Archives: Medical Student Finals

MSFinals-2521

A 56-year-old man visits his GP due to hip discomfort. He reports that it has been gradually worsening for the past three months. The pain is constant throughout the day and night, but it is most severe when he puts weight on it. He denies experiencing any morning stiffness. He has attempted to alleviate the pain with paracetamol and ibuprofen, but to no avail. The patient’s medical history includes active Crohn’s disease, which is being treated with corticosteroids. During the examination, there is tenderness when palpating the anterior groin area, but the range of passive motion is normal. What is the most probable diagnosis?

MSFinals-2522

A 7-year-old girl with sickle cell disease arrives at the emergency department. She has been running a fever for a week and complains of nausea and loss of appetite. In the past 24 hours, she has been experiencing intense pain in her left leg. The initial treatment for a sickle crisis is administered, including oxygen, fluids, morphine, and antibiotics. However, an X-ray reveals osteomyelitis in her leg.
What is the probable causative organism for her osteomyelitis?

MSFinals-2523

A 32-year-old woman presents to rheumatology with a 3 week history of joint pain, a pink, bumpy rash on her arms, legs, and trunk, and fevers that spike in the evenings. She has bilateral cervical lymphadenopathy and a palpable spleen on examination. Blood tests reveal a significant leucocytosis (≥ 10,000/µL) and elevated serum ferritin (350 ng/mL) levels, but negative antinuclear antibody and rheumatoid factor tests. What is the most probable cause of this patient’s symptoms?

MSFinals-2524

A 50-year-old woman, who has a history of rheumatoid arthritis, is planning to undergo a laparoscopic cholecystectomy. What pre-operative imaging is necessary?

MSFinals-2525

An 80-year-old woman comes to eye casualty with painless partial vision loss on the left side. Over the past two weeks, she has experienced a temporal headache on the left side with tenderness in the left scalp. Additionally, she has noticed pain in her left jaw when chewing. The patient reports low-grade fever and fatigue. She has no prior medical or ophthalmological history.

What would be the expected findings on fundoscopy, given the probable cause of the vision loss?

MSFinals-2526

A 27-year-old woman with a history of Crohn’s disease is seeking advice regarding her medication. She is currently taking methotrexate and wants to know if it is safe for her and her partner to conceive a child.

What is the best course of action to recommend?

MSFinals-2527

A 50-year-old woman comes to the doctor complaining of muscle weakness and a rash that has been developing over the past month. Upon examination, the doctor notes symmetrical weakness in the shoulders and hips, as well as red papules on the proximal interphalangeal joints. What skin manifestation is likely being described in this case?

MSFinals-2501

A 56-year-old woman presents to her doctor with a painful right hip that has been bothering her for the past 8 months. She takes codeine and paracetamol four times a day for pain relief. She has no history of hip injury or trauma. The patient has a mild asthma history and is in remission from breast cancer, which was treated with a bilateral mastectomy and chemotherapy 5 years ago. She drinks 2 glasses of wine over the weekend and does not smoke.

During the examination, the doctor notices no visible deformity of the right hip, but it is tender to the touch. The patient walks with a noticeable limp and appears to be in discomfort. A pelvis X-ray reveals a crescent sign. What is the most significant risk factor for this patient’s condition?

MSFinals-2502

A 79-year-old female presents to the emergency department with severe right-sided hip pain following a car accident. She has a medical history of polymyalgia rheumatica and COPD and is currently taking prednisolone, alendronic acid, colecalciferol, and a salbutamol inhaler. Upon examination, she is visibly in pain and unable to bear weight on her right leg. Her right leg appears shortened and externally rotated compared to the left side. What is the probable diagnosis?

MSFinals-2503

A 40-year-old man presents with a 3-day history of groin pain. He reports feeling a snapping sensation in his hip accompanied by deep groin and hip pain. The patient participated in a football game over the weekend. He has no prior history of such symptoms and is not on any regular medication. Upon further inquiry, he admits to consuming alcohol regularly, with an average of 70 units per week.

During the examination, the man’s large body habitus is noted. He is able to bear weight and move around the room without difficulty. However, his range of motion is restricted due to pain, particularly during external rotation.

What is the most probable diagnosis?