Archives: Medical Student Finals

MSFinals-2330

A 27-year-old man presented to the Emergency Department with perineal pain. He has been experiencing excruciating pain while passing stool every morning for the past two weeks. He had previously been diagnosed with an anal fissure by a surgeon, but treatment failed to relieve his symptoms. He has also noticed streaks of blood in his stool. The patient recently returned from a trip to Tokyo. He appeared very distressed and reported continuous anal discharge leading to soiling of his undergarments for the past five days.
What is the recommended treatment for this condition?

MSFinals-2331

A 32-year-old woman visits her GP complaining of dysuria and urinary frequency that have been present for 2 weeks. She denies any recent sexual activity or vaginal discharge and is in good health otherwise. The GP suspects a UTI. What is the leading cause of UTIs?

MSFinals-2332

A 35-year-old business woman recently returned from a work conference in Turkey, where she spent a lot of her time in air-conditioned conference rooms. She has a dry cough and a respiratory rate of 24. She also reports multiple episodes of vomiting and loose stools.
What is the most likely causative organism of this patient symptom?

MSFinals-2333

A 14-year-old boy with a history of sickle cell disease complains of worsening pain in his left thigh and has a fever. An X-ray of the femur shows bone alterations indicative of osteomyelitis.
What is the probable infectious agent responsible for this condition?

MSFinals-2334

A 45-year-old woman with human immunodeficiency virus (HIV) is hospitalized due to dehydration caused by chronic diarrhea. What is the most frequently identified pathogen in cases of chronic diarrhea linked to HIV?

MSFinals-2335

A 16-year-old girl presents to the general practitioner, having noticed some swellings in her left groin. She has recently acquired a cat and had a particularly nasty scratch on her left foot from it about 2 weeks earlier. She feels generally tired and unwell. On examination, she has a few swollen, tender left inguinal lymph nodes and some brownish papular discoloration around the site of the original scratch.
Investigations:
Investigation Result Normal value
Haemoglobin 131 g/l 115–155 g/l
White cell count (WCC) 5.3 × 109/l 4–11 × 109/l
Platelets 180 × 109/l 150–400 × 109/l
Erythrocyte sedimentation rate (ESR) 21 mm/hour 0–10mm in the 1st hour
Sodium (Na+) 140 mmol/l 135–145 mmol/l
Potassium (K+) 5.0 mmol/l 3.5–5.0 mmol/l
Creatinine 100 μmol/l 50–120 µmol/l
Which of the following is the most likely causative organism?

MSFinals-2336

A 40-year-old intravenous drug user (ivDU) presents with fever, cough, and SOB. Upon echocardiogram, severe tricuspid regurgitation and two vegetations on the valve are observed. What is the most probable organism to be cultured from the patient’s blood?

MSFinals-2337

What is the most frequent micro-organism responsible for haematogenous osteomyelitis?

MSFinals-2338

A 45-year-old woman recently had a UTI, which was found to be positive for Proteus mirabilis. What type of renal calculi is she now at a higher risk for developing?

MSFinals-2339

A geriatric patient develops a wound infection postoperatively on the abdominal wall. This is swabbed, and 2 days later, the following report is available:
Sample type: Pus from wound infection
Culture report: Significant Staphylococcal species
Sensitivities: Methicillin Sensitive
Ciprofloxacin Resistant
Tetracycline Resistant
Trimethoprim Resistant
Gentamicin Resistant
Which of the following would you commence?