Archives: Medical Student Finals

MSFinals-2242

A 29-year-old man comes to your clinic with concerns about his fertility. He and his partner have been trying to conceive for the past 2 years, but have been unsuccessful. The patient’s medical history includes frequent chest infections and ear infections, which have required multiple rounds of antibiotics. He reports that he often experiences upper respiratory tract infections. Upon examination, you note that his right testicle hangs lower than his left, but there are no other abnormalities. As part of a routine check-up, you perform a chest examination and observe that the apex beat is in the 5th intercostal space on the right midclavicular line. What is the most likely diagnosis?

MSFinals-2243

A 50-year-old male presents to the acute medical unit with severe jaundice and gross ascites. He has a history of alcohol abuse and was diagnosed with liver cirrhosis two years ago. He has been admitted to the hospital multiple times due to confusion and altered consciousness caused by his cirrhosis. What medications should be evaluated for preventing the recurrence of the aforementioned complication?

MSFinals-2244

A 30-year-old man from Ghana presents to the neurology outpatient department with a one-month history of progressive weakness following a recent diarrheal illness. Upon examination, there is 4/5 power at hip flexion and knee extension, which improves to 5/5 after a brief period of exercise. Knee reflexes are absent, but facial muscles and cranial nerves are normal. Creatinine kinase levels are elevated at 420 U/L (40-320), and EMG testing shows an increment in muscle action potentials after exercise. What is the probable diagnosis?

MSFinals-2245

A 35-year-old man visits his GP complaining of severe headaches and excruciating pain around his left eye that has been ongoing for a week. Upon further inquiry, he describes the pain as a sharp, stabbing sensation that lasts for about an hour and is localized to the left side of his head. He also mentions experiencing a congested nose and tearing in his left eye during the onset of the pain. The patient admits to smoking 10 cigarettes daily and consuming one glass of wine each night. Based on the probable diagnosis, what is the expected duration of his symptoms?

MSFinals-2246

A 57-year-old patient complains of sudden central chest pain that started 10 hours ago. She reports a recent discharge after experiencing a non-ST-elevation myocardial infarction 5 days ago. You suspect re-infarction and want to confirm the diagnosis by identifying the most useful biomarkers.

What biomarkers should you consider in this case?

MSFinals-2247

A 86-year-old man is brought to the emergency department from his nursing home. He was unable to move around this morning and he developed difficulty in his speech.

Upon examination, he appears alert and distressed. A neurological examination shows 1/5 strength in his left upper limb and 3/5 strength in his left lower limb. The right side of both the upper and lower limb is normal in strength. A sensory examination reveals sensory loss on both the upper and lower limb on the left side. He is unable to see objects on his left side in both eyes.

Based on the symptoms, what is the most likely location of the lesion?

MSFinals-2248

A patient with uncontrolled asthma is initiated on montelukast. What is the mechanism of action of this medication?

MSFinals-2249

A 30-year-old man presents to the clinic with 4 unprovoked episodes of rapid bilateral upper and lower limb muscle contraction and relaxation lasting approximately 15 seconds before stopping. He reports falling to the ground during these episodes but denies any loss of consciousness and is able to resume his activities afterward. Upon taking a collateral history, it is determined that there is no incontinence or tongue biting. There is no history of head injury. What is the most probable treatment for this patient’s diagnosis?

MSFinals-2250

A 42-year-old obese female is found to have gallstones during an abdominal ultrasound, which was ordered due to recurrent urinary tract infections. Other than the UTIs, she is in good health. What is the best course of action for managing the gallstones?

MSFinals-2251

A 27-year-old man is brought to the emergency department by a friend who found him confused and drowsy, with his hands over his abdomen. The patient has vomited twice on the way to the hospital and appears to be in pain. An arterial blood gas reveals the following results: pH 7.29 (normal range: 7.35-7.45), HCO3- 17 mmol/L (normal range: 22-26 mmol/L), pCO2 3kPa (normal range: 4.5-6kPa), p02 12kPa (normal range: 10-14kPa), and anion gap 20mEq/L (normal range: 10-14mEq/L). Which diagnostic test would provide the quickest indication of the patient’s condition?