Archives: Medical Student Finals

MSFinals-2593

A 43-year-old woman is undergoing investigation for symmetrical polyarthritis that is widespread. She reports experiencing a blue tinge in her fingers during cold weather. During examination, a prominent rash is observed over her nose and cheeks, but not in her nasolabial folds. Her blood tests show positive results for anti-dsDNA. She is advised to take a drug that is described as a ‘disease-modifying’ drug. What kind of regular monitoring will she need while undergoing treatment?

MSFinals-2594

A 23-year-old male patient visits the GP complaining of recurring lower back pain for the past 8 months. He reports that his back feels painful and stiff upon waking up and lasts for 2-3 hours, but gradually improves throughout the day. The patient’s medical history includes a resolved case of Achilles tendonitis. What physical examination finding would suggest the probable diagnosis?

MSFinals-2595

A 7-year-old boy is brought to the clinic by his mother for evaluation. He has a history of multiple fractures, delayed dental development, hearing impairment, and abnormal bone growth. The healthcare provider suspects osteogenesis imperfecta. What laboratory findings are expected in this case?

MSFinals-2596

A 50-year-old patient has been on prednisolone for 4-months to treat their polymyalgia rheumatica. You are concerned about the patient developing osteoporosis and are contemplating starting them on a bisphosphonate as a preventive measure. What ONE indication would prompt you to commence this medication?

MSFinals-2597

A 6-year-old girl is brought to the pediatrician due to concerns about her posture. During the examination, the pediatrician observes a kyphotic spine and blue-grey sclera. The child has not experienced any bone fractures. To investigate further, the pediatrician orders a bone profile blood test to confirm the suspicion of osteogenesis imperfecta.
What specific results from the bone profile blood test would be indicative of this condition?

MSFinals-2598

A 68-year-old man comes to the clinic reporting bone pains and fatigue that have persisted for the past year. He has also experienced a gradual decline in his hearing. Upon examination, the doctor notes bossing of the skull. An X-ray of the skull reveals significant thickening of the vault with a combination of lytic and sclerotic lesions. What laboratory finding is most probable in this patient?

MSFinals-2599

A 33-year-old woman presents to the haematology clinic after experiencing four consecutive miscarriages. Her GP ordered routine blood tests which revealed a prolonged APTT and the presence of lupus anticoagulant immunoglobulins. The patient is diagnosed with antiphospholipid syndrome and you recommend long-term pharmacological thromboprophylaxis. However, she has no history of venous or arterial clots. What would be the most appropriate form of thromboprophylaxis for this patient?

MSFinals-2600

A 75-year-old male presents with bilateral buttock pain that radiates through his thighs and calves. The pain worsens with standing and walking, limiting his ability to walk for more than 10 minutes or 2 to 3 blocks. However, the pain is relieved by sitting or forward flexion of the spine. There is no history of bladder or bowel dysfunction, and motor and sensory neurological examination of the lower limbs is normal. What is the most probable cause of these symptoms?

MSFinals-2567

A 82-year-old woman arrives at the emergency department by ambulance after falling in her nursing home room. She is experiencing severe pain and is unable to bear weight on her leg, which appears shortened and externally rotated. An X-ray reveals a displaced intracapsular neck of femur fracture, and the orthopaedic team is contacted. The patient has a history of heart failure, mild Alzheimer’s disease, and kidney stones. What is the most suitable form of pain relief for this patient?