MSFinals-2539
What is the deficiency associated with Marfan’s syndrome, a connective tissue disorder that affects multiple systems including musculoskeletal, visual, and cardiovascular, in individuals of all ages?
Archives: Medical Student Finals
MSFinals-2540
A 30-year-old female is referred to the medical assessment unit by her general practitioner with reports of a three-week history of rash and joint pains. She has no past medical history and does not take any regular medications.
On examination, there is a butterfly-shaped rash over her cheeks and nose that spares the nasolabial folds. The small joints of her hands are swollen and tender.
Blood tests:
Hb 136 g/L Male: (135-180)
Female: (115 – 160)
Platelets 101 * 109/L (150 – 400)
WBC 2.3 * 109/L (4.0 – 11.0)
Na+ 137 mmol/L (135 – 145)
K+ 4.2 mmol/L (3.5 – 5.0)
Urea 5.2 mmol/L (2.0 – 7.0)
Creatinine 88 µmol/L (55 – 120)
CRP 4 mg/L (< 5)
Antinuclear antibody positive (1:320) (negative)
Which of the following medications should all patients with this condition be taking long term?
MSFinals-2541
A 57-year-old woman presents with a 6-month history of deteriorating eyesight. She reports difficulty distinguishing between colors, central vision impairment, ‘floaters’, and tension-like headaches. Upon examination, her visual acuity is 20/50 in the right eye and 20/70 in the left eye. Ophthalmoscopy reveals a red spot on the macula surrounded by a ring of retinal epithelial pigment loss resembling a ‘bull’s eye’. The patient has poorly controlled type 2 diabetes mellitus and rheumatoid arthritis, and is obese. She is currently taking metformin, methotrexate, and hydroxychloroquine. What is the most probable cause of her visual disturbance?
MSFinals-2542
A 42-year-old woman presents with a chronic and progressive history of photophobia, flashing lights, and reading difficulties over several months. She has a medical history of systemic lupus erythematosus and is currently taking hydroxychloroquine. On fundoscopy, there is central depigmentation of a macula surrounded by thin speckled rings of hyperpigmentation, but otherwise normal. She denies any other symptoms and has not made any changes to her medication regimen. However, she has missed all of her follow-up appointments for the past 2 years. What is the underlying cause of her symptoms?
MSFinals-2543
A 75-year-old man has just been released from the hospital after suffering a hip fracture. He was diagnosed with osteoporosis during his hospitalization and has been prescribed alendronic acid. What potential risk is he facing while taking this medication?
MSFinals-2544
Sophie, a 19-year-old girl, arrives at the emergency department after a sports-related incident. She reports experiencing discomfort in her left knee, which worsens when crouching. Upon examination, her knee appears swollen and tender to the touch. Additionally, there is a painful clicking sensation during McMurray’s’s test.
What is the probable cause of injury in this scenario?
MSFinals-2545
A 45-year-old male comes to your clinic complaining of knee pain. He reports experiencing severe pain in his left knee for the past 5 days, and he describes the joint as feeling very warm. During the examination, you observe redness and swelling of the affected joint. Aspiration of the knee does not show any signs of septic arthritis, but it does reveal deposits of calcium pyrophosphate dihydrate crystals.
What is a risk factor for this condition?
MSFinals-2508
A 32-year-old male patient complains of pain following a fall onto his right hand while stretching backward. Upon examination, a flattened contour is observed in the right shoulder, and a small bulge is felt below the right clavicle. Additionally, a small area of anesthesia is noted over the distal attachment of the deltoid muscle. What type of injury could account for all of these examination findings?
MSFinals-2509
A 67-year-old woman is brought to the emergency department by ambulance following a car accident. She has been given morphine and paracetamol for pain relief and is currently comfortable. During examination, her right leg is internally rotated and appears shorter than the left. There is significant bruising over the right buttock and thigh. Neurovascular examination reveals altered sensation over the right posterior leg and foot, and there is weakness in dorsiflexion of the foot. What type of injury is likely to have occurred in this patient?
MSFinals-2510
A 79-year-old woman is admitted to hospital after a fall from standing. She is experiencing intense pain in her left hip and cannot bear weight. An initial X-ray reveals a neck of femur fracture, and she undergoes hemiarthroplasty. As she begins to weight bear and recover, her consultant advises that her fracture is likely due to osteoporosis and that she would benefit from long-term treatment. What is the most suitable ongoing management plan for this patient?