Archives: Medical Student Finals

MSFinals-6413

A 68-year-old man visits his GP with complaints of progressive reduction in sensation in his lower limbs over the past 3 months. He reports feeling increasingly unsteady on his feet but is otherwise in good health. On examination, there is symmetrical reduction in vibration and pinprick sensation, and he has a wide-based ataxic gait. His ankle reflexes are absent, but his knee reflexes are brisk. The patient has a medical history of hypertension managed with ramipril and underwent Subtotal gastrectomy for gastric cancer 4 years ago. He has a body mass index of 29.2kg/m² and drinks 10 units of alcohol per week. What is the most likely cause of his symptoms?

MSFinals-6414

A 16-year-old male patient complains of sudden pain in his left testicle. He denies any sexual activity. Upon examination, the scrotum appears normal, but the left testis is swollen and tender. The right testis appears to be normal. A urine dip test shows negative results. What is the probable diagnosis?

MSFinals-6415

A 50-year-old male presents to his doctor with severe groin pain that has been increasing for the past two days. He also reports developing a fever. He lives with his wife and has no other sexual partners. He is in good health and takes tamsulosin regularly. Upon examination, the doctor notes acute tenderness and swelling in the right testis, leading to a diagnosis of epididymo-orchitis. What is the most probable organism responsible for this patient’s symptoms?

MSFinals-6416

A 50-year-old man experiences polytrauma and necessitates a massive transfusion of packed red cells and fresh frozen plasma. After three hours, he presents with significant hypoxia and a CVP reading of 5 mmHg. A chest x-ray reveals diffuse pulmonary infiltrates in both lungs. What is the probable diagnosis?

MSFinals-6417

A 68-year-old woman has been diagnosed with breast cancer and is now taking anastrozole to prevent recurrence after a mastectomy. She has a medical history of hypothyroidism and depression, which are managed with levothyroxine and fluoxetine. What is the most probable complication she may encounter during her breast cancer treatment?

MSFinals-6418

A 50-year-old woman comes to the clinic complaining of a painful and swollen hand. She reports having a fracture in her radius that was treated with a plaster cast for four weeks. Since then, she has noticed tenderness and shiny skin in the affected hand. What is the most probable diagnosis for her symptoms?

MSFinals-6419

You are summoned to attend to a 22-year-old male patient in the Emergency Department. He had lacerated his arm, and a junior physician had been trying to stitch the wound. During the administration of lidocaine, she had neglected to aspirate the syringe to confirm that she was not in a blood vessel. The patient initially reported experiencing tongue numbness and a metallic taste in his mouth, and he is now experiencing seizures throughout his body.

What is the best course of action for treatment?

MSFinals-6420

A 65-year-old woman with a T4N0M0 primary triple-negative breast carcinoma is attending a pre-operative breast oncology clinic. The oncologist recommends neo-adjuvant chemotherapy (NACT) as a beneficial course of treatment. What should the patient be informed of when considering whether to undergo NACT?

MSFinals-6421

A 67-year-old man undergoes a subtotal colectomy and suffers iatrogenic injury to both ureters. He experiences renal failure and his serum potassium level is elevated at 6.9 mmol/L. An ECG is conducted, what is the probable result?

MSFinals-6422

An 80-year-old woman presents to the emergency department with abdominal pain and distention. She has been feeling unwell for the past 4 hours and she has vomited three times. Her past medical history includes hypertension and an appendicectomy in her late 40s. On examination, her abdomen is distended but not peritonitic, with absent bowel sounds. Her electrolytes were assessed and are as follows:

Na+ 138 mmol/L (135 – 145)
K+ 3.6 mmol/L (3.5 – 5.0)
Bicarbonate 24 mmol/L (22 – 29)
Urea 4 mmol/L (2.0 – 7.0)
Creatinine 105 µmol/L (55 – 120)
Calcium 2.4 mmol/L (2.1-2.6)
Phosphate 1.1 mmol/L (0.8-1.4)
Magnesium 0.9 mmol/L (0.7-1.0)

What is the first-line management for her condition?