MSFinals-2136
What is the most frequently occurring infectious agent linked to acute pyelonephritis?
Archives: Medical Student Finals
MSFinals-2137
A tool known as PrePex™ has been sanctioned by various organizations to reduce the spread of HIV. What is the purpose of this device?
MSFinals-2138
A 29-year-old electrician was referred to the hospital by his GP. He had presented a week ago with malaise, headache, and myalgia, which was followed by a dry cough and fever. Despite a course of amoxicillin/clavulanic acid, his symptoms persisted. At the time of referral, he complained of cough, mild dyspnea, global headache, myalgia, and arthralgia. On examination, he appeared unwell, had a fever of 39°C, and a maculopapular rash on his upper body. Fine crackles were audible in the left mid-zone of his chest, and mild neck stiffness was noted. Investigations revealed abnormal levels of Hb, WBC, reticulocytes, Na, creatinine, bilirubin, alk phos, and AST, and patchy consolidation in both mid-zones on chest x-ray. What is the most likely cause of his symptoms?
MSFinals-2139
A 6-year-old girl is brought to the Emergency Department by her parents. She has been suffering from a sore throat over the past few days, and now her parents have noticed that she has become increasingly drowsy and is complaining of a headache and neck stiffness. On examination, she is pyrexial at 38.2 °C. She has marked signs of meningism.
Investigations:
Investigation Result Normal value
Haemoglobin 121 g/l 115–155 g/l
White cell count (WCC) 15.2 × 109/l 5.0–12.0 × 109/l
Platelets 110 ×109/l 150–400 × 109/l
Sodium (Na+) 140 mmol/l 135–145 mmol/l
Potassium (K+) 4.8 mmol/l 3.5–5.0 mmol/l
Creatinine 100 μmol/l 29–53 µmol/l
Lumbar puncture Gram positive diplococci identified
Which of the following is the most likely diagnosis?
MSFinals-2140
A 50-year-old man who engages in sexual activity with other men comes to the clinic complaining of fatigue, pain in the upper right quadrant of his abdomen, and yellowing of his eyes. He has had several casual sexual partners in the past few months and confesses to not consistently using protection. He has not traveled abroad recently. During the physical examination, he displays jaundice, tenderness in the upper right quadrant, and a palpable liver edge. What is the most probable infection he has contracted?
MSFinals-2141
A 20-year-old male patient comes to you with a fever and rash one week after returning from a trip to Puerto Rico. He reports that his fever began five days ago and was followed by the appearance of a rash. Additionally, he has noticed bleeding gums while brushing his teeth and has experienced two nosebleeds since returning from his vacation. During the examination, you observe multiple mosquito bites on his legs. What is the probable diagnosis?
MSFinals-2142
A 2-year-old toddler has been brought into the general practice by their parent with the presenting complaint of a new rash around the lips, gumline and tongue. The parent reports that the rash is new, approximately three days old, and has become significantly worse. They find that their child is not eating or drinking and is very difficult to settle. The parent comments that they had a normal delivery, without post-delivery complications, and the child has been up-to-date with their vaccination protocol. Moreover, you assess that the toddler has normal growth and development. There is no family history of oral lesions.
On general examination, the toddler is visibly upset, although interacting appropriately with their parent. Temperature is recorded as 38.1 °C. Heart rate is 110 bpm, blood pressure 84/60 mmHg and oxygen saturation (SpO2) is 100% on air. On inspection of the oral cavity, multiple vesicular lesions are present on the lips, gum and anterior aspect of the tongue. You notice a small number of these have become ulcerated. There are no further rashes observed on the trunk and upper and lower limbs.
What is the most likely organism which has given rise to this clinical picture?
MSFinals-2143
A 35-year-old female patient complains of painful genital ulcers, accompanied by feelings of being unwell, feverish, headache, and muscle pains. She had engaged in unprotected sexual activity with a casual male partner two weeks prior to the onset of symptoms. Upon examination, multiple shallow ulcers are observed on her vulva, along with mildly tender muscles and a low-grade fever. What is the most probable diagnosis?
MSFinals-2111
A 33-year-old woman who gave birth three weeks ago is feeling very fatigued after walking to the park and back. The birth was via a caesarean section and she needed one unit of blood transfusion. She visits her family doctor and denies experiencing any chest pain, heart palpitations, shortness of breath, or further bleeding.
During the examination, there are no indications of ongoing bleeding, and the caesarean section incision is healing properly. The blood test results are as follows:
– Hb 95 g/L Female: (115 – 160)
– Platelets 240 * 109/L (150 – 400)
– WBC 7.0 * 109/L (4.0 – 11.0)
– Ferritin 6 µg/L (15 – 300)
What is the minimum haemoglobin level for this patient to be prescribed iron supplements?
MSFinals-2112
A 54-year-old patient complains of dysphagia that has persisted for four weeks. The GP deems it necessary to urgently refer the patient for an endoscopy within two weeks. During the endoscopy, a suspicious lesion is observed in the middle third of the oesophagus. A biopsy of the lesion is taken and sent to the pathology for further examination.
What are some potential characteristics of a cancerous cell that may be observed under a microscope?