Archives: Medical Student Finals

MSFinals-2113

A 50-year-old woman with insulin dependent diabetes complains of swollen legs and has a history of feeling constantly tired, experiencing nausea and vomiting. Her 24-hour urine collections reveal a urinary albumin excretion of 330 mg/24h. A kidney biopsy is performed and shows PAS-positive nodular deposits located in the mesangial space, at the outer edge of the glomerulus, which are encroaching on the capillaries. What is the term used to describe this pattern of nodular deposits?

MSFinals-2114

Langerhans cells, which are irregularly shaped cells with dendritic processes, an indented nucleus, and characteristic intracellular Birbeck granules, are distributed in multiple layers of the epidermis. What is the closest relative of these cells in the human body?

MSFinals-2115

A 48-year-old engineer presents with a lump in his neck. He first noticed the swelling in the lower right neck two months ago, and initially thought it would go away by itself; however, if anything, it seems to have got bigger. The patient has also noticed that he tends to be very tired at the end of the day. He mentions that he has also been experiencing night sweats.
On examination, the patient is found to have numerous enlarged cervical lymph nodes, as well as lymphadenopathy in the axilla. The patient is further investigated after which he is diagnosed with lymphoma.
From which cells do B and T lymphocytes originate?

MSFinals-2116

A 25-year-old woman presents with a chronic history of diarrhoea, weight loss and fatigue. Based upon the clinical history and examination findings, you suspect she has coeliac disease.
What is the most appropriate initial investigation?

MSFinals-2117

A newborn preterm-baby is observed to be jaundiced and having difficulty with feeding by the attending midwife. Bilirubin levels are measured, which rapidly increase throughout the day despite initiating phototherapy. The pregnancy was complicated by preterm labor; the mother also has a 3-year old child who is well and had no complications at birth. A direct Coombs test is performed and found to be positive; subsequently Rhesus haemolytic disease of the newborn is confirmed. What is the best example of the underlying cause of haemolysis in this preterm baby?

MSFinals-2118

A 35-year-old woman has been admitted to the Acute Medical Unit with shortness of breath, dizziness and feeling generally lethargic. Her full blood count reveals that her haemoglobin is 60 g/l. She reports that she suffers from menorrhagia. It is decided that she requires a blood transfusion. A few minutes after the transfusion begins, she develops a fever, lower back pain and starts vomiting.
What is the diagnostic tool used to identify an ABO incompatibility transfusion reaction?

MSFinals-2119

A biochemist isolated a receptor from a cell and found that it was a two-chained structure composed of α and β polypeptide chains linked by disulfide bonds. Further analysis revealed that the receptor consisted of transmembrane glycoproteins with short cytoplasmic tails and had a single antigen-binding site.
Which of the following cells most likely contained this receptor if the biochemist had isolated it from a cell of a 60-year-old individual?

MSFinals-2120

A 12-month-old girl is scheduled to receive her vaccinations today.
Which of the following vaccines are typically administered to a child at 12 months of age?

MSFinals-2121

A 27-year-old man comes to the Emergency Department with fever, chills, loin pain, and decreased urine output after receiving a left renal transplant six months ago. He receives symptomatic treatment, but his renal output and serum creatinine do not improve. After a renal biopsy, he is diagnosed with T-cell-mediated rejection (TCMR) with a Banff Ia grade histology. What is the initial treatment for TCMR in this case?

MSFinals-2122

A 28-year-old man presents with a low-grade fever, myalgia and multiple itchy, red, oedematous skin eruptions. The symptoms started 3 days previously. The skin lesions are rather symmetrical and oval-shaped, and are distributed over the palms, soles and limbs. Some of the lesions show central clearing and contain vesicles or bullae. The patient denies recent use of any medication prior to the appearance of the skin rash. He recalls a history of allergic rhinitis and urticaria in his sister.
What is the most likely underlying mechanism in the pathogenesis of this patient’s illness?