaint of significant loss of central vision. He has no prior history of vision problems and is concerned that it may be due to cancer. The patient has a complicated medical history that includes rheumatoid arthritis, erectile dysfunction, atrial fibrillation, and mild Parkinson’s disease. Which medication is the most probable cause of his symptoms?

MSFinals-2588

A 70-year-old man presents to his GP with bone pain and muscle tenderness. He has a past medical history of stage 3 chronic kidney disease.
The GP decides to take some blood, and the results are shown below.
Calcium 2.1 mmol/L (2.2-2.7)
Phosphate 0.72 mmol/L (0.8-1.4)
Magnesium 0.9 mmol/L (0.7-1.0)
Thyroid stimulating hormone (TSH) 4.8 mU/L (0.5-5.5)
Free thyroxine (T4) 10.8 pmol/L (9.0 – 18)
What is the most appropriate initial management?

MSFinals-2589

A 45-year-old patient visits her primary care physician with a complaint of net-like mottled skin on her hands, lower arms, feet, and calves that has persisted for 6 months. She reports no other symptoms. The physician orders routine blood tests, including FBC and coagulation screen, which reveal a haemoglobin level of 140 g/l, platelet count of 98 * 109/L, and white cell count of 8 * 109/L. The APTT is 45s, and the PT is 12s. An autoantibody screen is also performed, with the following significant results: positive for anti-cardiolipin antibodies and lupus anticoagulant, but negative for anti-dsDNA. What is the most appropriate treatment option for the likely diagnosis?

MSFinals-2590

A 38-year-old woman comes to the clinic with a chief complaint of swollen hands and feet for the past 3 months. She reports that the symptoms worsen in cold weather and her fingers frequently turn blue. She is now experiencing difficulty making a fist with both hands. Additionally, she has observed thickening of the skin spreading up her arms and thighs over the last month. She also reports a dry cough that started a month ago, accompanied by shortness of breath during physical activity. What is the probable diagnosis?

MSFinals-2591

A 26-year-old male has been admitted to the gastroenterology ward with a three-day history of severe bloody diarrhoea, passing 6-7 stools a day, with abdominal pain and poor oral intake. Colonoscopy shows inflammation throughout the colon and biopsies confirm Crohn’s disease. He has no significant past medical history and takes no regular medication.
Before starting azathioprine for inducing remission and long-term maintenance, which of the following blood tests must be carried out?

MSFinals-2592

A 36-year-old man with Crohn’s disease is taking azathioprine to keep his condition under control. He visits his doctor complaining of fever, fatigue, and cold-like symptoms that have lasted for three days. Given his medical history, the doctor is worried and decides to run some tests.

What is the most crucial test to perform in this scenario?