MSFinals-2060
A 65-year-old man has been diagnosed as being vitamin B12-deficient with a B12 level of < 50 pmol/l (160–900 pmol/l) and a haemoglobin (Hb) level of 85 (115–155 g/l). It is not diet-related.
What is the most suitable course of action?
Archives: Medical Student Finals
MSFinals-2061
A 50-year-old woman presents with headaches and nosebleeds and is found to have a raised platelet count. She is diagnosed with essential thrombocytosis by the haematologist.
Which of the following might be used to treat essential thrombocytosis?
MSFinals-2024
A 6-year-old child of African descent presents with a 2-day history of increasing abdominal pain. It is not associated with nausea or vomiting, and the bowels are opening regularly. The child’s mother tells you that he has had a few episodes of similar symptoms in the past, but none as severe.
On examination, the child has generalised abdominal tenderness, and splenomegaly is noted. After further investigation, the child is diagnosed with sickle-cell anaemia.
Which organ is most responsible for the removal of sickled red blood cells from the circulatory system?
MSFinals-2025
A 35-year-old woman is 10 weeks pregnant. She plans to undergo a Down’s syndrome screening test around 15 weeks into her pregnancy.
What is included in the measurement of a Down’s screening blood test?
MSFinals-2026
A 50-year-old female patient visits the clinic with complaints of abdominal discomfort and bloating that have been progressively worsening over the past few months. Upon examination, her GP discovered a complex left ovarian cyst. Which blood test would be the most useful in determining if the cyst is cancerous?
MSFinals-2027
A 14-year-old girl with known sickle-cell disease presents to the Emergency Department with severe abdominal pain.
On examination, she is found to have a tachycardia of 130 bpm, with generalised abdominal tenderness and 3 cm splenomegaly. Blood tests reveal marked anaemia, and a diagnosis of splenic sequestration crisis is considered.
Which blood vessel in the spleen is most responsible for monitoring the quality of red blood cells and removing aged ones from circulation?
MSFinals-2028
A 50-year-old man with acute myeloid leukemia is experiencing inadequate response to platelet transfusions despite treatment. He is currently 2 weeks post-chemotherapy, without fever, and only minor bruising as a symptom. What would be the most appropriate course of action to manage his platelet refractoriness?
MSFinals-2029
A 30-year-old donor experiences a sudden fainting spell during blood donation. What should be the immediate course of action to manage this adverse event?
MSFinals-2030
A 19-year-old Afro-Caribbean male with sickle cell disease complains of right upper abdominal pain and exhibits tenderness upon palpation. What diagnostic test should be performed to confirm the diagnosis?
MSFinals-2031
An 80-year-old man comes to the clinic with painless, symmetrical swellings in his neck. He reports no other symptoms. Laboratory tests show a haemoglobin level of 100 g/l and a white cell count of 23 × 109/l. A blood film reveals smear cells, with more than 60% of the cells being small mature lymphocytes. What is the probable diagnosis?