MSFinals-2459
A 55-year-old man is brought in following a fall from scaffolding resulting in an open tibial fracture and a 15 cm wound. Fortunately, he has no neurovascular damage. What is the most appropriate initial step to take?
Archives: Medical Student Finals
MSFinals-2460
A 78-year-old woman is being evaluated on the ward after undergoing a total hip replacement. She sustained a neck of femur fracture after falling from a standing position while vacuuming her living room. She was brought to the hospital by ambulance with a shortened, externally rotated left leg. The hip x-ray confirmed the fracture, and she underwent surgery promptly. The patient has a medical history of mild knee osteoarthritis and type II diabetes mellitus. She has been in the hospital for three days, is weight-bearing, and is ready for discharge. Calcium and vitamin D supplementation have been initiated.
What is the next appropriate step in managing this patient?
MSFinals-2461
An 80-year-old woman presents with a sudden pulsating headache in her temples and scalp tenderness. She is promptly treated with corticosteroids and a decision is made to start her on a long-term dose-reducing regimen. The patient has a medical history of proximal muscle stiffness that is worse in the morning.
Baseline investigations are conducted, revealing the following results:
– Calcium: 2.33 mmol/L (normal range: 2.10 – 2.60 mmol/L)
– Phosphate: 1.35 mmol/L (normal range: 0.74 – 1.40 mmol/L)
– Alkaline phosphatase: 78 mmol/L (normal range: 30 – 100 U/L)
– 25-hydroxycholecalciferol: 13 mU/L (normal range: 20 – 50 ng/mL)
What would be the most appropriate course of action for her management?
MSFinals-2462
A 65-year-old woman presented to the Emergency Department with complaints of a painful hand. Upon further examination, it was discovered that she had sustained a Colles’ fracture. A DEXA scan was performed, revealing a T-score of -2.7 from L2-L4 and -2.8 in the right hip. The patient is currently taking omeprazole for gastro-oesophageal reflux disease.
Na+ 140 mmol/L (135 – 145)
K+ 3.5 mmol/L (3.5 – 5.0)
Urea 4.5 mmol/L (2.0 – 7.0)
Creatinine 85 µmol/L (55 – 120)
Calcium 1.95 mmol/L (2.1 – 2.6)
Phosphate 1.2 mmol/L (0.8 – 1.4)
Magnesium 0.55 mmol/L (0.7 – 1.0)
Vitamin D 115 nmol/L (50 – 250)
Parathyroid hormone (PTH) 2.1 pmol/L (1.6 – 8.5)
What would be the most appropriate course of action at this point?
MSFinals-2463
A 28-year-old gravida 4, para 3 undergoes an assisted delivery with mid-cavity forceps following a prolonged second stage. After a couple of weeks, the patient visits her GP complaining of difficulty walking. Upon examination, she displays a limp in her left leg, a numb thigh, weak knee extension, and the absence of patellar reflex. Her right leg appears normal. What nerve has been affected by the forceps delivery?
MSFinals-2464
A 25-year-old tripped and fell while running, injuring his left calf. He experienced a dull ache, tightness, and mild swelling in the calf. Despite the discomfort, he continued running for another 20 minutes before stopping. However, the pain gradually increased, and he felt extreme discomfort when stretching and pulling his toes up. His partner convinced him to seek medical attention at the emergency department.
During the examination, the doctor noticed that the left calf was 6cm larger in circumference than the right calf. The anterior compartment musculature was tender, and passive dorsiflexion caused a significant amount of pain. However, all peripheral pulses were present, and there were no changes in sensation or color.
What initial investigation could be performed to confirm the diagnosis?
MSFinals-2465
A 45-year-old individual complains of numbness and tingling along the ulnar border of their wrist and forearm. During examination, you observe weak flexion of all digits, including the thumb. What is the probable diagnosis?
MSFinals-2431
A 35-year-old female patient visits your clinic with complaints of mouth and genital ulcers, accompanied by redness in her eyes. You suspect Behcet’s syndrome as the possible diagnosis. What skin manifestation would provide the strongest evidence to support your diagnosis?
MSFinals-2432
A 67-year-old patient with psoriasis, hypothyroidism and psychotic depression complains of painful aphthous-like ulcers that started 3 weeks ago after beginning a new medication. Which medication is the most probable cause of their symptom?
MSFinals-2433
A 35-year-old man with a history of scoliosis, pectus excavatum, recurrent pneumothorax, and mitral valve prolapse is contemplating starting a family. What is the mode of inheritance for this condition, considering the probable diagnosis?