Archives: Medical Student Finals

MSFinals-1966

A 28-year-old woman visits her GP complaining of heavy, irregular vaginal bleeding that has been ongoing for 4 weeks and is becoming unbearable. She denies experiencing abdominal pain, unusual vaginal discharge, or dysuria. The patient has been sexually active with her partner for 6 months and had the Nexplanon implant inserted 4 weeks ago.

Upon examination, the patient’s abdomen is non-tender, her heart rate is 79/min, her respiratory rate is 17/min, her blood pressure is 117/79 mmHg, her oxygen saturation is 98%, and her temperature is 37.5°C. A negative pregnancy test is obtained.

What treatment options is the GP likely to suggest to alleviate the patient’s symptoms?

MSFinals-1967

A 68-year-old woman visits her doctor complaining of vaginal discomfort, itching, and pain during sexual intercourse. Upon excluding other possible causes of her symptoms, the doctor diagnoses her with atrophic vaginitis. What additional treatments can be used in conjunction with topical estrogen cream to alleviate her symptoms?

MSFinals-1968

A 25-year-old female presents with sudden onset of abdominal pain. Upon examination, her abdomen is found to be tender all over. Laparoscopy reveals the presence of numerous small lesions between her liver and abdominal wall, while her appendix appears to be unaffected. What is the most probable diagnosis?

MSFinals-1969

A 65-year-old woman presents to your clinic with a complaint of spotting in the past month, despite having gone through menopause 8 years ago. She had taken hormone replacement therapy for 3 years. On examination, her abdomen appears normal, but she has vaginal dryness. What initial investigation would you perform?

MSFinals-1970

A 28-year-old woman visits her GP seeking the combined oral contraceptive pill. She experiences intense one-sided headaches and reports a tingling sensation that travels up her arm before the headache begins. She smokes 10-20 cigarettes on most weekends and has a BMI of 34 kg/m². Her younger sister has a history of thromboembolic disease. What specific aspect of her medical history is the most significant contraindication for prescribing the combined oral contraceptive?

MSFinals-1971

A 32-year-old female visits her GP seeking advice on contraception. She has recently started a new relationship after a divorce and wishes to start taking the combined oral contraceptive pill. Her BMI is 32 kg/m², and she is an ex-smoker, having quit two years ago after smoking 20 cigarettes a day. During her teenage years, she experienced frequent migraines without aura, and she has a medical history of factor V Leiden disease and gestational hypertension during her 2-year-old daughter’s pregnancy. What is the most significant contraindication to the combined oral contraceptive based on her medical history?

MSFinals-1972

A 28-year-old woman presents for the removal of her copper intrauterine device (IUD) on day 4 of her 30-day menstrual cycle. She wishes to start taking the combined oral contraceptive pill (COCP) after the removal of the IUD, and there are no contraindications to the COCP. What is the next best course of action for managing this patient?

MSFinals-1946

A 35-year-old patient has received a letter from her local hospital regarding her recent smear test. She is aware that she has had two consecutive inadequate sample results.

What will be the next course of action for this patient due to the two inadequate sample results?

MSFinals-1947

A 35-year-old female undergoes a cervical smear test at her local clinic as part of the UK cervical cancer screening programme. The results reveal that she is hr HPV positive, but her cytology shows normal cells. Following current guidelines, the test is repeated after 12 months, and the results are still hr HPV positive with normal cytology. Another 12 months later, the test is repeated, and the results remain the same. What is the best course of action to take?

MSFinals-1948

A 28-year-old woman was recently requested by her GP practice to come in for a repeat smear test. Her previous test results 18 months ago indicated that the sample was positive for high risk HPV (hrHPV), but cytologically normal. The patient is feeling quite nervous about being called back and has asked the practice nurse what the next steps will be. If the results come back as hrHPV negative, what course of action will the patient be recommended to take?